Disparity in assisted reproductive technologies outcomes in black women compared with white women

Abstract

Objective: To compare success rates in black and white women undergoing IVF.

Design: Retrospective cohort study.

Setting: Society for Assisted Reproductive Technology member clinics in 1999-2000 that performed >or=50 cycles of IVF and reported race/ethnicity in >95% of cycles.

Patient(s): Women receiving 80,309 IVF cycles.

Intervention(s): IVF using nondonor embryos.

Main outcome measure(s): Live-birth rate per cycle started.

Result(s): Black, white, and other race/ethnicity women underwent 3666 (4.6%), 68,607 (83.5%), and 8036 (11.9%) IVF cycles, respectively. Spontaneous abortions were more common among black women. The live-birth rate was 26.3% (95% confidence interval [CI], 25.9%-26.7%) among white women compared with 18.7% (95% CI, 17.5%-20.1%) among black women (rate ratio, 1.41). After controlling for increased tubal and uterine factor infertility among blacks and other characteristics, black race was an independent risk factor for not achieving a live birth (adjusted relative risk, 1.21; 95% CI, 1.12-1.36 if no prior ART, and RR, 1.38; 95% CI, 1.20-1.57 if prior ART). For cryopreserved embryo cycles, live-birth rates were equivalent.

Conclusion(s): Black women, who represented 7.8% of married reproductive-age women in the United States at that time, were underrepresented among IVF recipients. Race is a marker for prognosis that is not explained by characteristics available in the registry data set.