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. 2021 Oct 1;48(10):748-753.
doi: 10.1097/OLQ.0000000000001435.

Tubal Factor Infertility, In Vitro Fertilization, and Racial Disparities: A Retrospective Cohort in Two US Clinics

Gloria E Anyalechi  1 , Harold C Wiesenfeld  2 , Robert D Kirkcaldy  1 , Dmitry M Kissin  3 , Catherine L Haggerty, Karen R Hammond  4 , Edward W Hook 3rd  5 , Kyle T Bernstein  1 , Michael P Steinkampf  4 , William M Geisler  5
Affiliations

Tubal Factor Infertility, In Vitro Fertilization, and Racial Disparities: A Retrospective Cohort in Two US Clinics

Gloria E Anyalechi et al. Sex Transm Dis. .

Abstract

Background: Nearly 14% of US women report any lifetime infertility which is associated with health care costs and psychosocial consequences. Tubal factor infertility (TFI) often occurs as a result of sexually transmitted diseases and subsequent pelvic inflammatory disease. We sought to evaluate for and describe potential racial disparities in TFI and in vitro fertilization (IVF) prevalence.

Methods: Records of women aged 19 to 42 years in our retrospective cohort from 2 US infertility clinics were reviewed. We calculated TFI prevalence, IVF initiation prevalence, and prevalence ratios (PRs), with 95% confidence intervals (CIs) for each estimate, overall and by race.

Results: Among 660 infertile women, 110 (16.7%; 95% CI, 13.8-19.5%) had TFI which was higher in Black compared with White women (30.3% [33/109] vs 13.9% [68/489]; PR, 2.2 [95% CI, 1.5-3.1]). For women with TFI, IVF was offered to similar proportions of women by race (51.5% [17/33] vs 52.9% [36/68] for Black vs White women); however, fewer Black than White women with TFI started IVF (6.7% [1/15] vs 31.0% [9/29]; PR, 0.2 [95% CI, 0-1.0]), although the difference was not statistically different.

Conclusions: Tubal factor infertility prevalence was 2-fold higher among Black than White women seeking care for infertility. Among women with TFI, data suggested a lower likelihood of Black women starting IVF than White women. Improved sexually transmitted disease prevention and treatment might ameliorate disparities in TFI.

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Conflict of interest statement

Conflicts of Interest: K.R.H. is on the Speakers bureau for AbbVie, and W.M.G. has received research funds and consulting fees from Hologic and consulting fees from Roche. The other authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Tubal factor infertility prevalence by race and other demographic characteristics for women of Black or White race, N = 598 women. Legend: Black (dark gray), White (light gray). Note: Wilson CIs are calculated for (1) Black women with: age less than 25 years, in the Pittsburgh clinic, with public insurance, and with duration of infertility less than 24 months; and (2) White women with: age less than 25 years.
Figure 2.
Figure 2.
A, In vitro fertilization (IVF) outcomes for tubal factor infertility (TFI) by race, n = 106 women, and (B) IVF outcomes for non-tubal factor infertility by race, n = 530 women. Legend: Offered IVF (black), IVF started (dark gray), intrauterine pregnancy (light gray), IVF live birth (white). Note: Percentages are calculated for women with outcome data among all women with infertility in the racial group. Wilson confidence intervals (CI) calculated for: (1) White women with TFI, with intrauterine pregnancy or live birth; (2) Black women with TFI, with IVF; (3) other women with TFI, with IVF offered, or IVF; (4) Black women without TFI, with IVF, or intrauterine pregnancy, or live birth; and (5) other women without TFI, with live birth.
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References

    1. Haggerty CL, Gottlieb SL, Taylor BD, et al. Risk of sequelae after Chlamydia trachomatis genital infection in women. J Infect Dis 2010; 201(Suppl 2):S134–S155. - PubMed
    1. Westrom L, Joesoef R, Reynolds G, et al. Pelvic inflammatory disease and fertility. A cohort study of 1,844 women with laparoscopically verified disease and 657 control women with normal laparoscopic results. Sex Transm Dis 1992; 19:185–192. - PubMed
    1. Hoffman BL, Schorge JO, Bradshaw KD, et al., eds. Evaluation of the infertile couple. In: Williams Gynecology, 3rd ed. New York, NY: McGraw-Hill Education; 2016.
    1. Centers for Disease Control and Prevention. National public health action plan for the detection, prevention, and management of infertility Atlanta: U.S. Department of Health & Human Services; 2014.
    1. Kodaman PH, Arici A, Seli E. Evidence-based diagnosis and management of tubal factor infertility. Curr Opin Obstet Gynecol 2004; 16:221–229. - PubMed

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