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. 2023 Aug;30(8):2373-2396.
doi: 10.1007/s43032-023-01236-6. Epub 2023 Apr 26.

Inequities in Medically Assisted Reproduction: a Scoping Review

Abbi Huddleston  1 , Kaylin Ray  2 , Rigel Bacani  2 , Jordan Staggs  2 , Reece M Anderson  2 , Matt Vassar  2   3
Affiliations

Inequities in Medically Assisted Reproduction: a Scoping Review

Abbi Huddleston et al. Reprod Sci. 2023 Aug.

Abstract

Infertility has a high prevalence in the USA and health inequities play a large role in access to medically assisted reproduction (MAR). The aim of this study was to identify gaps in research pertaining to inequities in MAR and propose suggestions for future research directions. Searches were performed using MEDLINE and Ovid Embase. Articles that reported on MAR inequities, published between 2016 and 2021 in the USA, and written in English were included. The inequities investigated were adapted from the NIH-designated health disparities populations. Each article's inequity findings were extracted and reported, along with frequencies of inequities. Our sample included 66 studies. The majority of the studies investigated MAR outcomes by race/ethnicity and found that historically marginalized populations had poorer outcomes. LGBTQ + populations were less likely to use MAR or seek infertility care. Most studies found positive correlations with MAR use with income and education. The least commonly studied inequities in our sample were sex and/or gender and rural/under-resourced populations; findings showed that men and people from rural/under-resourced populations were less likely to access MAR. Studies that examined occupational status had varying findings. We suggest that future research be targeted toward: (1) standardizing and diversifying race/ethnicity reporting regarding MAR, (2) the use of community-based participatory research to increase data for LGBTQ + patients, and (3) increasing access to infertility care for men.

Keywords: Healthcare inequities; Infertility; Medically assisted reproduction; Scoping review.

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Conflict of interest statement

No financial or other sources of support were provided during the development of this manuscript. Dr. Vassar reports receipt of funding from the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, the US Office of Research Integrity, Oklahoma Center for Advancement of Science and Technology, and internal grants from Oklahoma State University Center for Health Sciences — all outside of the present work. All other authors have nothing to report.

Figures

Fig. 1
Fig. 1
PRISMA flowchart
Fig. 2
Fig. 2
Frequency of inequities examined over time
Fig. 3
Fig. 3
Frequency of studies investigating sexual and gender minorities inequities since 2016
See this image and copyright information in PMC

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