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Disparate IVF Outcomes and the Role of Uterine and Oocyte Factors

[ Vol. 14 , Issue. 3 ]

Author(s):

Ijeoma Okeigwe and Erica E. Marsh*   Pages 251 - 260 ( 10 )

Abstract:


Infertility has become an important public health issue, with over 12% of the U.S. population being affected. Moreover, the role of race and ethnicity has become increasingly recognized as an important contributor to health outcomes. Despite in vitro fertilization (IVF) playing a significant role in helping many women achieve their reproductive goals, data show disparities in IVF outcomes among racial and ethnic minority groups. This review examines the literature on disparities in IVF outcomes among black, Asian, and Hispanic women. Data analyzed show that black and Asian women have decreased clinical pregnancy and live-birth rates compared to white women and increased rates of pregnancy loss and fetal growth restriction. While consistent findings have not been identified among Hispanic women, likely due to inadequate studies among Hispanic women, limited epidemiologic data suggest decreased clinical pregnancy and live-birth rates among Hispanic women, while clinic based studies show no differences in outcomes when compared to white women. The biological plausibility associated with these disparate outcomes suggests a role for obesity, fibroids, and impaired endometrial hormonal milieu affecting outcomes among black women, while variation in ovarian reserve and endometrial hormonal milieu may contribute to poorer outcomes among Asian women.

Keywords:

In vitro fertilization (IVF), disparities, fibroids, minorities, race, ethnicity.

Affiliation:

Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Feinberg School of Medicine, Northwestern University, Chicago, IL, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Feinberg School of Medicine, Northwestern University, Chicago, IL



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