title: 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.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  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.
  
  
  METHODS
  Women receiving 80,309 IVF cycles.
  
  
  METHODS
  IVF using nondonor embryos.
  
  
  METHODS
  Live-birth rate per cycle started.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Genesis Fertility and Reproductive Medicine, Maimonides Medical Center, Brooklyn, New York 11228, USA. drseifer@genesisfertility.com
authors.forename: David B
authors.initials: DB
authors.lastname: Seifer
authors.forename: Linda M
authors.initials: LM
authors.lastname: Frazier
authors.forename: David A
authors.initials: DA
authors.lastname: Grainger
mesh_terms: D000022:Abortion, Spontaneous / Q000208:ethnology; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D007246:Infertility / Q000208:ethnology / Q000209:etiology / Q000628:therapy*; D050498:Live Birth; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D012042:Registries; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data