Disparity in assisted reproductive technologies outcomes in black women compared with white women.
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.
Seifer
David B
DB
Genesis Fertility and Reproductive Medicine, Maimonides Medical Center, Brooklyn, New York 11228, USA. drseifer@genesisfertility.com
Frazier
Linda M
LM
Grainger
David A
DA
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