title: Asian ethnicity and poor outcomes after in vitro fertilization blastocyst transfer.
abstract: OBJECTIVE
  To estimate the effect of ethnicity on in vitro fertilization (IVF) outcomes after blastocyst transfer.
  
  
  METHODS
  We conducted a review of fresh blastocyst transfer IVF cycles from January 1, 2005, to December 31, 2006. Data collection included demographic information, infertility history, treatment protocol details, and treatment outcomes. Statistics were performed using the Student t test and chi2 test. To establish the independent contribution of Asian ethnicity, a multivariable logistic regression analysis was performed.
  
  
  RESULTS
  We reviewed 180 blastocyst transfer cycles among white (62%) and Asian (38%) women. The groups were similar in most baseline characteristics. Asian women, however, had a lower body mass index (22.6 compared with 24.2, P=.02), were more likely to be nulligravid (53% compared with 35%, P=.03), and were more likely to have had at least one prior IVF cycle (37% compared with 20%, P=.02) The groups were similar in treatment characteristics, number of oocytes retrieved, fertilization rate, and number of blastocysts transferred. However, Asian women had a thicker endometrial lining (10.9 compared with 10.2, P=.02). Despite these similarities, Asian women had a lower implantation rate (28% compared with 45%, P=.01), clinical pregnancy rate (43% compared with 59%, P=.03), and live birthrate (31% compared with 48%, P=.02). In multivariable analysis, the decreased live birthrate among Asian women persisted (adjusted odds ratio 0.48, 95% confidence interval 0.24-0.96, P=.04).
  
  
  CONCLUSIONS
  When compared with white women, Asian women have lower clinical pregnancy and live birthrates after blastocyst transfer.
authors.affiliation: From the Department of Obstetrics and Gynecology and Division of Reproductive Endocrinology and Infertility, Stanford University Medical Center, Stanford, California; and Department of Obstetrics, Gynecology and Reproductive Sciences and Division of Reproductive Endocrinology and Infertility, University of California, San Francisco, California.
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Langen
authors.forename: Lora K
authors.initials: LK
authors.lastname: Shahine
authors.forename: Julie D
authors.initials: JD
authors.lastname: Lamb
authors.forename: Ruth B
authors.initials: RB
authors.lastname: Lathi
authors.forename: Amin A
authors.initials: AA
authors.lastname: Milki
authors.forename: Victor Y
authors.initials: VY
authors.lastname: Fujimoto
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Westphal
mesh_terms: D000328:Adult; D044466:Asian People; D010064:Embryo Implantation; D004624:Embryo Transfer / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D011247:Pregnancy; D018873:Pregnancy Rate / Q000208:ethnology*; D012189:Retrospective Studies; D044465:White People