title: Will decreasing assisted reproduction technology costs improve utilization and outcomes among minority women?
abstract: OBJECTIVE
  To evaluate assisted reproduction technology (ART) usage and outcomes in minority women seeking care at enhanced access, military ART programs.
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  Federal ART programs.
  
  
  METHODS
  Two thousand fifty women undergoing first cycle, fresh, nondonor ART from 2000 to 2005.
  
  
  METHODS
  None.
  
  
  METHODS
  Rate of ART use, clinical pregnancy rate, live birth rate.
  
  
  RESULTS
  African American women had an almost fourfold increased use of ART and Hispanic women had decreased use. Clinical pregnancy rates were significantly lower for African American women compared with white women (46.1% vs. 52.6%, relative risk [RR] 0.88; 95% confidence interval [CI], 0.78-0.99) as were live birth rates (33.7%. vs. 45.7%, RR 0.74; 95% CI, 0.63-0.91).
  
  
  CONCLUSIONS
  Economics appear to influence ART use by African American women but not Hispanic women. Despite increased use by African American women, outcomes in this group were worse when compared with Caucasian women. Improving access through decreased cost may increase use by some but not all minority groups. Improved access may not translate into improved outcomes in some ethnic groups.
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892-1109, USA.
authors.forename: Desireé M
authors.initials: DM
authors.lastname: McCarthy-Keith
authors.forename: Enrique F
authors.initials: EF
authors.lastname: Schisterman
authors.forename: Randal D
authors.initials: RD
authors.lastname: Robinson
authors.forename: Kathleen
authors.initials: K
authors.lastname: O'Leary
authors.forename: Richard S
authors.initials: RS
authors.lastname: Lucidi
authors.forename: Alicia Y
authors.initials: AY
authors.lastname: Armstrong
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D015331:Cohort Studies; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D054625:Healthcare Disparities / Q000191:economics / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007246:Infertility / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D008913:Minority Groups / Q000706:statistics & numerical data; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted / Q000191:economics* / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome