title: Does elevated progesterone on day of oocyte maturation play a role in the racial disparities in IVF outcomes?
abstract: The aim of this study was to evaluate if premature progesterone elevation on the last day of assisted reproduction technique stimulation contributes to racial disparities in IVF outcome. A total of 3289 assisted reproduction technique cycles were evaluated in Latino, Asian, African American, and white women. Live birth was more likely in white women (42.6%) compared with Asian (34.8%) and African American women (36.3%), but was similar to Latino women (40.7%). In all racial groups, progesterone was negatively associated with live birth and the negative effect of progesterone persisted when adjusting for confounders. Although the effect of elevated progesterone was similar in all racial groups, the prevalence of elevated progesterone differed. Progesterone > 1.5 ng/ml occurred in only 10.6% of cycles in white women compared with 18.0% in Latino and 20.2% in Asian women. Progesterone > 2 ng/ml occurred in only 2.3% of cycles in white women compared with 6.3% in Latino, 5.9% in Asian and 4.4% in African American women. The increased prevalence of premature elevated progesterone persisted when controlling for IVF stimulation parameters. In conclusion, premature progesterone elevation had a negative effect on live birth in all racial groups studied. The prevalence of elevated progesterone was higher in racial minorities.
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA. Electronic address: hillmicah@mail.nih.gov.
authors.forename: Micah J
authors.initials: MJ
authors.lastname: Hill
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
authors.forename: G Donald
authors.initials: GD
authors.lastname: Royster
authors.affiliation: Inova Fairfax Hospital, Fairfax, VA, USA.
authors.forename: Mansi
authors.initials: M
authors.lastname: Taneja
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Mae Wu
authors.initials: MW
authors.lastname: Healy
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Shvetha M
authors.initials: SM
authors.lastname: Zarek
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Alicia Y
authors.initials: AY
authors.lastname: Christy
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Alan H
authors.initials: AH
authors.lastname: DeCherney
authors.affiliation: Shady Grove Fertility Science Center, Rockville, MD, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Widra
authors.affiliation: Shady Grove Fertility Science Center, Rockville, MD, USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Devine
mesh_terms: D000328:Adult; D001741:Black or African American; D044466:Asian People; D044383:Black People; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D054624:Health Status Disparities; D006801:Humans; D050498:Live Birth; D009865:Oocytes / Q000166:cytology*; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D018873:Pregnancy Rate; D015995:Prevalence; D011374:Progesterone / Q000097:blood*; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D016896:Treatment Outcome; D044465:White People
chemical_list: D006063:Chorionic Gonadotropin; D011374:Progesterone
keywords: ART outcomes; ethnicity; racial disparity; serum progesterone level