Racial disparities in in vitro fertilization outcomes


      To evaluate the impact of race on in vitro fertilization (IVF) outcomes.


      Retrospective analysis.


      Private practice.


      All women who underwent a first autologous IVF cycle at Fertility Centers of Illinois from January 2010 to December 2012.


      Information was collected on baseline characteristics, cycle parameters, and outcomes. Race was self-reported.

      Main Outcome Measure(s)

      Clinical intrauterine pregnancy and live birth rates.


      A total of 4,045 women were included: 3,003 white (74.2%), 213 black (5.3%), 541 Asian (13.4%), and 288 Hispanic women (7.1%). A multivariable logistic regression was performed to control for confounders. Compared with white women, the adjusted odds ratio for clinical intrauterine pregnancy was 0.63 (95% confidence interval [CI] 0.44–0.88) in black women, 0.73 (95% CI 0.60–0.90) in Asian women, and 0.82 (95% CI 0.62–1.07) in Hispanic women. The adjusted odds ratio for live birth was 0.50 (95% CI 0.33–0.72) in black women, 0.64 (95% CI 0.51–0.80) in Asian women, and 0.80 (95% CI 0.60–1.06) in Hispanic women compared with white women. The spontaneous abortion rate was 14.6% in white women versus 28.9% in black women, 20.6% in Asian women, and 15.3% in Hispanic women.


      Black and Asian women had lower odds of clinical intrauterine pregnancy and live birth and higher rates of spontaneous abortion compared with white women. Further research is needed to better characterize the mechanisms associated with this racial disparity and to improve treatment options for black and Asian women.

      Key Words

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        • American Society for Reproductive Medicine
        Testing and interpreting measures of ovarian reserve; a committee opinion.
        Fertil Steril. 2012; 98: 1407-1415
        • Purcell K.
        • Schembri M.
        • Frazier L.M.
        • Rall M.J.
        • Shen S.
        • Croughan M.
        Asian ethnicity is associated with reduced pregnancy outcomes after assisted reproductive technology.
        Fertil Steril. 2007; 87: 297-302
        • Seifer D.B.
        • Frazier L.M.
        • Grainger D.A.
        Disparity in assisted reproductive technologies outcomes in black women compared with white women.
        Fertil Steril. 2008; 90: 1701-1710
        • Fujimoto V.Y.
        • Luke B.
        • Brown M.B.
        • Jain T.
        • Armstrong A.
        • Grainger D.A.
        Racial and ethnic disparities in assisted reproductive technology outcomes in the United States.
        Fertil Steril. 2010; 93: 382-390
        • Baker V.L.
        • Luke B.
        • Brown M.B.
        • Alvero R.
        • Frattarelli J.L.
        • Usadi R.
        Multivariate analysis of factors affecting probability of pregnancy and live birth with in vitro fertilization: an analysis of the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System.
        Fertil Steril. 2010; 94: 1410-1416
        • Feinberg E.C.
        • Larsen F.W.
        • Catherino W.H.
        • Zhang J.
        • Armstrong A.Y.
        Comparison of assisted reproductive technology utilization and outcomes between Caucasian and African American patients in an equal-access-to-care setting.
        Fertil Steril. 2006; 85: 888-894
        • Sharara F.
        • McClamrock H.D.
        Differences in in vitro fertilization (IVF) outcome between white and black women in an inner-city, university based IVF program.
        Fertil Steril. 2000; 73: 1170-1173
        • Nichols J.E.
        • Higdon H.L.
        • Crane M.M.
        • Boone W.R.
        Comparison of implantation and pregnancy rates in African American and white women in an assisted reproductive technologies practice.
        Fertil Steril. 2001; 76: 80-84
        • Dayal M.B.
        • Gindoff P.
        • Dubey A.
        • Spitzer T.L.
        • Bergin A.
        • Peak D.
        Does ethnicity influence in vitro fertilization (IVF) birth outcomes?.
        Fertil Steril. 2009; 91: 2414-2418
        • Langen E.S.
        • Shahine L.K.
        • Lamb J.D.
        • Lathi R.B.
        • Milki A.A.
        • Fujimoto V.Y.
        • et al.
        Asian ethnicity and poor outcomes after in vitro fertilization blastocyst transfer.
        Obstet Gynecol. 2010; 115: 591-596
        • Csokmay J.M.
        • Hill M.J.
        • Maguire M.
        • Payson M.D.
        • Fujimoto V.Y.
        • Armstrong A.Y.
        Are there ethnic differences in pregnancy rates in African American Women versus white women undergoing frozen blastocyst transfers?.
        Fertil Steril. 2011; 95: 89-93
        • Wellons M.F.
        • Fujimoto V.Y.
        • Baker V.L.
        • Barrington D.S.
        • Broomfield D.
        • Catherino W.H.
        • et al.
        Race matters: a systematic review of racial/ethnic disparity in Society for Assisted Reproductive Technology reported outcomes.
        Fertil Steril. 2012; 98: 406-409
        • Geronimus A.T.
        Black/white differences in the relationship of maternal age to birthweight: a population-based test of the weathering hypothesis.
        Soc Sci Med. 1996; 42: 589-597
        • Purcell S.H.
        • Moley K.H.
        The impact of obesity on egg quality.
        J Assist Reprod Genet. 2011; 28: 514-524
        • Grindler N.M.
        • Moley K.H.
        Maternal obesity, infertility and mitochondrial dysfunction: potential mechanisms emerging from mouse model systems.
        Mol Hum Reprod. 2013; 19: 486-494
        • Huddleston H.G.
        • Rosen M.P.
        • Lamb J.D.
        • Modan A.
        • Cedars M.I.
        • Fujimoto V.Y.
        Asian ethnicity in anomymous oocyte donors is associated with increased estradiol levels but comparable recipient pregnancy rates compared with Caucasians.
        Fertil Steril. 2010; 94: 2059-2063