Racial Differences in Infertility Knowledge and Treatment

October 28, 2014

Racial and cultural disparities exist in women's understanding of conception and pregnancy, as well as in the effectiveness of infertility treatments.

It's known that racial minorities in the United States might not receive the same level of care as whites. Research presented at ASRM 2014 and published in the September issue of Fertility and Sterility shows that this disparity also exists in the realm of treatment for infertility.

The first study from researchers at Columbia University Medical Center compared IVF success rates between 71 African American women and 63 controls who received donor eggs. The medical history of the two groups were similar in regards to fibroids, myomectomy, c-sections, intrauterine adhesions, and hysteroscopy.

The African American group was found to contain women with more complicated reproductive histories, so in an effort to make both groups comparable in that regard, 5 women from the control group were matched up twice. Normally fertilized oocytes, fertilization rates, and implantation rates were all higher in the control group. The authors concluded that race is a factor in fertility treatment but didn't speculate on why this is the case.

A second study used an online questionnaire to ascertain women's understanding of reproduction. Women's understanding of certain concepts about conception differed based on their ethnicity. Education and income appeared to be less correlated to knowledge about fertility than ethnicity: women with higher education level and income did not always have the greater percentage of correct answers. Differences were also seen between ethnicities in a study that examined women's subjective burden about fertility. All ethnicities reported a burden of stress surrounding getting pregnant, yet Asian women were more likely to feel that starting a family was difficult to talk about or taboo.

The last study compared the effectiveness of IVF in 4045 women of different ethnicities, where women self-reported being of Black, Asian, and Hispanic, or white heritage. There were clear differences between racial groups, with white women experiencing a significantly higher conception and live birth rate (36.2% and 30.7%, respectively) than black women (24.4% and 16.9%) or Asian women (31.4% and 24%) descent. The authors made no guesses as to the reasons for the disparity but called for studies to better understand the causes of these differences.