F&S reports · 2025
Impact of race and ethnicity on in vitro fertilization outcomes in infertile women with polycystic ovary syndrome in the United States.
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Mora Calderon Guido, D'Ambrosio Fabiola, Schwartz Alan, Scoccia Bert
Аннотация
OBJECTIVE: To study the impact of maternal race and ethnicity on live birth rates (LBRs) in white, Asian, Hispanic, and African American women with infertility, with and without polycystic ovary syndrome (PCOS), undergoing in vitro fertilization (IVF) in the United States.
DESIGN: Retrospective cohort study.
SUBJECTS: We reviewed 256,018 patient records from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database, from 2014 to 2017, and 128,703 patients met our study inclusion criteria, who were women aged 21-40 years, undergoing their first nondonor fresh embryo transfer during IVF.
EXPOSURE: Maternal race and ethnicity in women with PCOS.
MAIN OUTCOME MEASURES: Live birth rate.
RESULTS: There were 21,866 women with infertility and PCOS and 106,837 women with infertility without PCOS. The LBR in the PCOS group was highest in white women (49.5%), compared with Hispanic (42.7%), Asian (41.6%), and African American (36%) women. The LBR in the non-PCOS group was highest in white women (45.1%), compared with Hispanic (40.5%), Asian (35.4%), and African American (34.3%) women. Logistic regression models were performed comparing women with PCOS vs. white women without PCOS as the referent group. The likelihood of having a live birth was significantly lower in African American and Asian women with PCOS. The likelihood of having a pregnancy loss was significantly higher in African American and Hispanic women with PCOS. In women who had a live birth, the likelihood of a neonatal death was significantly higher in Asian, Hispanic, and African American women in the PCOS group.
CONCLUSION: This is the largest IVF study to date assessing the impact of maternal race and ethnicity on live birth and neonatal death rates in women with infertility with and without PCOS. Our data suggest that there are significant racial and ethnic outcome disparities in women with infertility with and without PCOS undergoing IVF in the United States.
DESIGN: Retrospective cohort study.
SUBJECTS: We reviewed 256,018 patient records from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database, from 2014 to 2017, and 128,703 patients met our study inclusion criteria, who were women aged 21-40 years, undergoing their first nondonor fresh embryo transfer during IVF.
EXPOSURE: Maternal race and ethnicity in women with PCOS.
MAIN OUTCOME MEASURES: Live birth rate.
RESULTS: There were 21,866 women with infertility and PCOS and 106,837 women with infertility without PCOS. The LBR in the PCOS group was highest in white women (49.5%), compared with Hispanic (42.7%), Asian (41.6%), and African American (36%) women. The LBR in the non-PCOS group was highest in white women (45.1%), compared with Hispanic (40.5%), Asian (35.4%), and African American (34.3%) women. Logistic regression models were performed comparing women with PCOS vs. white women without PCOS as the referent group. The likelihood of having a live birth was significantly lower in African American and Asian women with PCOS. The likelihood of having a pregnancy loss was significantly higher in African American and Hispanic women with PCOS. In women who had a live birth, the likelihood of a neonatal death was significantly higher in Asian, Hispanic, and African American women in the PCOS group.
CONCLUSION: This is the largest IVF study to date assessing the impact of maternal race and ethnicity on live birth and neonatal death rates in women with infertility with and without PCOS. Our data suggest that there are significant racial and ethnic outcome disparities in women with infertility with and without PCOS undergoing IVF in the United States.