Racial and ethnic disparities in assisted reproductive technology outcomes in the United States.

OBJECTIVE

To evaluate ethnic differences in assisted reproductive technology (ART) outcomes in the United States.

DESIGN

Historical cohort study.

SETTING

Clinic-based data.

PATIENT(S): A total of 139,027 ART cycles from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System online database for 2004-2006, limited to white, Asian, black, and Hispanic women.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Logistic regression was used to model the odds of pregnancy and live birth; among singletons and twins, the odds of preterm birth and fetal growth restriction. Results are presented as adjusted odds ratios, with white women as the reference group.

RESULT(S): The odds of pregnancy were reduced for Asians (0.86), and the odds of live birth were reduced for all groups: Asian (0.90), black (0.62), and Hispanic (0.87) women. Among singletons, moderate and severe growth restriction were increased for all infants in all three minority groups (Asians [1.78, 2.05]; blacks [1.81, 2.17]; Hispanics [1.36, 1.64]), and preterm birth was increased among black (1.79) and Hispanic women (1.22). Among twins, the odds for moderate growth restriction were increased for infants of Asian (1.30) and black women (1.97), and severe growth restriction was increased among black women (3.21). The odds of preterm birth were increased for blacks (1.64) and decreased for Asians (0.70).

CONCLUSION(S): There are significant disparities in ART outcomes according to ethnicity.