Will decreasing assisted reproduction technology costs improve utilization and outcomes among minority women?

doi:10.1016/j.fertnstert.2010.02.021

Fertility and Sterility

Volume 94, Issue 7, December 2010, Pages 2587-2589

Presented in part at the 64th annual meeting of the American Society for Reproductive Medicine, November 8–12, 2008, San Francisco, California.

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Objective

To evaluate assisted reproduction technology (ART) usage and outcomes in minority women seeking care at enhanced access, military ART programs.

Design

Retrospective cohort.

Setting

Federal ART programs.

Patient(s)

Two thousand fifty women undergoing first cycle, fresh, nondonor ART from 2000 to 2005.

Intervention(s)

None.

Main Outcome Measure(s)

Rate of ART use, clinical pregnancy rate, live birth rate.

Result(s)

African American women had an almost fourfold increased use of ART and Hispanic women had decreased use. Clinical pregnancy rates were significantly lower for African American women compared with white women (46.1% vs. 52.6%, relative risk [RR] 0.88; 95% confidence interval [CI], 0.78–0.99) as were live birth rates (33.7%. vs. 45.7%, RR 0.74; 95% CI, 0.63–0.91).

Conclusion(s)

Economics appear to influence ART use by African American women but not Hispanic women. Despite increased use by African American women, outcomes in this group were worse when compared with Caucasian women. Improving access through decreased cost may increase use by some but not all minority groups. Improved access may not translate into improved outcomes in some ethnic groups.

Key Words

ART utilization

ethnic disparity

infertility

Cited by (0)

: D.M.M. has nothing to disclose. E.F.S. has nothing to disclose. R.D.R. is a member of the speakers bureau for Duramed, Schering Plough, and Wyeth. K.O. has nothing to disclose. R.S.L. has nothing to disclose. A.Y.A. has nothing to disclose. The views in this manuscript reflect the opinion of the authors and not the Federal Government or the Department of Defense.

: Supported in part by the Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Published by Elsevier Inc.