Disparity in assisted reproductive technologies outcomes in black women compared with white women
Disparity in assisted reproductive technologies outcomes in black women compared with white women
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DOI：
10.1016/j.fertnstert.2007.08.024
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发表时间：
2008-11-01
影响因子：
6.7
通讯作者：
Grainger, David A.
中科院分区：
文献类型：
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作者：
Seifer, David B.;Frazier, Linda M.;Grainger, David A.
目的：比较黑人和白人女性接受 IVF 的成功率。设计：回顾性队列研究。背景：辅助生殖技术协会成员诊所在 1999-2000 年进行了 50 个 IVF 周期，并在 >95% 的周期中报告了种族/民族。患者：接受 80,309 个 IVF 周期的女性。干预措施：使用非供体胚胎进行 IVF。主要结果测量：每个周期开始的活产率。结果：黑人、白人和其他种族/族裔女性分别接受了 3666 (4.6%)、68,607 (83.5%) 和 8036 (11.9%) 个 IVF 周期。自然流产在黑人女性中更为常见。白人女性的活产率为 26.3%（95% 置信区间 [CI]，25.9%-26.7%），而黑人女性的活产率为 18.7%（95% CI，17.5%-20.1%）（比率为 1.41）。在控制了黑人中输卵管和子宫因素不孕症增加以及其他特征后，黑人种族是未实现活产的独立危险因素（调整后的相对风险，1.21；如果没有既往接受过 ART，则 95% CI，1.12-1.36；如果既往 ART，则 RR，1.38；95% CI，1.20-1.57）。对于冷冻胚胎周期，活产率是相当的。 结论：黑人女性占当时美国已婚育龄女性的 7.8%，但在 IVF 接受者中所占比例不足。种族是预后的一个标志，不能用注册数据集中可用的特征来解释。 （Fertil Steril(R) 2008；90:1701-10。(C)2008，美国生殖医学会。）
Objective: To compare success rates in black and white women undergoing IVF.Design: Retrospective cohort study.Setting: Society for Assisted Reproductive Technology member clinics in 1999-2000 that performed 50 cycles of IVF and reported race/ethnicity in >95% of cycles.Patient(s): Women receiving 80,309 IVF cycles.Intervention(s): IVF using nondonor embryos.Main Outcome Measure(s): Live-birth rate per cycle started.Result(s): Black, white, and other race/ethnicity women underwent 3666 (4.6%), 68,607 (83.5%), and 8036 (11.9%) IVF cycles, respectively. Spontaneous abortions were more common among black women. The live-birth rate was 26.3% (95% confidence interval [CI], 25.9%-26.7%) among white women compared with 18.7% (95% CI, 17.5%-20.1%) among black women (rate ratio, 1.41). After controlling for increased tubal and uterine factor infertility among blacks and other characteristics, black race was an independent risk factor for not achieving a live birth (adjusted relative risk, 1.21; 95% CI, 1.12-1.36 if no prior ART, and RR, 1.38; 95% CI, 1.20-1.57 if prior ART). For cryopreserved embryo cycles, live-birth rates were equivalent.Conclusion(s): Black women, who represented 7.8% of married reproductive-age women in the United States at that time, were underrepresented among IVF recipients. Race is a marker for prognosis that is not explained by characteristics available in the registry data set. (Fertil Steril(R) 2008;90:1701-10. (C)2008 by American Society for Reproductive Medicine.)