Racial disparities in in vitro fertilization outcomes
Racial disparities in in vitro fertilization outcomes
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DOI：
10.1016/j.fertnstert.2015.05.012
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发表时间：
2015-08-01
影响因子：
6.7
通讯作者：
Uhler, Meike L.
中科院分区：
文献类型：
--
作者：
McQueen, Dana B.;Schufreider, Ann;Uhler, Meike L.
目的：评估种族对体外受精（IVF）结局的影响。设计：回顾性分析。设置：私人诊所。患者：2010年1月至2012年12月在伊利诺伊州生育中心接受第一个自体IVF周期的所有女性。干预：收集基线特征、周期参数和结局的信息。主要结果测量：临床宫内妊娠率和活产率。结果：共纳入4，045名妇女：3，003名白色妇女（74.2%），213名黑人妇女（5.3%），541名亚洲妇女（13.4%）和288名西班牙裔妇女（7.1%）。进行多变量逻辑回归以控制混杂因素。与白色女性相比，黑人女性临床宫内妊娠的校正比值比为0.63（95%置信区间[CI] 0.44-0.88），亚洲女性为0.73（95% CI 0.60-0.90），西班牙裔女性为0.82（95% CI 0.62-1.07）。与白色女性相比，黑人女性活产的调整优势比为0.50（95% CI 0.33-0.72），亚裔女性为0.64（95% CI 0.51-0.80），西班牙裔女性为0.80（95% CI 0.60-1.06）。白色妇女的自然流产率为14.6%，黑人妇女为28.9%，亚裔妇女为20.6%，西班牙裔妇女为15.3%.Conclusions：与白色妇女相比，黑人和亚裔妇女的临床宫内妊娠和活产率较低，自然流产率较高。需要进一步的研究来更好地描述与这种种族差异相关的机制，并改善黑人和亚洲妇女的治疗选择。(C)2015年，美国生殖医学会（American Society for Reproductive Medicine）
Objective: To evaluate the impact of race on in vitro fertilization (IVF) outcomes.Design: Retrospective analysis.Setting: Private practice.Patient(s): All women who underwent a first autologous IVF cycle at Fertility Centers of Illinois from January 2010 to December 2012.Intervention(s): Information was collected on baseline characteristics, cycle parameters, and outcomes. Race was self-reported.Main Outcome Measure(s): Clinical intrauterine pregnancy and live birth rates.Result(s): A total of 4,045 women were included: 3,003 white (74.2%), 213 black (5.3%), 541 Asian (13.4%), and 288 Hispanic women (7.1%). A multivariable logistic regression was performed to control for confounders. Compared with white women, the adjusted odds ratio for clinical intrauterine pregnancy was 0.63 (95% confidence interval [CI] 0.44-0.88) in black women, 0.73 (95% CI 0.60-0.90) in Asian women, and 0.82 (95% CI 0.62-1.07) in Hispanic women. The adjusted odds ratio for live birth was 0.50 (95% CI 0.33-0.72) in black women, 0.64 (95% CI 0.51-0.80) in Asian women, and 0.80 (95% CI 0.60-1.06) in Hispanic women compared with white women. The spontaneous abortion rate was 14.6% in white women versus 28.9% in black women, 20.6% in Asian women, and 15.3% in Hispanic women.Conclusion(s): Black and Asian women had lower odds of clinical intrauterine pregnancy and live birth and higher rates of spontaneous abortion compared with white women. Further research is needed to better characterize the mechanisms associated with this racial disparity and to improve treatment options for black and Asian women. (C) 2015 by American Society for Reproductive Medicine.