Objective
We conducted a systematic review to evaluate the influence of race and ethnicity on
clinical pregnancy and live birth outcomes after in vitro fertilization (IVF).
Study
We searched PubMed, EMBASE, Web of Science, CINAHL, POPLINE, and Cochrane Central,
and hand-searched relevant articles published through July 22, 2015.
Study Appraisal and Synthesis Methods
Two reviewers independently evaluated abstracts to identify studies that compared
clinical pregnancy rates and live birth rates for ≥2 racial and/or ethnic groups after
nondonor IVF cycles.
Results
Twenty-four studies were included. All 5 US registry-based studies showed that black,
Hispanic, and Asian women had lower clinical pregnancy rates and/or live birth rates
after IVF, compared with white women. Similarly, most clinic-specific studies reported
significant disparities in these primary outcomes, potentially attributable to differences
in infertility diagnosis, spontaneous abortion, and obesity. Studies varied with respect
to definitions of race/ethnicity, inclusion of first cycles vs multiple cycles for
individual women, and collected covariates. Most studies were limited by sample size,
inadequate adjustment for confounding, selection bias, and extensive missing data.
Conclusions
Although current evidence points to race and ethnicity, especially black race, as
strong predictors of poorer outcomes after IVF, the utility of results is constrained
by the limitations described.
Key words
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Article Info
Publication History
Published online: September 09, 2015
Footnotes
The authors report no conflict of interest.
Identification
Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
