United States racial/ethnic disparities in PGT-A use: an analysis of 2014–2020 SART CORS database

Abstract Background The use of preimplantation genetic testing for aneuploidy (PGT-A) allows for the selection of euploid embryos and has been thought to improve outcomes in ART, particularly in women ≥ 35 years old. However, little is known regarding PGT-A utilization among minority women in the Un...

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Main Authors: Akailah Mason-Otey, David B. Seifer
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Reproductive Biology and Endocrinology
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Online Access:https://doi.org/10.1186/s12958-025-01399-8
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author Akailah Mason-Otey
David B. Seifer
author_facet Akailah Mason-Otey
David B. Seifer
author_sort Akailah Mason-Otey
collection DOAJ
description Abstract Background The use of preimplantation genetic testing for aneuploidy (PGT-A) allows for the selection of euploid embryos and has been thought to improve outcomes in ART, particularly in women ≥ 35 years old. However, little is known regarding PGT-A utilization among minority women in the United States (US). The objective of this study was to determine the trend of utilization of PGT-A in the US among minority women. Methods We conducted a retrospective cohort study using the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) database. We included initial autologous ART cycles performed between 2014 and 2020. We assessed the rate of PGT-A utilization by race/ethnicity. Results This study included 150,604 PGT-A and 287,979 non-PGT-A initial autologous cycles. The overall trend of PGT-A utilization, regardless of race/ethnicity, increased from 11.5 to 49.0% (p < 0.001) over seven years. Of all ART cycles, 33% of White women used PGT-A, in comparison to 24% of Black women, 31% of Hispanic women, and 44% of Asian women (p < 0.001). Multiple Logistic Regression (MLR) determined race/ethnicity as an independent predictor of PGT-A utilization when adjusting for age, BMI, and AMH (p < 0.001). Compared to White women, MLR showed that Black and Hispanic women were 35% and 16% less likely to use PGT-A (aOR = 0.65, 95% CI 0.63–0.67, and aOR = 0.86, 95% CI 0.84–0.88, respectively, p < 0.001). In contrast, Asian women were 41% (aOR = 1.41, 95% CI 1.39–1.44) more likely to use PGT-A (p < 0.001). Overall, regardless of race/ethnicity, women 35 and older were 71% (aOR = 1.71, 95% CI 1.69–1.74) more likely to use PGT-A compared to women younger than 35 (p < 0.001). Conclusion Despite a significant increase in overall PGT-A utilization in the US over 7 years, utilization has been consistently less in ART cycles for Black and Hispanic women, in comparison to White women. This is in marked contrast to an increase in PGT-A utilization in cycles for Asian women.
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spelling doaj-art-478edd5f85d64ea898dba65a600cce4f2025-08-20T01:49:38ZengBMCReproductive Biology and Endocrinology1477-78272025-05-012311710.1186/s12958-025-01399-8United States racial/ethnic disparities in PGT-A use: an analysis of 2014–2020 SART CORS databaseAkailah Mason-Otey0David B. Seifer1Yale School of Medicine, Department of Obstetrics, Gynecology, and Reproductive ScienceYale School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Reproductive Endocrinology and InfertilityAbstract Background The use of preimplantation genetic testing for aneuploidy (PGT-A) allows for the selection of euploid embryos and has been thought to improve outcomes in ART, particularly in women ≥ 35 years old. However, little is known regarding PGT-A utilization among minority women in the United States (US). The objective of this study was to determine the trend of utilization of PGT-A in the US among minority women. Methods We conducted a retrospective cohort study using the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) database. We included initial autologous ART cycles performed between 2014 and 2020. We assessed the rate of PGT-A utilization by race/ethnicity. Results This study included 150,604 PGT-A and 287,979 non-PGT-A initial autologous cycles. The overall trend of PGT-A utilization, regardless of race/ethnicity, increased from 11.5 to 49.0% (p < 0.001) over seven years. Of all ART cycles, 33% of White women used PGT-A, in comparison to 24% of Black women, 31% of Hispanic women, and 44% of Asian women (p < 0.001). Multiple Logistic Regression (MLR) determined race/ethnicity as an independent predictor of PGT-A utilization when adjusting for age, BMI, and AMH (p < 0.001). Compared to White women, MLR showed that Black and Hispanic women were 35% and 16% less likely to use PGT-A (aOR = 0.65, 95% CI 0.63–0.67, and aOR = 0.86, 95% CI 0.84–0.88, respectively, p < 0.001). In contrast, Asian women were 41% (aOR = 1.41, 95% CI 1.39–1.44) more likely to use PGT-A (p < 0.001). Overall, regardless of race/ethnicity, women 35 and older were 71% (aOR = 1.71, 95% CI 1.69–1.74) more likely to use PGT-A compared to women younger than 35 (p < 0.001). Conclusion Despite a significant increase in overall PGT-A utilization in the US over 7 years, utilization has been consistently less in ART cycles for Black and Hispanic women, in comparison to White women. This is in marked contrast to an increase in PGT-A utilization in cycles for Asian women.https://doi.org/10.1186/s12958-025-01399-8Preimplantation genetic testingAneuploidyPGT-AHealthcare disparitiesNational registrySART CORS
spellingShingle Akailah Mason-Otey
David B. Seifer
United States racial/ethnic disparities in PGT-A use: an analysis of 2014–2020 SART CORS database
Reproductive Biology and Endocrinology
Preimplantation genetic testing
Aneuploidy
PGT-A
Healthcare disparities
National registry
SART CORS
title United States racial/ethnic disparities in PGT-A use: an analysis of 2014–2020 SART CORS database
title_full United States racial/ethnic disparities in PGT-A use: an analysis of 2014–2020 SART CORS database
title_fullStr United States racial/ethnic disparities in PGT-A use: an analysis of 2014–2020 SART CORS database
title_full_unstemmed United States racial/ethnic disparities in PGT-A use: an analysis of 2014–2020 SART CORS database
title_short United States racial/ethnic disparities in PGT-A use: an analysis of 2014–2020 SART CORS database
title_sort united states racial ethnic disparities in pgt a use an analysis of 2014 2020 sart cors database
topic Preimplantation genetic testing
Aneuploidy
PGT-A
Healthcare disparities
National registry
SART CORS
url https://doi.org/10.1186/s12958-025-01399-8
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