Impact of race and ethnicity on in vitro fertilization outcomes in infertile women with polycystic ovary syndrome in the United States

Objective: To study the impact of maternal race and ethnicity on live birth rates (LBRs) in white, Asian, Hispanic, and African American women with infertility, with and without polycystic ovary syndrome (PCOS), undergoing in vitro fertilization (IVF) in the United States. Design: Retrospective coho...

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Main Authors: Guido Mora Calderon, M.D., Fabiola D’Ambrosio, M.D., Alan Schwartz, Ph.D., Bert Scoccia, M.D.
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:F&S Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666334125000303
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author Guido Mora Calderon, M.D.
Fabiola D’Ambrosio, M.D.
Alan Schwartz, Ph.D.
Bert Scoccia, M.D.
author_facet Guido Mora Calderon, M.D.
Fabiola D’Ambrosio, M.D.
Alan Schwartz, Ph.D.
Bert Scoccia, M.D.
author_sort Guido Mora Calderon, M.D.
collection DOAJ
description Objective: To study the impact of maternal race and ethnicity on live birth rates (LBRs) in white, Asian, Hispanic, and African American women with infertility, with and without polycystic ovary syndrome (PCOS), undergoing in vitro fertilization (IVF) in the United States. Design: Retrospective cohort study. Subjects: We reviewed 256,018 patient records from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database, from 2014 to 2017, and 128,703 patients met our study inclusion criteria, who were women aged 21–40 years, undergoing their first nondonor fresh embryo transfer during IVF. Exposure: Maternal race and ethnicity in women with PCOS. Main Outcome Measures: Live birth rate. Results: There were 21,866 women with infertility and PCOS and 106,837 women with infertility without PCOS. The LBR in the PCOS group was highest in white women (49.5%), compared with Hispanic (42.7%), Asian (41.6%), and African American (36%) women. The LBR in the non-PCOS group was highest in white women (45.1%), compared with Hispanic (40.5%), Asian (35.4%), and African American (34.3%) women. Logistic regression models were performed comparing women with PCOS vs. white women without PCOS as the referent group. The likelihood of having a live birth was significantly lower in African American and Asian women with PCOS. The likelihood of having a pregnancy loss was significantly higher in African American and Hispanic women with PCOS. In women who had a live birth, the likelihood of a neonatal death was significantly higher in Asian, Hispanic, and African American women in the PCOS group. Conclusion: This is the largest IVF study to date assessing the impact of maternal race and ethnicity on live birth and neonatal death rates in women with infertility with and without PCOS. Our data suggest that there are significant racial and ethnic outcome disparities in women with infertility with and without PCOS undergoing IVF in the United States.
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spelling doaj-art-d8ee0e7ae6a34311bf72c11f045f21642025-08-20T03:47:20ZengElsevierF&S Reports2666-33412025-06-016216817510.1016/j.xfre.2025.02.008Impact of race and ethnicity on in vitro fertilization outcomes in infertile women with polycystic ovary syndrome in the United StatesGuido Mora Calderon, M.D.0Fabiola D’Ambrosio, M.D.1Alan Schwartz, Ph.D.2Bert Scoccia, M.D.3Division of Pediatric Endocrinology, Department of Pediatrics, University of Illinois College of Medicine at Chicago, Chicago, IllinoisDivision of Pediatric Endocrinology, Department of Pediatrics, University of Illinois College of Medicine at Chicago, Chicago, IllinoisDivision of Pediatric Endocrinology, Department of Pediatrics, University of Illinois College of Medicine at Chicago, Chicago, IllinoisDivision of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Illinois College of Medicine at Chicago, Chicago, Illinois; Correspondence: Bert Scoccia, M.D., Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Illinois College of Medicine at Chicago, 820 S Wood St., M/C 808, Chicago, Illinois 60612.Objective: To study the impact of maternal race and ethnicity on live birth rates (LBRs) in white, Asian, Hispanic, and African American women with infertility, with and without polycystic ovary syndrome (PCOS), undergoing in vitro fertilization (IVF) in the United States. Design: Retrospective cohort study. Subjects: We reviewed 256,018 patient records from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database, from 2014 to 2017, and 128,703 patients met our study inclusion criteria, who were women aged 21–40 years, undergoing their first nondonor fresh embryo transfer during IVF. Exposure: Maternal race and ethnicity in women with PCOS. Main Outcome Measures: Live birth rate. Results: There were 21,866 women with infertility and PCOS and 106,837 women with infertility without PCOS. The LBR in the PCOS group was highest in white women (49.5%), compared with Hispanic (42.7%), Asian (41.6%), and African American (36%) women. The LBR in the non-PCOS group was highest in white women (45.1%), compared with Hispanic (40.5%), Asian (35.4%), and African American (34.3%) women. Logistic regression models were performed comparing women with PCOS vs. white women without PCOS as the referent group. The likelihood of having a live birth was significantly lower in African American and Asian women with PCOS. The likelihood of having a pregnancy loss was significantly higher in African American and Hispanic women with PCOS. In women who had a live birth, the likelihood of a neonatal death was significantly higher in Asian, Hispanic, and African American women in the PCOS group. Conclusion: This is the largest IVF study to date assessing the impact of maternal race and ethnicity on live birth and neonatal death rates in women with infertility with and without PCOS. Our data suggest that there are significant racial and ethnic outcome disparities in women with infertility with and without PCOS undergoing IVF in the United States.http://www.sciencedirect.com/science/article/pii/S2666334125000303PCOSraceethnicityIVF outcomeslive birth rate
spellingShingle Guido Mora Calderon, M.D.
Fabiola D’Ambrosio, M.D.
Alan Schwartz, Ph.D.
Bert Scoccia, M.D.
Impact of race and ethnicity on in vitro fertilization outcomes in infertile women with polycystic ovary syndrome in the United States
F&S Reports
PCOS
race
ethnicity
IVF outcomes
live birth rate
title Impact of race and ethnicity on in vitro fertilization outcomes in infertile women with polycystic ovary syndrome in the United States
title_full Impact of race and ethnicity on in vitro fertilization outcomes in infertile women with polycystic ovary syndrome in the United States
title_fullStr Impact of race and ethnicity on in vitro fertilization outcomes in infertile women with polycystic ovary syndrome in the United States
title_full_unstemmed Impact of race and ethnicity on in vitro fertilization outcomes in infertile women with polycystic ovary syndrome in the United States
title_short Impact of race and ethnicity on in vitro fertilization outcomes in infertile women with polycystic ovary syndrome in the United States
title_sort impact of race and ethnicity on in vitro fertilization outcomes in infertile women with polycystic ovary syndrome in the united states
topic PCOS
race
ethnicity
IVF outcomes
live birth rate
url http://www.sciencedirect.com/science/article/pii/S2666334125000303
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