A review of disparities in access to infertility care and treatment outcomes among Hispanic women

Abstract

Hispanic women have lower rates of use of infertility services than non-Hispanic White women. There are many barriers that impede access to infertility care including economic, geographic, cultural, and societal factors and there are disparities in treatment outcomes. Hispanic women are less likely to seek infertility care than non-Hispanic White women and even after infertility evaluation, Hispanic women are less likely to receive treatment for their infertility. Lower use of infertility treatments among Hispanic women is unlikely to be driven solely by economic factors. There is disappointingly little data on in-vitro fertilization treatment outcomes including the population of Hispanic women, and existing data has yielded conflicting results. Incomplete and variable reporting of race data across clinics raises the potential for misclassification bias and invalid study conclusions. Addressing disparities in access to reproductive medicine in the Hispanic population will required a multifaceted approach including expanded insurance coverage, improved education for both patients and providers, and additional research on barriers to care.

Racial Disparities in Fertility Care: A Narrative Review of Challenges in the Utilization of Fertility Preservation and ART in Minority Populations

“…This study also demonstrated that Black and Hispanic patients may travel twice the distance to their IVF clinic in comparison to White and Asian patients [20]. Hispanic women have reported a higher perceived stigma surrounding the use of fertility services, and they may have more religious and ethical concerns regarding use of fertility treatments [21]. These studies indicate that a strong cultural influence surrounds the use of any fertility services, and that this influence likely extends to planned OC.…”

Racial and ethnic differences in self-reported satisfaction with fertility clinics and doctors

“…Additionally, data suggests that access to fertility care is also adversely affected by race/ethnicity, as infertility care is accessed at a higher rate by non-Hispanic white women with higher socioeconomic parameters, and at a lower rate for Hispanic women. (29,30) Literature on patient perspective on self-reported fertility care satisfaction by race/ethnicity is extremely limited, despite the more extensive literature on disparities in outcomes as above. A study of 1,460 patients at an academic fertility center in Illinois found that Black women (14.7%) were more likely to report that race was a barrier to getting fertility treatment compared with White (0.0%), Hispanic (5.1%), and Asian (5.4%) women, though satisfaction with fertility care was not assessed.…”

Navigating Unequal Paths

“… 46 Hispanic women report more social stigma surrounding infertility and may have more ethical and religious concerns about ART treatment. 50 It is important to note that most of the women included in these studies had already overcome initial obstacles and sought medical care, indicating that discrimination may exert an even stronger influence on those who do not progress to this stage (Fig. 1 ).…”