Racial/ethnic disparities in infertility treatment utilization in the US, 2011–2019

Dongarwar, Deepa; Mercado-Evans, Vicki; Adu-Gyamfi, Sylvia; Laracuente, Mei‐Li; Salihu, Hamisu M.

doi:10.1080/19396368.2022.2038718

Cited by 17 publications

(4 citation statements)

References 52 publications

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“…Our results demonstrating patients in low-volume months are more likely to be younger, healthier, and less likely to have a diagnosis of infertility could be explained by a shift in the patient demographic at that those times. Patients undergoing graduate or professional training may schedule their IVF encounters for time during school breaks, which align with the low-volume months [ 29 ]. This may reflect the egg freezing population, which generally are younger maternal patients with better prognosis.…”

Section: Discussionmentioning

confidence: 99%

Seasonal fluctuation of in vitro fertilization encounters in the United States

McGough

Doody

Foy

et al. 2023

J Assist Reprod Genet

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Purpose To examine patient and hospital characteristics related to seasonal fluctuation in in vitro fertilization (IVF). Methods This retrospective cohort study examined 33,077 oocyte retrievals identified in the National Ambulatory Surgery Sample. Exposure assignment was monthly IVF encounters: low-volume months (<25%ile), mid-volume months (≥25/<75%ile), and high-volume months (>75%ile). Main outcomes were patient and hospital characteristics related to the exposure groups, assessed with a multinomial regression model. Results The median IVF encounters were 977 per month, ranging from 657 to 1074 (absolute-difference 417). January, July, and December were the lowest-quartile volume months, ranging from 657 to 710 encounters per month (low-volume months). May, August, and November were the top-quartile volume months, ranging from 1049 to 1074 encounters per month (high-volume months). In a multivariable analysis, patients undergoing IVF in the low-volume months were younger and less likely to have infertility or comorbidities. Patients undergoing IVF in the high-volume months were more likely to have lower household income and receive IVF at urban teaching facilities. Northeastern residents were less likely to have IVF in the low-volume months but more likely to have IVF in the high-volume months. Sensitivity analyses showed that the lowest-to-highest variability in monthly IVF encounters was higher in Northeast region compared to other regions (320 vs 50–128); infertility patients compared to those without (317 vs 190); privately insured patients compared to self-pay (227 vs 156); and older patients compared to younger (234 vs 192). Conclusion This study suggests substantial seasonal fluctuation in IVF oocyte retrieval in the USA based on patient and hospital factors.

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Section: Discussionmentioning

confidence: 99%

Seasonal fluctuation of in vitro fertilization encounters in the United States

McGough

Doody

Foy

et al. 2023

J Assist Reprod Genet

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“…Given the financial, emotional, and physical resources required for infertility treatments, those patients may be uniquely motivated to avoid a COVID-19 infection. Finally, while data regarding race and socioeconomic status were not available for all patients included in this study, these are possible confounders that could be responsible for the difference in COVID-19 positivity rate rather than the type of gynecologic treatment, as the prevalence of COVID-19 varies between races and socioeconomic statuses, with higher rates of infection and mortality in black and Hispanic populations [ 13 , 14 ], and it has been well documented that there are racial and socioeconomic disparities between those who can afford infertility procedures and those who undergo general gynecology procedures [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Rates of COVID-19 infection among in vitro fertilization patients undergoing treatment at a university reproductive health center

Abigail

Berger

Lee

et al. 2022

J Assist Reprod Genet

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Background The coronavirus disease 2019 (COVID-19) caused an unprecedented challenge for in-vitro fertilization (IVF) patients. The incidence of COVID-19 infection among this population is a fundamental knowledge gap. Objective The purpose of this study was to determine the rate of COVID-19 infection among IVF patients compared to other gynecologic surgery patients. Materials and methods This retrospective study evaluated the incidence of COVID-19 infection among patients undergoing IVF, female fertility-related surgeries (FRS) and other gynecologic surgeries at a single academic institution in Los Angeles, California. All patients underwent routine COVID-19 polymerase chain reaction (PCR) screening prior to treatment. Result A total of 2742 patients underwent asymptomatic COVID-19 screening before a surgical procedure or IVF between March 1, 2020, and April 5, 2021. The rate of COVID-19 infection among patients who underwent preoperative testing for a non-fertility-related gynecologic procedure was 1.74% (28/1612). In comparison, the positive test results for those who underwent either FRS or IVF were 0.56% (1/180) and 0.34% (1/290), respectively, representing 6.70% (2/30) of positive tests for the whole cohort. The infertility patients had a significantly lower positivity rate compared to the other gynecologic patients during preoperative COVID-19 testing (0.43% vs 1.74%, p = 0.03). Conclusion(s). Our study demonstrated that there was a significantly lower incidence of COVID-19 infections in infertility patients undergoing IVF or FRS compared to other gynecologic surgery patients. Future studies should evaluate the cost-effectiveness of routine screening in both the gynecology and infertility patient population, especially in the setting of different variant surges and vaccination rates. Supplementary Information The online version contains supplementary material available at 10.1007/s10815-022-02581-2.

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“…Similarly, in a retrospective cohort study involving 554,995 live births associated with fertility treatment, Black and Hispanic women were approximately 70% less likely to receive any form of infertility treatment compared with White women. 22 Moreover, White women accounted for the majority of live births associated with any type of infertility treatment (53.8%), whereas Black and Hispanic women were the least represented groups (4.0% and 7.6%, respectively).…”

Section: Who Receives Fertility Treatment?mentioning

confidence: 99%

Navigating Unequal Paths

Weiss,

Marsh

2023

Obstetrics &Amp; Gynecology

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Infertility is one of the most emotionally devastating conditions experienced during the reproductive window. Although not life-threatening, it significantly erodes quality of life for those with the diagnosis. Disturbingly, data demonstrate the existence of profound racial disparities that persist along the entire journey of infertility. Though most of the scientific literature emphasizes disparities in clinical outcomes after infertility treatment, it is important to recognize that these inequities are the downstream effect of a series of distinct challenges encountered by historically marginalized people on their path to parenthood. In this review, we explore the current state of knowledge concerning the inequities at each “step” in the path to overcome infertility challenges and propose solutions to create a future in which reproductive medicine is truly equitable, accessible, and supportive for everyone.

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Racial/ethnic disparities in infertility treatment utilization in the US, 2011–2019

Cited by 17 publications

References 52 publications

Seasonal fluctuation of in vitro fertilization encounters in the United States

Seasonal fluctuation of in vitro fertilization encounters in the United States

Rates of COVID-19 infection among in vitro fertilization patients undergoing treatment at a university reproductive health center

Navigating Unequal Paths

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