Skip to main content
SpringerLink
Log in

Decreased live births among women of Middle Eastern/North African ethnicity compared to Caucasian women

  • Assisted Reproduction Technologies
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

The objective of this study is to determine if IVF outcome disparities exist among MENA women in the USA in comparison to a control group of Caucasian women.

Methods

A retrospective cohort study comparing MENA (N = 190) and Caucasian (N = 200) women undergoing their first IVF cycle between 5/2006 and 5/2014 was carried out at an academically affiliated fertility practice. All MENA cycles during that time period undergoing IVF/ICSI using autologous embryos and blastocyst transfers were compared to a control group of Caucasian women.

Results

MENA women were significantly younger (32.9 vs 34.5, P < 0.005) and had a lower BMI (25.2 vs 27.1, P < 0.001). Male factor infertility was higher among partners of MENA women (62 vs 50%, P < 0.05). MENA women experienced decreased live birth rates per blastocyst transfer compared to Caucasian women after controlling for age and BMI (OR 0.55, 95% CI 0.35–0.85 P = 0.007). The odds of a miscarriage were also significantly higher among MENA women (OR 2.55, 95% CI 1.04–6.27 P = 0.036).

Conclusion

Middle Eastern/North African women have worse IVF outcomes with decreased live birth rates per blastocyst transfer and increased miscarriage rates compared to Caucasian women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Sunderam S, Kissin DM, Crawford SB, Folger SG, Jamieson DJ, Warner L, et al. Assisted reproductive technology surveillance—United States, 2013. Morb Mortal Wkly Rep Surveill Summ Wash DC 2002. 2015;64:1–25.

    Google Scholar 

  2. Ethics Committee of the American Society for Reproductive Medicine. Disparities in access to effective treatment for infertility in the United States: an ethics committee opinion. Fertil Steril. 2015;104:1104–10.

    Article  Google Scholar 

  3. NIH policy on reporting race and ethnicity data: subjects in clinical research [Internet]. 2016. Available from: http://grants.nih.gov/grants/guide/notice-files/NOT-OD-01-053.html

  4. Huddleston HG, Cedars MI, Sohn SH, Giudice LC, Fujimoto VY. Racial and ethnic disparities in reproductive endocrinology and infertility. Am J Obstet Gynecol. 2010;202:413–9.

    Article  PubMed  Google Scholar 

  5. Jain T, Hornstein MD. Disparities in access to infertility services in a state with mandated insurance coverage. Fertil Steril. 2005;84:221–3.

    Article  PubMed  Google Scholar 

  6. Wellons MF, Fujimoto VY, Baker VL, Barrington DS, Broomfield D, Catherino WH, et al. Race matters: a systematic review of racial/ethnic disparity in Society for Assisted Reproductive Technology reported outcomes. Fertil Steril. 2012;98:406–9.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Aboul-Enein BH, Aboul-Enein FH. The cultural gap delivering health care services to Arab American populations in the United States. J Cult Divers. 2010;17:20–3.

    PubMed  Google Scholar 

  8. Krogstad JM. Census Bureau explores new Middle East/North Africa ethnic category. Pew Res. Cent. [Internet]. 2016; Available from: http://www.pewresearch.org/fact-tank/2014/03/24/census-bureau-explores-new-middle-eastnorth-africa-ethnic-category/

  9. Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, Stevens GA. National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med. 2012;9:e1001356.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Feichtinger M, Göbl C, Weghofer A, Feichtinger W. Reproductive outcome in European and Middle Eastern/North African patients. Reprod BioMed Online. 2016;33:684–9.

    Article  PubMed  Google Scholar 

  11. Maryam Asi and Daniel Beaulieu. Arab Households in the United States: 2006–2010 [Internet]. 2013. Available from: https://www.census.gov/prod/2013pubs/acsbr10-20.pdf

  12. Gardner DK, Surrey E, Minjarez D, Leitz A, Stevens J, Schoolcraft WB. Single blastocyst transfer: a prospective randomized trial. Fertil Steril. 2004;81:551–5.

    Article  CAS  PubMed  Google Scholar 

  13. Inhorn MC, Fakih MH. Arab Americans, African Americans, and infertility: barriers to reproduction and medical care. Fertil Steril. 2006;85:844–52.

    Article  PubMed  Google Scholar 

  14. Inhorn MC, Kobeissi L, Nassar Z, Lakkis D, Fakih MH. Consanguinity and family clustering of male factor infertility in Lebanon. Fertil Steril. 2009;91:1104–9.

    Article  PubMed  Google Scholar 

  15. Schuh-Huerta SM, Johnson NA, Rosen MP, Sternfeld B, Cedars MI, Reijo Pera RA. Genetic markers of ovarian follicle number and menopause in women of multiple ethnicities. Hum Genet. 2012;131:1709–24.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Sharara FI, McClamrock HD. Differences in in vitro fertilization (IVF) outcome between white and black women in an inner-city, university-based IVF program. Fertil Steril. 2000;73:1170–3.

    Article  CAS  PubMed  Google Scholar 

  17. Bendikson K, Cramer DW, Vitonis A, Hornstein MD. Ethnic background and in vitro fertilization outcomes. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2005;88:342–6.

    Article  CAS  Google Scholar 

  18. Dayal MB, Gindoff P, Dubey A, Spitzer TLB, Bergin A, Peak D, et al. Does ethnicity influence in vitro fertilization (IVF) birth outcomes? Fertil Steril. 2009;91:2414–8.

    Article  PubMed  Google Scholar 

  19. Fujimoto VY, Jain T, Alvero R, Nelson LM, Catherino WH, Olatinwo M, et al. Proceedings from the conference on Reproductive Problems in Women of Color. Fertil. Steril. 2010;94:7–10.

  20. Jayaprakasan K, Pandian D, Hopkisson J, Campbell BK, Maalouf WE. Effect of ethnicity on live birth rates after in vitro fertilisation or intracytoplasmic sperm injection treatment. BJOG Int J Obstet Gynaecol. 2014;121:300–6.

    Article  CAS  Google Scholar 

  21. Missmer SA, Seifer DB, Jain T. Cultural factors contributing to health care disparities among patients with infertility in Midwestern United States. Fertil Steril. 2011;95:1943–9.

    Article  PubMed  Google Scholar 

  22. Chandra A, Copen CE, Stephen EH. Infertility service use in the United States: data from the National Survey of Family Growth, 1982–2010. Natl. Health Stat. Rep. 2014;1–21.

Download references

Acknowledgements

The authors want to especially thank the patients of IVF Michigan for their participation along with Prof. Hakam, Dr. H Salem, and Dr. Wadhera for inspiration.

Author information

Authors and Affiliations

  1. University of Southern California, 020 Zonal Ave, IRD Room 533, Los Angeles, CA, 90033, USA

    W. H. Salem & K. Bendikson

  2. IVF Michigan, Rochester Hills/Flint MI, 3950 S Rochester Rd, Ste 2300, Rochester Hills, MI, 48307, USA

    A. Abdullah, O. Abuzeid & M. Abuzeid

  3. Virginia Center for Reproductive Medicine, 11150 Sunset Hills Rd #100, Reston, VA, 20190, USA

    F. I. Sharara

Authors
  1. W. H. Salem
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Abdullah
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. O. Abuzeid
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K. Bendikson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. F. I. Sharara
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Abuzeid
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W. H. Salem.

Ethics declarations

Funding

This study was not provided any external or institutional funding.

Conflict of interest

The authors declare that they have no conflicts of interests.

Appendix

Appendix

Fig. 1
figure 1

Patient selection flowchart

Full size image

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Salem, W.H., Abdullah, A., Abuzeid, O. et al. Decreased live births among women of Middle Eastern/North African ethnicity compared to Caucasian women. J Assist Reprod Genet 34, 581–586 (2017). https://doi.org/10.1007/s10815-017-0904-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-017-0904-8

Keywords

Search

Navigation