Optimizing IVF For African American Patients

Hyperstimulation and Protocols

If an African American woman or couple moves forward with IVF, there are a few things they may want to keep in mind, beyond what other patients should hear.

The first major step in the IVF process is for a woman to take hormones to stimulate the growth of an abnormally large number of eggs.

Protocols On Timeline

Occasionally, women can become “hyperstimulated” in the process, which can be both painful, and in some cases, dangerous. As you can see from the data below, African American women are more likely to “hyperstimulate” than Caucasian women.

Hyperstimulation is often a reaction to the medication protocol strategy, or drug volumes, prescribed by the doctor. To oversimplify the subject, there are really two core protocols: the “Long Agonist” protocol and the “Antagonist” protocol.

The two have similar success rates, but with the “Antagonist” protocol, hyperstimulation is generally less of an issue. Below is an example of this taken from a study on women with polycystic ovarian syndrome (PCOS). Thus, African American women should ask their doctor specifically about whether the “Antagonist” protocol provides a better risk vs. reward.

PCOS Protocols

Fresh or Frozen Embryo Transfer

Once a woman has had her eggs retrieved, those eggs will be fertilized with sperm to create embryos. Now the decision becomes when to transfer them.

Sample IVF Schedule Hormones

The embryos could be transferred just a few days after a retrieval, in what is known as a “fresh transfer.” Or someone can wait a month or longer to have embryos transferred, in which case the embryos will stay frozen until they’re needed. This is known as a “frozen transfer.” To learn more about the distinction, you can see our lesson on the subject here.

In one study that took place at Walter Reed National Military Medical Center, African American women had higher live birth rates after a frozen transfer than after a fresh transfer. Said differently, when frozen embryos were used African American women had success rates on par with Caucasian women.

You're previewing
African American Fertility

In this lesson we cover high-level subjects (e.g. the basics of reproduction) and break down specific issues that pertain to African American patients namely, higher rates of infertility, inadequate referral patterns, variation in IVF success rates, tubal factor, fibroids, miscarriage, lifestyle factors and more