Johns Hopkins School of Medicine
Over the years, we’ve learned that fertility treatment success rates often vary by a patient’s race and ethnicity. The information below is to help Black patients recalibrate and discount the data (based mostly on Caucasian patients) that their clinic will show them.
For patients who do intrauterine insemination, or IUI, the data suggests, on average, each cycle is likely to work 1 - 15% of the time. Most of the studies that have compared IUI success rates between Black and Caucasian women have found no meaningful difference.
As you can see here in our lesson on IUI success rates, rates of success vary by patient type and the fertility drugs taken but there’s limited evidence that Black patients do better or worse than Caucasian patients in this process.
Unfortunately, it appears Black IVF patients have lower success rates than Caucasian women. Most, but not all studies, back this up.
As a result, Black women and couples may need to recalibrate, or even discount, the general success rates their clinic advertises.
To illustrate the point, we’ll look at one study that includes about 300 Black patients treated at a single center. This study has strengths and weaknesses but it’s amongst the best available today. It’s also reasonably representative of what we see from similar studies.
“Success rates” can be measured in many ways and so we’ll focus on 3: pregancy rate, miscarriage rate, and live birth rate.
What It is: This is the percentage of women who start an IVF cycle and get pregnant from that cycle. A “cycle” starts when a woman takes hormones and has her eggs retrieved.
Study Observations: 36% of Caucasian women and 24% of Black women conceived after one IVF cycle. After adjusting for a few factors, investigators determined Black women were half as likely to get pregnant from one round of IVF.
What It Is: The percentage of IVF pregnancies that end in miscarriage.
Study Observations: 15% of Caucasian women and 29% of Black women miscarried if they conceived through IVF.
What It Is: The percentage of women who start an IVF cycle and successfully deliver a live baby from that cycle.
Study Observations: 31% of Caucasian women delivered a child after one cycle. For Black women, success rates were around half of what Caucasian women recorded.
As we covered in the first lesson, Black patients tend to get treated at older ages and, as we’ll cover in the next lesson, other factors (like uterine fibroids) tend to disproportionately impact their fertility.
However, after “controlling” for these differences, investigators still observed a major difference in treatment outcomes.
This data could lead Black women or couples to wonder “why should I consider IVF if it works better for Caucasian patients.” We think it’s also relevant to ask, “amongst all of my options, which is most likely to lead to a birth for me personally?”
Indeed, IVF success rates may be higher for other populations, but compared with the alternatives (like doing no treatment at all), IVF success rates often rank favorably. Again, below is the data for the odds of conceiving naturally within the first year: unfortunately, the odds of conception gradually approach zero.