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Fertility for Black Families

Lesson 2 of 5

Reasons Black Patients Get Treated Later

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As we covered in the previous lesson, there can be a real penalty to delaying fertility treatment. But, unfortunately, Black women and couples tend to be treated later than patients of other races.

In this lesson we’ll distill some of the underlying factors that likely cause a delay in treatment, namely Black women and couples are:

  • More likely to be wrongly perceived as fertile by their primary caregivers

  • Less likely to view fertility treatment as a primary option

  • More likely to worry financial and scheduling barriers to treatment

Wrongly Perceived As More Fertile

Generally speaking, referring doctors tend to under-appreciate the fertility challenges that Black people face.

As you can see in the data below, Black women record dramatically higher rates of infertility compared with other races. This data comes from a survey of over 15,000 married, US women and reflects the percentage of women who’ve been trying unsuccessfully to have a child. After adjusting for a few factors, investigators considered Black women and couples nearly twice as likely to suffer from fertility issues.

However, in a survey of over 150 family doctors and OBGYNS, investigators noted “only 16% correctly identified Black patients as the racial group most at risk for infertility.

A likely byproduct of these two facts is that Black women aren’t being referred along for fertility treatment as swiftly as Caucasian women. In turn, more burden may be placed on Black women to self-diagnose an issue and find care.

Unfortunately, Black clinicians are under-represented in the fertility field, as you can see in the data below. This may make it harder for Black patients to find a clinician less burdened by bias or with whom they feel more comfortable.

De-prioritizing Medical Treatment

Black women and couples often place more trust in their community or religious institutions than they do in the medical system and thus may be more reluctant to seek treatment.

In a survey of 1,350 women with fertility challenges, Black women were roughly 3 times more likely (than Caucasian women) to believe their ability to conceive relied upon “religious faith” or “God’s will” and 1/10th as likely to see it as dependant upon “trusting a medical provider.”

Black Treatment Delay

Financial and Time Commitment

As we alluded to in the last lesson, undergoing fertility treatment can be time-consuming and costly, especially with treatments like IUI or IVF.

Black women report being roughly four to six times more likely than Caucasian women to have trouble paying for care, finding time for appointments or locating a doctor with whom they feel comfortable.

Black Fertility Financial Factors

To help cover the costs of treatment, we’ve listed over 30 agencies and nonprofits that help assuage the financial burden of care. Additionally, for those living in the United States, residents of certain states are more likely to have coverage made available through their insurance carrier and you can find a list of those states here. We should note that if you work for a large employer that is “self insured” state mandates may not influence your coverage. For this reason, it’s critical to talk to a member of your employer’s Human Resources or Benefits team.

For those outside of the United States, fertility treatment reimbursement varies from region to region. For a more in-depth understanding of available treatments and their associated costs, we encourage you to explore our global courses or our sample global costs available here.

While IVF may be costly, initial evaluations and many fertility treatments (e.g. ovulation induction, IUI) are often far less costly. Many experts suggest patients be seen sooner rather than later and not delay care for fear of being unable to afford IVF per se.

Additionally, loan options are available to many patients. These options change continually and so it’s crucial to do your own research and figure out which you qualify for and the exact interest rates, fees and terms as they apply to your case. Below is a high-level comparison and the facts can change with time or as they pertain to your circumstances.

Loan Summary

We estimate over half of all US fertility clinics offer some sort of “volume bundle” discount (“pay upfront for two cycles, get the third free”) or refund program (“baby or your money back”). These programs are often complex and here’s our guide on the relevant questions to ask.

Finally, Black patients can read assessments of doctors and clinics written by other Black patients. You can go here to begin.