Impact of race versus ethnicity on infertility diagnosis between Black
American, Haitian, African, and White American women seeking infertility
care: a retrospective review
Abstract
Objective: Studies have examined the impact of race on infertility, but
few have compared ethnic differences in infertility within a given race.
We sought to determine whether infertility etiologies differ between
Black ethnic subgroups. Design/Setting: Retrospective study in an urban
safety net hospital. Population: Women seeking infertility care between
2005-2015. Methods: Charts of women with infertility and PCOS ICD-9
diagnoses were reviewed to confirm diagnoses. Data was stratified by
race and subsequently by ethnicity to evaluate differences in
infertility etiologies between Black American, Haitian, and African
women. White American women were used as the comparison group. Main
outcome measures: Infertility diagnoses between ethnic groups. Results:
A total of 358 women met inclusion criteria including 99 Black American,
110 Black Haitian, 61 Black African, and 88 White American women.
Anovulation/polycystic ovarian syndrome (PCOS) was the most common
diagnosis in each ethnic group, accounting for 40% of infertility among
White American, 57% among Black American, 25% among Haitian, and 21%
among African women. There were no significant differences in individual
infertility diagnoses between Black and White women. Between ethnic
subgroups, multivariate analysis showed significantly higher odds of
infertility due to anovulation/PCOS in Black American women compared to
African women (odds ratio [OR]=4.9; 95% CI=1.4-17.0). Compared to
African women, higher odds of tubal factor infertility were observed in
Black American (OR=4.7; 95% CI=1.16-18.7) and Haitian women (OR=4.0;
95% CI=1.1-14.0). Conclusions: Causes of infertility weren’t
homogeneous across Black ethnic groups. Studies examining infertility
should specify ethnic subgroups within race as this may affect results.