Tubal Factor Infertility, In Vitro Fertilization, and Racial Disparities: A Retrospective Cohort in Two US Clinics.

Autor:	Anyalechi GE; From the Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA., Wiesenfeld HC; University of Pittsburgh School of Medicine and Magee-Women's Research Institute, Pittsburgh, PA., Kirkcaldy RD; From the Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA., Kissin DM; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA., Haggerty CL, Hammond KR; Alabama Fertility Specialists., Hook EW 3rd; Department of Medicine, University of Alabama at Birmingham, Birmingham, AL., Bernstein KT; From the Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA., Steinkampf MP; Alabama Fertility Specialists., Geisler WM; Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.
Jazyk:	angličtina
Zdroj:	Sexually transmitted diseases [Sex Transm Dis] 2021 Oct 01; Vol. 48 (10), pp. 748-753.
DOI:	10.1097/OLQ.0000000000001435
Abstrakt:	Background: Nearly 14% of US women report any lifetime infertility which is associated with health care costs and psychosocial consequences. Tubal factor infertility (TFI) often occurs as a result of sexually transmitted diseases and subsequent pelvic inflammatory disease. We sought to evaluate for and describe potential racial disparities in TFI and in vitro fertilization (IVF) prevalence. Methods: Records of women aged 19 to 42 years in our retrospective cohort from 2 US infertility clinics were reviewed. We calculated TFI prevalence, IVF initiation prevalence, and prevalence ratios (PRs), with 95% confidence intervals (CIs) for each estimate, overall and by race. Results: Among 660 infertile women, 110 (16.7%; 95% CI, 13.8-19.5%) had TFI which was higher in Black compared with White women (30.3% [33/109] vs 13.9% [68/489]; PR, 2.2 [95% CI, 1.5-3.1]). For women with TFI, IVF was offered to similar proportions of women by race (51.5% [17/33] vs 52.9% [36/68] for Black vs White women); however, fewer Black than White women with TFI started IVF (6.7% [1/15] vs 31.0% [9/29]; PR, 0.2 [95% CI, 0-1.0]), although the difference was not statistically different. Conclusions: Tubal factor infertility prevalence was 2-fold higher among Black than White women seeking care for infertility. Among women with TFI, data suggested a lower likelihood of Black women starting IVF than White women. Improved sexually transmitted disease prevention and treatment might ameliorate disparities in TFI. Competing Interests: Conflicts of Interest: K.R.H. is on the Speakers bureau for AbbVie, and W.M.G. has received research funds and consulting fees from Hologic and consulting fees from Roche. The other authors declare no conflicts of interest. (Copyright © 2021 American Sexually Transmitted Diseases Association. All rights reserved.)
Databáze:	MEDLINE
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