Co-authored by Jake Anderson-Bialis, co-founder of FertilityIQ
We know that age plays a major factor in in vitro fertilization success rates. But how about race? New data from a well-regarded fertility clinic suggests white and Hispanic patients enjoy far greater success with IVF than Asian and black patients.
The study results appeared in this month's Fertility and Sterility and showed that 29 - 31% of white and Hispanic patients had successful outcomes compared with 24% of Asian patients and only 17% of black patients. That amounts to a nearly two fold gap in performance between white and black patients. What's more, black patients also suffered a significantly higher number miscarriages along the way.
As fertility patients, many of us closely weigh the costs and benefits before selecting a course of treatment and clinic. The costs are substantial, but often well-established. One round of IVF, with drugs, typically costs $10,000 - $20,000 and given that 85% of Asian and black women live in states with no reimbursement, they often pay this entirely out of pocket.
What is harder to decipher is each patient's own likelihood of success and which clinic offers the best chances to have a healthy child. Add race into the equation and things may get infinitely more opaque. IVF statistics collected at a national level are rarely broken down by race and thus can make it hard for racial groups to know what's truly realistic for them.
When it comes to selecting a clinic, things get no easier. According to our FertilityIQ database, under 5% of U.S. clinics are able, or prepared, to break out their performance by race. More specifically, we could not find a single clinic in New York, Boston, Los Angeles, San Francisco or Houston that tracked success rates by race. In such environments, Asian or black patients may find it particularly hard to know if they are at a clinic that excels with patients like them. For a black patient, maybe that 17 percent success rate is what they can expect on average. Maybe it's the worst in town. Or maybe it's the best. There is simply no way to approximate. We're hoping that our FertilityIQ database can help inform this discussion by asking for each reviewer's race and ethnicity before gathering the details of their experience and outcomes at each clinic.
There is no question this study suffers from limitations, namely its single center nature. However, it has some incredible strengths that make its findings notable. First, it had a large enough patient population to absorb differences in weight and age and still deliver statistically significant results. Second, having all patients treated within a single center removes a lot of the clinic-to-clinic variability endemic in fertility treatment studies. Finally, the trial took place in a state with superb reimbursement, meaning it focused on a real world patient population, and not just those who could foot the bill -- also a rarity for fertility.
Ultimately, we're left to wonder what might drive such uneven racial performance in a well-regarded clinic and whether such a disparity in outcomes is commonplace. Said differently, is this the only clinic experiencing a problem or is this the only clinic acknowledging its problem? In the interim, we're also left to wonder how patients from certain racial minorities ascertain their own odds of success, and where to be treated, when so little data is available.