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.