The effect of donor and recipient race on outcomes of assisted reproduction using data from a vitrified donor oocyte bank Público

Abstract

Study question: Does the race of female oocyte donors and recipients affect live birth rates and pregnancy outcomes following vitrified donor oocyte ART?

What is known already: A growing literature suggest that minority races- particularly Black women- have lower probability of live birth and worse pregnancy outcomes after autologous ART; however, questions still remain as to whether these racial disparities are due to differences in oocyte/embryo quality, an impaired uterine environment, or a combination of the two. Oocyte donation ART represents a unique approach to examine this question.

Study design, size, duration: This was a retrospective study conducted at a private fertility clinic that included 327 oocyte donors and 899 oocyte recipients who underwent a total of 1601 embryo transfer cycles between 2008 and 2015. All embryo transfer cycles included in this study used oocytes that were cryopreserved via vitrification for an oocyte bank and later thawed for recipients’ use.

Participants/materials, setting, methods: Self-reported race of the donor and recipient and clinical endpoints were abstracted from medical records. The primary outcome was live birth, which was defined as the delivery of at least one live born neonate in a given embryo transfer cycle. We used multivariable cluster weighted generalized estimating equations with binomial distribution and log link function to evaluate the association between donor and recipient race on ART outcomes adjusted for donor age and BMI, recipient age and BMI, tubal and uterine factor infertility, and year.

Main results and the role of chance: Women who received oocytes from Hispanic donors had significantly higher probability of positive pregnancy test (RR 1.10, 95% CI 1.01, 1.20) and live birth (RR 1.20, 95% CI 1.05, 1.36) compared with women who received oocytes from White donors. Embryo transfer cycles with oocytes from Black donors (RR 0.86, 95% CI 0.72, 1.03) and Black recipients (RR 0.84, 95% CI 0.71, 0.99) had a lower probability of live birth compared to their White counterparts. There was no significant difference in the probability of live birth among Hispanic, Asian, and Other race recipients compared with White recipients.

Table of Contents

Introduction 2

Materials and Methods 3

Study Design and Inclusion Criteria 3

Exposure and Covariate Assessment 4

Recipient Preparation and Outcome Assessment 4

Statistical Analysis 5

Results 7

Discussion 9

Reference 13

Tables 17

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology Health Sciences, Obstetrics and Gynecology
Palabra Clave	race pregnancy live birth ethnicity in vitro fertilization oocyte donor oocyte recipient
Committee Chair / Thesis Advisor	Gaskins, Audrey, Emory University

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