Neighborhood Deprivation and Outcomes of Donor Oocyte IVF in Georgia Restricted; Files Only
Suresh, Tanvi (Spring 2023)
Abstract
Background. Socioeconomically disadvantaged neighborhoods have adverse effects on reproductive health outcomes. However, the extent to which the neighborhood environment affects female fertility outcomes remains unclear. By utilizing a donor oocyte cohort, we can gain insights into the effects exclusively at the oocyte level.
Objective. To examine the relation of neighborhood deprivation index (NDI) to markers of ovarian reserve and outcomes of controlled ovarian stimulation among young, healthy oocyte donors.
Design. Retrospective cohort study.
Setting. Reproductive Biology Associates, a private fertility center in Sandy Springs,
Georgia, USA.
Patients. 547 oocyte donors who underwent a total of 905 retrieval cycles
between 2008 and 2020.
Intervention(s). None.
Main outcome measure(s). Markers of ovarian reserve, antral follicle count(AFC) and anti-Mullerian hormone(AMH) levels, and outcomes of controlled ovarian stimulation, total number of oocytes retrieved and total number of mature oocytes retrieved.
Results. Among our population of oocyte donors, the mean age was 25 years and 71% identified as White, 12% Black, 6% Asian, 5% Hispanic, and 6% Other. There was no association between donor NDI and markers of ovarian reserve. The adjusted mean AMH and AFC value among women in the lowest quintile of neighborhood deprivation was 4.7 (95% CI 4.1, 5.5) and 38.9 (95% CI 36.9, 41.4) compared to 4.9 (95% CI 4.4, 5.5) and 39.5 (95% CI 36.9, 42.4) among women in the highest NDI quintile. There was a modest negative association between NDI quintile and total number of oocytes retrieved. Donors from the most deprived neighborhoods had a lower adjusted mean count of 32.9 (95% CI 31.0, 34.9) total oocytes retrieved compared to donors from least deprived neighborhoods with an adjusted mean count of 34.7 (95% CI 32.2, 37.5). When analyses were stratified by race, little significant differences were observed; however, the association between NDI and total oocyte count was only evident among White donors.
Conclusions. Among our large donor oocyte cohort, we found no associations between NDI and markers of ovarian reserve and only a modest negative association between NDI and total number of oocytes retrieved. Future research might focus on additional measures of neighborhood deprivation and cumulative impacts over time.
Table of Contents
Introduction ................................................................................................................................ 1
Methods ....................................................................................................................................... 2
Results .......................................................................................................................................... 5
Discussion ................................................................................................................................... 7
References .................................................................................................................................. 10
Tables and Figures ................................................................................................................... 14
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