Back to Search
Start Over
Racial and Ethnic Differences in Pregnancy Rates Following Intrauterine Insemination with a Focus on American Indians
- Source :
- Journal of Racial and Ethnic Health Disparities. 5:1077-1083
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- BACKGROUND: No research exists on American Indian pregnancy rates following infertility treatment. Most racial/ethnic fertility research has focused on pregnancy following in vitro fertilization, with only rare studies looking at intrauterine insemination (IUI). The objective of our study was to compare fecundability following IUI by race/ethnicity, with a special focus on American Indians. METHODS: This was a retrospective analysis of subjects undergoing IUI July 2007—May 2012 at a university-based infertility clinic. The primary outcome was positive pregnancy test, with a secondary outcome of ongoing pregnancy/delivery (OP/D). We calculated risk ratios (RR) and 95% confidence intervals (CI) using cluster-weighted generalized estimating equations method to estimate modified Poisson regression models with robust standard errors to account for multiple IUI cycles in the same patient. RESULTS: A total of 663 females (median age 32) undergoing 2007 IUI cycles were included in the analysis. Pregnancy rates overall were 15% per IUI cycle. OP/D rates overall were 10% per IUI cycle. The American Indian patients had significantly lower pregnancy (RR 0.34, 95%CI 0.16–0.72) and OP/D rates (RR 0.33, 95%CI 0.12–0.87) compared to non-Hispanic whites when patient and cycle characteristics were controlled. Pregnancy and OP/D rates for blacks, Asians and Hispanics did not differ from non-Hispanic whites. CONCLUSIONS: Our finding of lower IUI treatment success among American Indian patients is novel, as no published studies of assisted reproductive technology or other fertility treatments have examined this subgroup separately. Further investigation of patient and clinical factors that may mediate racial/ethnic disparities in fertility treatment outcomes is warranted.
- Subjects :
- Adult
Infertility
medicine.medical_specialty
Health (social science)
Pregnancy Rate
Sociology and Political Science
medicine.medical_treatment
media_common.quotation_subject
Fertility
Article
White People
Young Adult
03 medical and health sciences
symbols.namesake
0302 clinical medicine
Pregnancy
medicine
Humans
Positive Pregnancy Test
030212 general & internal medicine
Poisson regression
Insemination, Artificial
Retrospective Studies
media_common
030219 obstetrics & reproductive medicine
Assisted reproductive technology
Asian
Obstetrics
business.industry
Health Policy
Pregnancy Outcome
Public Health, Environmental and Occupational Health
Hispanic or Latino
medicine.disease
Confidence interval
Black or African American
Treatment Outcome
Anthropology
Relative risk
Indians, North American
symbols
Female
business
Subjects
Details
- ISSN :
- 21968837 and 21973792
- Volume :
- 5
- Database :
- OpenAIRE
- Journal :
- Journal of Racial and Ethnic Health Disparities
- Accession number :
- edsair.doi.dedup.....41f3bc0da0ad2c12d6922506c3835bc4