Racial and ethnic disparities in assisted reproductive technology pregnancy and live birth rates within body mass index categories

Objective To evaluate the effect of maternal race and ethnicity within body mass index (BMI) categories on assisted reproduction technology (ART) pregnancy and live birth rates. Design Historical cohort study. Setting Clinic-based data. Patient(s) 31,672 ART embryo transfers from the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System for 2007, limited to women with documented race, ethnicity, height, and weight, with women grouped as white, Asian, Hispanic, or black and by BMI. Intervention(s) None. Main Outcome Measure(s) Failure to achieve a clinical intrauterine gestation and failure to achieve a live birth as adjusted odds ratios within BMI categories overall with normal-weight women as the reference group, and by race and ethnicity with white women as the reference group. Result(s) Failure to achieve a clinical intrauterine gestation was significantly more likely among obese women overall (1.22), normal-weight and obese Asian women (1.36 and 1.73, respectively), normal-weight Hispanic women (1.21), and overweight and obese black women (1.34 and 1.47, respectively). Among women who did conceive, failure to achieve a live birth was significantly more likely among overweight and obese women overall (1.16 and 1.27, respectively), overweight and obese Asian women (1.56 and 2.20, respectively) and Hispanic women (1.57 and 1.76, respectively), and normal-weight and obese black women (1.45 and 1.84, respectively). Conclusion(s) These findings indicate significant disparities in pregnancy and live birth rates by race and ethnicity, even within BMI categories.