No Prior ART | Prior ART | |||||
---|---|---|---|---|---|---|
Black (n = 8458) | White (n = 64,878) | Black (n = 5259) | White (n = 44,126) | |||
Characteristics (% reporting) | % (95% CI) | % (95% CI) | p | % (95% CI) | % (95% CI) | p |
Women’s age (year) | < 0.001 | < 0.001 | ||||
< 35 | 38.5 (37.5–39.6) | 54.6 (54.2–55) | 20.9 (19.8–22.1) | 32.2 (32.2–33.1) | ||
35–37 | 22.4 (21.5–23.3) | 21.2 (20.8–21.5) | 17.7 (16.6–18.7) | 21.9 (21.5–22.3) | ||
38–40 | 19.8 (18.9–20.6) | 15.2 (14.9–15.4) | 24.7 (23.6–25.9) | 22.1 (21.7–22.4) | ||
41–42 | 10.1 (9.4–10.7) | 5.7 (5.5–5.8) | 16.3 (15.3–17.3) | 11.8 (11.5–12.1) | ||
> 42 | 9.3 (8.7–9.9) | 3.5 (3.3–3.6) | 20.4 (19.3–21.5) | 11.7 (11.4–12) | ||
BMI > =30 | 47.4 (46.4–48.5) | 31.5 (31.1–31.9) | <.001 | 49.4 (48–50.7) | 34.5 (34.1–35) | < 0.001 |
Nulliparous | 55.6 (54.1–57.1) | 51.2 (50.5–51.8) | < 0.001 | 53.3 (51.7–55) | 44.4 (43.8–44.9) | < 0.001 |
Past spontaneous abortions | 28.6 (27.6–29.6) | 20.2 (19.9–20.5) | < 0.001 | 41.1 (39.8–42.5) | 32.8 (32.4–33.3) | < 0.001 |
Diagnosis | ||||||
Tubal Factor | 29.8 (28.8–30.8) | 11 (10.8–11.2) | < 0.001 | 29.1 (27.8–30.3) | 10.4 (10.2–10.7) | < 0.001 |
Tubal Ligation | 3.2 (2.8–3.6) | 1.7 (1.6–1.8) | < 0.001 | 2.1 (1.7–2.5) | 1 (0.9–1.1) | < 0.001 |
Hydrosalpinx | 2.9 (2.6–3.3) | 0.8 (0.7–0.8) | < 0.001 | 2.9 (2.5–3.4) | 0.7 (0.6–0.8) | < 0.001 |
Other | 24.2 (23.3–25.2) | 8.6 (8.4–8.9) | < 0.001 | 24.5 (23.4–25.7) | 8.8 (8.6–9.2) | < 0.001 |
Male Infertility | 31.6 (30.6–32.6) | 34.2 (33.9–34.6) | < 0.001 | 31.3 (30.1–32.6) | 36 (35.5–36.4) | < 0.001 |
Uterine Factor | 12.6 (11.9–13.4) | 3.8 (3.6–3.9) | < 0.001 | 14.5 (13.6–15.5) | 4.5 (4.3–4.7) | < 0.001 |
History of endometriosis | 6 (5.5–6.5) | 9.2 (9–9.4) | < 0.001 | 7.4 (6.7–8.1) | 9.8 (9.5–10.1) | < 0.001 |
Diminished ovarian reserve | 27.4 (26.4–28.3) | 21.5 (21.2–21.8) | < 0.001 | 44.9 (43.5–46.2) | 41.3 (40.8–41.7) | 0.73 |
Unexplained | 7.3 (6.7–7.9) | 13.3 (13–13.6) | < 0.001 | 5.7 (5.1–6.4) | 10.4 (10.1–10.7) | < 0.001 |
Ovulation Disorder (PCOS) | 9 (8.4–9.6) | 13.9 (13.7–14.2) | < 0.001 | 6.8 (6.1–7.5) | 10.2 (10–10.5) | < 0.001 |
Other | 22.5 (21.6–23.4) | 25.5 (25.1–25.8) | < 0.001 | 20.4 (19.3–21.5) | 21.2 (20.9–21.6) | 0.15 |
Metrics of ovarian reserve | ||||||
Day 3 FSH > =10 (IU/L) | 71.8 (70.8–72.8) | 65.4 (65.1–65.8) | < 0.001 | 81.2 (80.1–82.2) | 74 (73.6–74.4) | < 0.001 |
Mean Day 3 FSH (IU/L) | 11.5 (11.2–11.83) | 11.7 (11.65–11.75) | 0.217 | 11.6 (11.55–11.65) | 12.0 (11.7–12.2) | 0.024 |
FSH dosage > = 37 ampules (91.7) | 59 (57.9–60.1) | 52.2 (51.8–52.6) | < 0.001 | 69 (67.7–70.4) | 64.8 (64.3–65.2) | < 0.001 |
Mean AMH (ng/mL) | 3.2 (3.1–3.3) | 3.4 (3.4–3.4) | 0.003 | 2.1 (2.0–2.2) | 2.3(2.3–2.3) | < 0.001 |
AMH < 1 among women< 40 yr | 13.4 (12.6–14.3) | 13.4 (13.1–13.6) | 0.95 | 21.7 (20.2–23.3) | 21 (20.6–21.5) | 0.4 |
High ovarian response | 0.8 (0.7–10.6) | 0.5 (0.4–0.5) | < 0.001 | 1 (0.8–1.3) | 0.7 (0.7–0.8) | 0.049 |
Mean oocytes retrieved | 13.8 (13.6–14.0) | 14.3 (14.2–14.4) | < 0.001 | 14.4 (14.1–14.7) | 14.5 (14.4–14.6) | 0.52 |
Mean embryos cryopreserved | 2.70 (2.61–2.79) | 2.75 (2.72–2.78) | 0.24 | 1.29 (1.22–1.36) | 1.30 (1.28–1.32) | 0.77 |
Cycle Cancelled | 12.9 (12.2–13.6) | 9.9 (9.6–10.1) | < 0.001 | 17.1 (16.1–18.1) | 13.3 (13.0–13.6) | < 0.001 |
Due to low response | 76.4 (73.8–78.9) | 84.1 (83.2–85) | < 0.001 | 77 (74.1–79.7) | 80.1 (79.1–81.1) | 0.03 |
ICSI | 57.7 (56.7–58.8) | 61.2 (60.8–61.6) | < 0.001 | 58.3 (56.9–59.6) | 63.9 (63.4–64.3) | < 0.001 |
No of embryos | < 0.001 | 0.018 | ||||
1 | 34.9 (33.6–36.3) | 38.2 (37.7–38.6) | 25.6 (24–27.3) | 26.3 (25.8–26.8) | ||
2 | 53.4 (52–54.8) | 54.1 (53.6–54.6) | 51.5 (49.7–53.4) | 53.1 (52.5–53.7) | ||
3+ | 11.7 (10.8–12.6) | 7.7 (7.5–8) | 22.8 (21.3–24.4) | 20.6 (20.1–21.1) | ||
No. of embryos transferred: mean (sd) | 1.8 (0.74) | 1.7 (0.67) | < 0.001 | 2.06 (0.9) | 2.02 (0.88) | 0.03 |
Implantation rate %: mean (sd) | 72.4 (32.4) | 76.5 (33.4) | < 0.001 | 63.9 (35.3) | 67.1 (34.1) | 0.01 |
Treatment outcome | ||||||
Clinical intrauterine gestation (CIG) | 24.4 (23.5–25.3) | 33 (32.7–33.4) | <.001 | 17.2 (16.2–18.2) | 25.1 (24.7–25.3) | < 0.001 |
Spontaneous abortion | 21 (19.3–22.8) | 14.5 (14–15) | 0.2 | 27.5 (24.6–30.5) | 18.6 (17.8–19.3) | <.001 |
Live birth per CIG | 76.4 (74.5–78.2) | 84.6 (84.1–85) | <.001 | 69.8 (66.6–72.7) | 80.5 (79.7–81.2) | < 0.001 |
Biochemical pregnancy | 4.8 (4.4–5.3) | 5.7 (5.5–5.9) | 0.0013 | 4.2 (3.7–4.8) | 5.7 (5.5–6) | < 0.001 |
Ectopic or heterotopic | 0.5 (0.4–0.7) | 0.5 (0.5–0.6) | 0.75 | 0.3 (0.1–0.5) | 0.5 (0.4–0.6) | 0.02 |
Not pregnant | 58.3 (57.2–59.4) | 47.2 (46.8–47.6) | <.001 | 68.4 (67.1–70) | 58.3 (57.8–58.7) | < 0.001 |
Live birth per cycle started | 18.6 (17.8–19.5) | 27.9 (27.6–28.3) | <.001 | 12 (11.1–12.9) | 20.2 (19.8–20.6) | < 0.001 |
Plurality of birth (24) | <.001 | < 0.001 | ||||
Singleton | 76 (73.8–78) | 76.9 (76.2–77.5) | 75.2 (71.7–78.5) | 75.8 (74.9–76.6) | ||
Twins | 21.2 (19.2–23.3) | 21.9 (21.3–22.5) | 21.1 (18–24.5) | 22.6 (21.8–23.5) | ||
Triples or more | 2.8 (2.1–3.8) | 1.3 (1.1–1.5) | 3.7 (2.4–5.5) | 1.6 (1.3–1.9) | ||
eSET (%) < 38 y/o (44.1) | 21 (19.9–22.2) | 23.9 (31.5–31.9) | <.001 | 12.7 (11.3–14.2) | 13.9 (13.4–14.3) | 0.16 |
States | ||||||
Mandated | 34.7 (33.7–35.7) | 27.7 (27.4–28.1) | <.001 | 39.8 (38.4–41.1) | 32.4 (32–32.9) | <.001 |
Non-mandated | 65.1 (64.1–66.1) | 71.5 (71.1–71.8) | <.001 | 60.2 (58.9–61.5) | 67 (66.5–67.4) | <.001 |