Elective Single Embryo Transfer May Be Less Successful for in Ethnic Minority Groups

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Minority women appear to experience less success with elective single embryo transfer.
Minority women appear to experience less success with elective single embryo transfer.

Despite similar demographic variables, the clinical pregnancy rate for women who undergo elective single embryo transfer (eSET) was lower for non-Caucasian patients than it was for Caucasian patients, according to results presented at the American Society for Reproductive Medicine (ASRM) Annual Meeting in Baltimore.

“Our data indicated that minority women have a significantly lower odds ratio … for [clinical pregnancy rate] in eSET cycles,” Charalampos Chatzicharalampous, MD, MS, researcher from the Brooklyn Hospital Center in Brooklyn, New York, said in an interview. “However, in [elective double embryo transfer (eDET)] cycles, the [clinical pregnancy rate] did not differ by ethnicity.”

Dr Chatzicharalampous told Endocrinology Advisor that the impetus for the study involved recent articles on racial disparities in in vitro fertilization (IVF) outcomes, as well as the high rate of minority patients in the practices of study investigators.

The retrospective analysis featured women who underwent IVF or intracytoplasmic sperm injection (ICSI) between 2010 and 2013. All women were aged younger than 38 years and had less than 2 previous fresh IVF cycles.

Ethnic groups in the analysis were Caucasian, African American, Asian, and Hispanic, which were dichotomized into 2 main groups: Caucasian and non-Caucasian.

Overall, 565 fresh embryo transfer cycles — 214 single and 351 double — were examined.

There were no significant differences between the 2 ethnic groups in age; BMI; day 3 follicle-stimulating hormone; gravidity; parity; number of previous fresh cycles, oocytes retrieved, and total and quality of blastocysts; and fertilization rate. However, non-Caucasians experienced higher peak estradiol levels (P=.02).

Dr Chatzicharalampous and colleagues reported a comparable rate of infertility diagnoses between groups, except for more tubal factor in non-Caucasian women (P=.001) and more incidences of unexplained infertility in Caucasian women (P=.02).

Among women who received eSET, those who were Caucasian had a higher clinical pregnancy rate compared with ethnic minorities (49% vs 27%; P=.02), a difference that remained after accounting for differences in infertility diagnosis.

In the eDET cohort, however, there was no significant difference in the clinical pregnancy rate between groups (Caucasian, 45% vs non-Caucasian, 44%).

In addition, Dr Chatzicharalampous said, “The multiple gestation rates in eSET and eDET were similar, but the ectopic rate was markedly higher in the eDET ethnic minority group.”

Although a greater percentage of minority women electively received 2 embryos, Dr Chatzicharalampous noted that further research is necessary to identify any confounding factors that could help determine which minority women might benefit from an even more liberal use of eDET.

Reference

  1. Chatzicharalampous C, Stelling J, Jenkins J, Saketos M, Sung L, Bray MA. Abstract O-271. Should Embryo Transfer Number Be Upgraded in Ethnic Minority Groups? Presented at: ASRM Annual Meeting; Oct. 17-21, 2015; Baltimore. 
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