ART Outcomes in Black Patients

There is a long-standing history of poor reproductive outcomes among Black patients compared to their White counterparts. This is as true for Black patients using in vitro fertilization (IVF) as it is for those who conceive spontaneously. Despite efforts to improve access to care, Black patients face unique barriers to establishing care with an infertility clinic and identifying providers with whom they identify. Additionally, although insurance mandates for the inclusion of fertility benefits are intended to increase assisted reproductive technology (ART) utilization among minority groups, they appear to primarily benefit groups who already have access to these services. Once pregnant, Black patients have higher miscarriage rates than their White peers, even when controlling for pelvic pathologies or the use of donor oocytes, suggesting that other factors, such as physician implicit biases and structural inequities, may be playing a role in these poorer outcomes. This chapter reviews the disparities in access and outcomes for Black patients seeking infertility care. These disparities cannot be explained by any single factor, illuminating the need for intervention at the individual, systemic, and structural level to work towards equitable outcomes for all patients.