Ethnic Differences in Fertility and Assisted Reproduction

Over the past 10 years, studies have shown that the rates of fertility vary in different ethnic groups. Ethnic differences also play a significant role in the outcome of assisted reproductive technology (ART) cycles. In the United States, minority groups--African Americans, Hispanics (mainly Mexicans and Central Americans), East Asians (Chinese, Japanese, Koreans, Philippinos) and South Asians (Indians, Pakistanis, and Bengalis)--have significantly lower chances of live births compared to Caucasian women. Birth outcome data collected by the Society for Assisted Reproductive Technology shows a worsening trend in conception rates between the years 1999-2000 and 2004-2006, raising more concern that the disparity in fertility rates between minority groups and white women is widening over time. This comprehensive book serves to answer the questions that arise when managing infertility in a multi-ethnic population. An expert assembly of key leaders in the field of reproductive medicine imparts insight and clinical experience in order to identify and analyze the possible causes of racial disparities in fertility outcome. Some of the reviewed causes include higher Body Mass Index (BMI), tubal diseases, metabolic syndrome, and fibroids in African Americans; tubal disease and higher early pregnancy loss in Hispanics; higher incidence of diminished ovarian reserve and lower BMI in East Asians; and higher incidence of polycystic ovarian disease (PCOS) in South Asians. The book also provides a review of data on access to care and ART services in developing countries. A thoughtful combination of evidence-based medicine and advanced treatment options, this book is sure to distinguish itself as the definitive reference on ethnic differences in assisted reproduction. ?

Fady Sharara, M.D. is Clinical Professor at George Washington University, Dept of OB/GYN and the Medical Director of the Virginia Center for Reproductive Medicine. Dr. Sharara has authored more than 80 peer-reviewed papers and book chapters. His clinical research includes racial disparities in IVF outcome, prevention of ovarian hyperstimulation syndrome, ovarian stimulation protocols, ovarian reserve testing, and the role of Vitamin D in reproduction, among others.