Racial disparities, neighborhood disadvantages present challenges for patients seeking fertility care

Researchers have identified key factors related to racial and socioeconomic disadvantage that may negatively impact reproductive health outcomes. Two posters presented at the 2023 American Society for Reproductive Medicine (ASRM) Scientific Meeting & Exposition address these issues.

The first poster aims to understand the relationship between time to conception and life in disadvantaged areas of the United States.^first Using an academic-based database of more than 50,000 unique births with conception, pregnancy, and birth data from August 2011 to July 2022, researchers obtained records of all singleton births to nulliparous patients who are actively trying to conceive.

For each birth, the researchers assigned a Social Deprivation Index (SDI) score based on the stereotypical ZIP code of residence. The SDI is a composite measure from 1 to 100, comprised of 7 demographic characteristics collected by the American Community Survey based on the following percentages:

• People live in poverty
• People with less than 12 years of education
• Single-parent household
• Live in rented houses
• Living in overcrowded housing
• The household does not have a car
• Unemployed adults

A total of 4788 births were recorded, for which there was a significant association between SDI and time to conception (odds ratio [OR], 1.05; 95% CI, 1.01-1.10) and in models adjusted for age (adjusted OR [aOR], 1.09; 95% CI, 1.04-1.14). This association was also observed in those younger than 35 years at the time of delivery (n = 4234) in unadjusted models (OR, 1.06; 95% CI, 1.01-1.11 ) and adjusted for age (aOR, 1.09; 95% CI, 1.04-1.14)

Thus, the study found that the prejudice of living in a socially disadvantaged neighborhood was associated with increased time to conception in nulliparous gradidae individuals who later gave birth. child is successful.

The second poster aimed to investigate the impact of racial disparities in health insurance coverage for those initiating oocyte preservation due to newly diagnosed cancer.²

The researchers performed a retrospective cohort analysis in a state with mandatory insurance coverage for medically necessary fertility preservation, including for patients with cancer. Sixty-eight patients who completed 72 planned gonadotoxic treatment-induced oocyte preservation were included in the study between October 2010 and March 2023. Forty-one (60.3 %) patients were white; 2 (2.9%), Asian; 5 (7.35%), Black; 5 (7.35%), Hispanic; 1 (1.5), mixed race; and 14 (20.6%) were omitted.

These patients’ electronic medical records were collected, with researchers extracting data regarding patient-identified race/ethnicity and insurance or self-pay status.

The analysis found that the proportion of individuals with insurance for fertility preservation did not differ significantly by race or ethnicity (P = 0.702), and insurance coverage did not differ significantly between White patients and those identifying as minorities (63.4% vs. 53.8%; P = .5373).

These findings suggest that minority individuals seeking fertility preservation with a recent cancer diagnosis and planned gonadotoxic treatment may benefit from living in a states have mandatory coverage for medically necessary fertility preservation and may face fewer disparities because of this.

Presenter

1. Sassin A, Goulding A, Aagaard K. Association between conception time and neighborhood disadvantage measured by social deprivation index (SDI) scores in nulliparous gradidae. Poster presented at: ASRM 2023 Scientific Conference & Exposition; October 14-18, 2023; New Orleans, LA.

2. So M, Koniares K, Godiwala P. Racial disparities in access to fertility preservation for infertile patients are reduced with comprehensive reproductive regulation. Poster presented at: ASRM 2023 Scientific Conference & Exposition; October 14-18, 2023; New Orleans, LA.