22 August 2016
A major new UK study has offered evidence that women's ethnicity can play a potentially significant role in the success of fertility treatments.
Conducted in partnership between the University of Nottingham and the Royal Derby Hospital's fertility unit, the research examined data from nearly 39,000 women and discovered that racial background can affect the rate of successful live births associated with treatments such as in vitro fertilisation (IVF).
Published in BJOG: An International Journal of Obstetrics and Gynaecology, the research was the largest study conducted so far that examined individual ethnic subgroups as an independent factor influencing the success rates of fertility treatments. The majority of the cohort - 73.39 per cent - were white British women, with the remainder made up of white European, Indian, Bangladeshi, Pakistani , Chinese, black British, black African, black Caribbean, Mediterranean European, Middle Eastern, mixed-race and other Asian subjects.
Each of the women were undergoing their first cycle of IVF or intracytoplasmic sperm injections (ICSI) between 2000 and 2010, with the research team analysing fertility outcomes such as the number of eggs retrieved and fertilised, the number of embryos created, and implantation and live birth rates.
It was shown that Irish, Indian, Bangladeshi, Pakistani, black African and other Asian women had a significantly lower odds of a live birth than white British women, while some groups - including Bangladeshi, black African and Middle Eastern women - had a significantly lower number of eggs collected.
Meanwhile Indian, Bangladeshi, Pakistani, black British, black African, black Caribbean and Middle Eastern women were all shown to be at a higher risk of not reaching the embryo transfer stage.
Dr Kanna Jayaprakasan, an associate professor in Gynaecology at the University of Nottingham, said: "The data suggests that ethnicity is a major independent factor determining the chances of IVF or ICSI treatment success. While the reason for this association is difficult to explain, the potential factors could be the observed differences in cause of infertility, ovarian response, fertilisation rates and implantation rates, which are all independent predictors of IVF success.
"The main strengths of the study are the use of the UK HFEA national database which includes a large number of women treated in all UK units. However, the numbers in some of the sub-ethnic minorities, such as Bangladeshi women, were low in the study."
Although women's genetic background could be a potential determinant of their egg and sperm quality, it was suggested that the differences in outcome between the ethnic groups could also have much to do with variations in environmental exposures relating to lifestyle, dietary factors, socioeconomic and cultural factors. Accessibility of fertility treatment and behaviour towards seeking medical care and consequent reproductive outcomes are likely to be affecting these results.
Further research may now be needed to gain a better understanding of the reasons behind these variations in treatment outcomes between ethnic groups, with future studies incorporating ethnicity as a major determinant factor.
Posted by Philip Briggs
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