Survey Finds Racial Disparities among Women Seeking Fertility Care during Pandemic

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Black women were less likely to report being vaccinated against COVID-19 and were more dissatisfied with how major health care systems handled the pandemic compared with women of other races/ethnicities, according to a new survey of women seeking fertility care during the pandemic.

Black women also reported being more comfortable visiting a fertility clinic in-person during the COVID-19 pandemic compared to women of other races/ethnicities, according to findings presented at the American Society for Reproductive Medicine 2022 Scientific Congress & Expo, held in-person in Anaheim, California, October 22-26, 2022.

“It is well-known that there is a racial disparity in medicine in general, and this has also been proven to be the case specifically for assisted reproductive treatment and IVF success rates,” said lead author Marco Mouanness, MD, director of internal medical affairs and cofounder of Rejuvenating Fertility Center in Westport, Connecticut, in the presentation. “In fact, when comparing Black vs. non-Black patients, studies have shown that there is a lower pregnancy rate with assisted reproductive technique in Black patients.”

The effect of the pandemic on racial disparities in access to and outcomes of fertility planning and treatment has not been well studied, according to Mouanness and colleagues. To fill this gap, researchers sent an online survey to all patients who went to a university-affiliated fertility clinic between January 2021 and December 2021 to assess their fertility plans before and during the pandemic.

Investigators collected data about age, race, ethnicity, employment, vaccination, fertility treatments prior to the pandemic, and changes in treatments during the pandemic.

Results

A total of 233 women (mean age 41 years) filled out the questionnaire, according to the study abstract. When all participants were asked about fertility treatment plans prior to the pandemic, 58% reported pursuing in vitro fertilization, 7% said oocyte freezing, 4% said intrauterine insemination, and 31% said fertility work-up.

The majority (69%) of participants reported that the pandemic did not change their fertility plans and the minority reported either postponing or cancelling their fertility treatments with financial instability being the most reported reason (22%).

Investigators noted that fewer Black women were vaccinated compared to non-Black women (35% vs 52%; p=.03). When asked whether the pandemic was well-handled by major health care systems, Black women were less likely to think that it met expectations compared to non-Black women (35% vs 54%; p=.02). In addition, Black women were less likely to be uncomfortable visiting the fertility clinic in-person during the pandemic compared to non-Black women (2% vs 15%; p=.02).

The team did not observe a difference between Black women and non-Black women when they asked participants if they thought that the COVID-19 vaccine could affect fertility or pregnancy outcomes or whether receiving the vaccine stopped them from pursuing fertility treatments (p>.05).

The authors conclude that the COVID-19 pandemic has contributed to racial disparity in fertility treatment and that a clearer understanding of the underlying reasons is needed.

Reference: Mouanness M, Seckin S, Morelli P, Ramadan H, Merhi Z. Racial disparity in health care experience among patients seeking fertility care during the COVID-19 pandemic. Fertil Steril. 2022;118:E86-E87. doi: 10.1016/j.fertnstert.2022.08.263.