Pandemic contributes to disparities for Black women seeking fertility treatment
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ANAHEIM, Calif. — Compared with other women, Black women pursuing fertility treatment reported greater barriers to care during the COVID-19 pandemic, according to data presented here.
“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,” Marco Mouanness, MD, a reproductive endocrinology and infertility specialist at Rejuvenating Fertility Center in Westport, Connecticut, said in a 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.”
Throughout 2021, Mouanness and colleagues sent an online survey to patients at their fertility clinic to assess their fertility plans before and during the pandemic. The survey also collected data about sociodemographics, vaccination status and perspectives on fertility care access during the pandemic. The researchers specifically examined differences between Black patients and those of other racial and ethnic backgrounds to assess whether the pandemic exacerbated known racial disparities.
Changes in treatment
In total, 223 patients (mean age, 41 years) responded to the survey, 22% of whom were Black.
Prior to the pandemic, 58% of patients were pursuing IVF, 31% were pursuing fertility workups, 7% were pursuing oocyte cryopreservation and 4% were pursuing intrauterine insemination. Most (69%) reported no changes in their fertility plans, with 25% reporting any postponement of treatment, 4% reporting changes in their fertility plans and 2% reporting cancelation of fertility treatment. The most commonly reported reason for postponing or canceling treatment was financial instability (22%).
Pandemic views
Compared with women of other races and ethnicities, Black women were less likely to be vaccinated (52% vs. 35%; P = .03), less likely to say major health systems handled the pandemic well (54% vs. 35%; P= .02) and less likely to report comfort with in-person appointments during the pandemic (15% vs. 2%; P = .02).
The researchers also asked about nontraditional health care, such as telehealth and mobile clinics.
“We wanted to see whether there was a racial disparity when it came to telehealth [for fertility care] itself, and our results showed that there was no statistical difference between groups, with an inclination in both groups for in-person treatment,” Mouanness said. “However, both groups also said they would utilize home or mobile monitoring in the case it was offered to them.”
Mouanness said future studies should enroll a larger, more racially and ethnically diverse cohort to confirm the findings and evaluate other disparities.
Perspective
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Racial disparities for COVID-19 have been well-documented, but less is known about how these disparities interacted with care-seeking behaviors for fertility services during the pandemic. This study compared vaccination status, attitudes about the pandemic and in-person care vs. telehealth between Black and non-Black patients accessing fertility services. Black patients were less likely to be vaccinated, less likely to believe that major health care systems handled the pandemic properly and were much less likely to visit the office in person for care, compared with non-Black patients. The twin crises of structural racism and the COVID-19 pandemic continue to have far-reaching effects, including access to fertility care and beliefs about health care services.
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Mouanness M, et al. Racial disparity in health care experience among patients seeking fertility care during the COVID-19 pandemic. Presented at: ASRM Scientific Congress & Expo; Oct. 22-26, 2022; Anaheim, California.
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