Investigators identify racial differences in IVF outcomes.(Gynecology)

PHILADELPHIA -- Asian women and black women seem to start out with a 5-year disadvantage when they seek in vitro fertilization.

A pair of retrospective studies presented at the annual meeting of the American Society for Reproductive Medicine found that Asian patients had significantly fewer pregnancies or live births after IVF with fresh, nondonor cycles than did non-Asian women. One of the studies also found the same phenomenon for black women, compared with white or Hispanic women.

"Being 35 and Asian is the equivalent of being 40 and white," said Karen J. Purcell, M.D., of the University of California, San Francisco, at a press conference held during the meeting.

Dr. Purcell, who presented one of the studies, said the IVF pregnancy rate for Asian women at the age of 35 mirrored that of all races for women who are 40. She recommended that Asian women who have never been pregnant and are trying to have a child act quickly to obtain treatment. "If you are Asian, and you are 34 and wait until 37 [to seek IVF], you have changed your pregnancy rate a huge amount, while you haven't really changed it that much if you are Caucasian."

Dr. Purcell and colleagues analyzed information on 1,159 cycles in a UCSF database with IVF data from 2001 to 2003. All cycles involved fresh, nondonor embryos. About a quarter of the cycles were in Asian women, predominately of Japanese ancestry. Asian patients were 35% less likely to achieve a clinical pregnancy than were Caucasian women and 39% less likely to have an ongoing pregnancy.

Ultrasound scans showed that Asian patients were less likely to have a visualized gestational sac, and they had a lower pregnancy rate. The groups were similar for mean age, day 3 FSH level, starting dose of gonadotropins, total amount of medication used, number of follicles that were at least 13 mm, and total number of eggs retrieved or embryos transferred.

Even though Asian patients' peak estradiol levels were higher, there were significantly fewer follicles that were 18 mm or larger among these patients. "By parameters we normally use to judge a good cycle," she said, "Asians actually ...