Fibroids to blame for fertility problems in blacks

NEW YORK (Reuters Health) - African American women who require assisted reproductive technologies (ART), such as in vitro fertilization, to become pregnant are more likely to experience a miscarriage than are their white counterparts, new research shows.

The reason for the difference, according to the authors, may, in part, relate to African Americans having a higher rate of fibroids, common tumors that grow in the walls of the uterus. Although not cancerous, fibroids can become quite large and may affect pregnancy outcomes.

Prior research has demonstrated that the rates of infertility are similar between white and African American women; however, minority women are less likely to seek infertility services than white women, Dr. Alicia Armstrong and her associates note in their report, published in the medical journal Fertility and Sterility.

Armstrong, from the National Institute of Child Health and Human Development in Bethesda, Maryland, and her team examined the use of ART among women served by the military health care system, in which there is equal access to care and infertility coverage is widely available.

They evaluated outcomes for 1457 patients treated between 1999 and 2003. The proportion of white and African American patients was 66.9 and 17.4 percent, respectively, reflecting the US population at large. In the military system, African American women used ART services at a four-fold higher rate than in the general population of blacks in the US.

Armstrong and her associates found that African Americans and whites had similar rates of pregnancy -- about 41 percent.

However, treatment was less likely to result in live births among African American women and they were more likely to experience a miscarriage.

African-American women were three times as likely to have fibroids than white women, the report shows.

The authors observed that when fibroids were present, there were no significant differences between African-American and Caucasian women with regard to live birth rates. Similarly, women without fibroids had improved outcomes, regardless of race.

"African American patients can be counseled that differences in ART outcomes (are due to multiple factors) and that race alone is not a negative predictor success," Armstrong and her associates conclude.

SOURCE: Fertility and Sterility, April 2006.