Racial and ethnic differences in reproductive potential across the life cycle. 2010

Samantha F Butts, and David B Seifer
Division of Infertility and Reproductive Endocrinology, University of Pennsylvania Medical School, Philadelphia, Pennsylvania, USA. sbutts@obgyn.upenn.edu

OBJECTIVE To review variations in specific reproductive health outcomes by race and ethnicity. A growing number of reports have explored potential gaps in the quality of reproductive health and healthcare across racial and ethnic groups. Diverse results from numerous investigations have made it challenging for practitioners to confirm the significance of these disparities. METHODS Three specific areas of the reproductive life cycle were examined: pubertal onset, outcomes from treatment with assisted reproductive technologies (ART), and the menopausal transition. These areas were selected as they encompass a continuum of events across the reproductive life span of women. Outcomes were compared in black, white, Asian, and Hispanic women. Medline searches querying on keywords puberty, IVF, ART, menopause, menopausal symptoms, racial disparity, race, Asian, Japanese, Chinese, African American, black, Hispanic, and Latino were performed to isolate relevant publications for review. RESULTS Differences across race and ethnicity were noted in each clinical endpoint. The most notable findings included earlier puberty in blacks and Hispanics compared with whites, significantly lower live birth rates after ART in all racial and ethnic groups compared with whites, and differences in perimenopausal symptomatology and possibly timing in various racial/ethnic groups compared with whites. Additional research is needed to completely unravel the full significance and basic underpinnings of these disparities. Some of the limitations of the current state of the literature in drawing conclusions about the independent effect of race/ethnicity on reproductive disparities include small samples sizes in some studies, inconsistencies in the characterization of racial/ethnic groups, and incomplete control of potential confounding. CONCLUSIONS Race and ethnicity appear to be important correlates of outcomes from the initiation of reproduction functioning through to its conclusion. The ultimate goal of identifying racial disparities in reproduction is to isolate the basic determinants of disparities and formulate strategies to improve outcomes for women at risk. The differences demonstrated in this review of the literature could represent environmental, sociocultural, and/or genetic correlates of race that influence these important milestones.

UI MeSH Term Description Entries
D007247 Infertility, Female Diminished or absent ability of a female to achieve conception. Sterility, Female,Sterility, Postpartum,Sub-Fertility, Female,Subfertility, Female,Female Infertility,Female Sterility,Female Sub-Fertility,Female Subfertility,Postpartum Sterility,Sub Fertility, Female
D008593 Menopause The last menstrual period. Permanent cessation of menses (MENSTRUATION) is usually defined after 6 to 12 months of AMENORRHEA in a woman over 45 years of age. In the United States, menopause generally occurs in women between 48 and 55 years of age. Change of Life, Female
D011627 Puberty A period in the human life in which the development of the hypothalamic-pituitary-gonadal system takes place and reaches full maturity. The onset of synchronized endocrine events in puberty lead to the capacity for reproduction (FERTILITY), development of secondary SEX CHARACTERISTICS, and other changes seen in ADOLESCENT DEVELOPMENT. Puberties
D012098 Reproduction The total process by which organisms produce offspring. (Stedman, 25th ed) Human Reproductive Index,Human Reproductive Indexes,Reproductive Period,Human Reproductive Indices,Index, Human Reproductive,Indexes, Human Reproductive,Indices, Human Reproductive,Period, Reproductive,Periods, Reproductive,Reproductive Index, Human,Reproductive Indices, Human,Reproductive Periods
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D044469 Racial Groups Groups of individuals with similar physical appearances often reinforced by cultural, social and/or linguistic similarities. Continental Population Groups,Race,Racial Stocks,Continental Population Group,Group, Continental Population,Group, Racial,Groups, Continental Population,Groups, Racial,Population Group, Continental,Population Groups, Continental,Races,Racial Group,Racial Stock,Stock, Racial,Stocks, Racial
D027724 Reproductive Techniques, Assisted Clinical and laboratory techniques used to enhance fertility in humans and animals. Reproductive Technology, Assisted,Assisted Reproductive Technics,Assisted Reproductive Techniques,Assisted Reproductive Technic,Assisted Reproductive Technique,Assisted Reproductive Technologies,Assisted Reproductive Technology,Reproductive Technic, Assisted,Reproductive Technics, Assisted,Reproductive Technique, Assisted,Reproductive Technologies, Assisted,Technic, Assisted Reproductive,Technics, Assisted Reproductive,Technique, Assisted Reproductive,Techniques, Assisted Reproductive,Technologies, Assisted Reproductive,Technology, Assisted Reproductive

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