These data suggest that specific types of dietary fat are associated with the incidence of laparoscopically confirmed endometriosis, and that these relations may indicate modifiable risk. This evidence additionally provides another disease association that supports efforts to remove trans fat from hydrogenated oils from the food supply.

Objective To evaluate ethnic differences in assisted reproductive technology (ART) outcomes in the United States. Design Historical cohort study. Setting Clinic-based data. Patient(s) A total of 139,027 ART cycles from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System online database for 2004–2006, limited to white, Asian, black, and Hispanic women. Intervention(s) None. Main Outcome Measure(s) Logistic regression was used to model the odds of pregnancy and live birth; among singletons and twins, the odds of preterm birth and fetal growth restriction. Results are presented as adjusted odds ratios, with white women as the reference group. Result(s) The odds of pregnancy were reduced for Asians (0.86), and the odds of live birth were reduced for all groups: Asian (0.90), black (0.62), and Hispanic (0.87) women. Among singletons, moderate and severe growth restriction were increased for all infants in all three minority groups (Asians [1.78, 2.05]; blacks [1.81, 2.17]; Hispanics [1.36, 1.64]), and preterm birth was increased among black (1.79) and Hispanic women (1.22). Among twins, the odds for moderate growth restriction were increased for infants of Asian (1.30) and black women (1.97), and severe growth restriction was increased among black women (3.21). The odds of preterm birth were increased for blacks (1.64) and decreased for Asians (0.70). Conclusion(s) There are significant disparities in ART outcomes according to ethnicity.

Objective To compare the risks for adverse pregnancy and birth outcomes by diagnoses with and without ART treatment to non-ART pregnancies in fertile women. Design Historical cohort Setting Massachusetts vital records linked to ART clinic data from SART CORS Patients Diagnoses included male factor (ART only), endometriosis, ovulation disorders, tubal (ART only) and reproductive inflammatory disorders (non-ART only). Pregnancies resulting in singleton and twin live births from 2004–08 were linked to hospital discharges in women who had ART treatment (N=3,689), women with no ART treatment in the current pregnancy (N=4,098) and non-ART pregnancies to fertile women (N= 297,987). Interventions None Main Outcome Measures Risks of gestational diabetes, prenatal hospitalizations, prematurity, low birth weight, and small-for-gestation were modeled using multivariate logistic regression with fertile deliveries as the reference group adjusted for maternal age, race/ethnicity, education, chronic hypertension, diabetes mellitus, and plurality (adjusted odds ratios, AORs, and 95% confidence intervals, CI). Results Risk of prenatal hospital admissions was increased for endometriosis (ART 1.97, 1.38–2.80; non-ART 3.34, 2.59–4.31), ovulation disorders (ART 2.31, 1.81–2.96; non-ART 2.56, 2.05–3.21), tubal (ART 1.51, 1.14–2.01), and reproductive inflammation (non-ART 2.79, 2.47–3.15). Gestational diabetes was increased for women with ovulation disorders (ART 2.17, 1.72–2.73; non-ART 1.94, 1.52–2.48). Preterm delivery (AORs 1.24–1.93) and low birthweight (AORs 1.27–1.60) were increased in all groups except endometriosis with ART. Conclusions The findings indicate substantial excess perinatal morbidities associated with underlying infertility-related diagnoses in both ART-treated and non-ART-treated women.