Primary ovarian insufficiency: a glimpse into the racial and socioeconomic disparities found within third-party reproduction

Abstract

Objective: To describe a unique case of primary ovarian insufficiency and review the systemic barriers in place that hinder reproductive autonomy for Black women who require third-party reproduction. Design: Case report and review of the literature. Setting: Safety-net hospital in an urban community. Patient(s): A 36-year-old Black woman, gravida 0, with primary ovarian insufficiency who desires future fertility but is restricted by systemic barriers. Intervention(s): Chromosome analysis. Main Outcome Measure(s): Not applicable. Result(s): Balanced reciprocal translocation between chromosomes 1 and 13: 46,XX,t(1;13)(q25;q14.1). Conclusion(s):The field of assisted reproductive technology has evolved at an exponential rate, yet it unfortunately benefits some and not all. It is imperative that when we advocate for full spectrum infertility care, that this encompasses everyone. As we continue to further study and develop assisted reproductive technology, we must not forget to consider the factors leading to racial and socioeconomic disparities in reproductive care access, utilization, and outcomes.

Why Causation Matters

“…These two pathways are by no means exhaustive, and the complexity, various mechanisms, and epidemiologic underpinnings by which anti-Black racism negatively affects the health and well-being of Black women are being examined across disciplines and diverse fields of medicine. [10][11][12][13][14][15][16][17] Simultaneously, the use of Black "race" as a risk factor in medicine is being challenged across various health outcomes. [18][19][20][21] Accordingly, the intention of this article is to encourage a paradigm shift in our causal frameworks, one that embraces anti-racist thinking and praxis by recognizing the harm and limitedness of maintaining a race-based paradigm that labels Black "race" as the risk factor and instead names anti-Black racism as the root cause of these persistent disparities, thereby revealing important and highly treatable pathways (Fig.…”