Racial and ethnic disparities in reproductive endocrinology and infertility

Huddleston, Heather G.; Cedars, Marcelle I.; Sohn, Sae H.; Giudice, Linda C.; Fujimoto, Victor Y.

doi:10.1016/j.ajog.2009.12.020

Cited by 100 publications

(57 citation statements)

References 75 publications

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“…There was no statistical difference between the ethnicity subgroups, largely due to the small number of patients in these comparisons. However, those of Asian and African American ethnicity didn't have lower live birth rates with "good" embryos compared to Whites, which is consistent with previous literature examining ethnicity related IVF outcomes [3,4,7,11,15].…”

Section: Resultssupporting

confidence: 88%

The simplified SART embryo scoring system is highly correlated to implantation and live birth in single blastocyst transfers

Heitmann

Hill

Richter

et al. 2013

J Assist Reprod Genet

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Objective Prior studies have validated the ability of the SART embryo scoring system to correlate with outcomes in cleavage stage embryo transfers. However, this scoring system has not been evaluated in blastocyst transfers. The objective of this study was to estimate the correlation between the simplified SART embryo scoring system and ART cycle outcomes in single blastocyst transfers. Materials and methods All fresh, autologous single blastocyst transfers cycles from a large ART center from 2010 were analyzed. Blastocysts were given a single grade of good, fair, or poor based upon SART criteria which combines the grading of the inner cell mass and trophectoderm. Multiple logistic regression assessed the predictive value of the SART grade on embryo implantation and live birth. Results Seven hundred seventeen fresh, autologous single blastocyst transfers cycles were included in the analysis. The live birth rate was 52 % and included both elective and nonelective SBT. Chi square analysis showed higher live birth in good grade embryos as compared to fair (p=0.03) and poor (p=0.02). Univariate binary logistic regression analysis demonstrated SART embryo grading to be significantly correlated with both implantation and live birth (p<0.01). This significance persisted when patient age, BMI, and the stage of the blastocyst were controlled for with multiple logistic regression. In five patients with a poor blastocyst score, there were no live births. Conclusion These data demonstrate that the SART embryo scoring system is highly correlated to implantation and live birth in single blastocyst transfers. Patients with a good grade embryo are excellent candidates for a single blastocyst transfer.

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Section: Resultssupporting

confidence: 88%

The simplified SART embryo scoring system is highly correlated to implantation and live birth in single blastocyst transfers

Heitmann

Hill

Richter

et al. 2013

J Assist Reprod Genet

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“…La alteración del factor tubo-peritoneal constituye una de las causa más frecuente de infertilidad (6,24), tal como se evidenció en las mujeres infér-tiles valoradas, se conoce que la enfermedad inflamatoria pélvica es una de las condiciones patológi-cas más importantes que causan daño permanente y las adherencias que afectan a las trompas de Falopio (25,26,27), antecedente significativo en estas pacientes (p<0,05). Al respecto, patógenos como CT y NG han sido considerados los principales patógenos en provocar daño irreversible en la mucosa tubárica, aunque recientemente se han involucrado también en el daño tubárico a microorganismos de la familia Mycoplasmataceae como UU y MH (28).…”

Section: Discussionunclassified

Infertilidad tubárica e infección genital por Chlamydia trachomatis-Ureaplasma urealyticum

et al. 2013

Rev. chil. obstet. ginecol.

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RESUMENObjetivo: Establecer la asociación entre la infertilidad tubárica y la infección cervical por Chlamydia trachomatis (CT) o Ureaplasma urealiticum (UU), en mujeres infértiles. Métodos: Investigación comparativa y aplicada, con diseño de tipo no experimental, de casos y controles, contemporáneo transeccional y de campo, que incluyó 60 mujeres, separadas en dos grupos pareados de acuerdo si eran infértiles (casos) o fértiles (controles), a las cuales se les tomó una muestra de hisopado endocervical para el diagnóstico molecular de CT o UU y se les realizó una histerosalpingografía para evaluar la permeabilidad de las trompas uterinas. Resultados: Se detectó una prevalencia en mujeres infértiles y fértiles de infección por CT o UU del 18% y 35%, respectivamente; siendo mayor entre las mujeres infértiles, diferencia significativa solo para UU (p<0,05). Se detectó una mayor permeabilidad tubárica en las pacientes fértiles que en las infértiles (80% vs. 40%), siendo el compromiso tubárico mayor en las pacientes infértiles (p<0,05). Al asociar el diagnóstico de CT o UU con los resultados de la histerosalpingografía se constató que la detección de uno de estos microorganismos aumentaba casi 3 o 5 veces más la probabilidad de presentar obstrucción tubárica, respectivamente, diferencias no significativas (p>0,05). Conclusión: Una gran parte de las mujeres infértiles presentan infección por CT o UU, patógenos de transmisión sexual que pudiesen tener responsabilidad en el daño tubárico. PALABRAS CLAVE: Chlamydia trachomatis, infección genital, infertilidad tubárica, Ureaplasma urealyticum SUMMARYObjective: To establish the association between tubal infertility and cervical infection by Chlamydia trachomatis (CT) or Ureaplasma urealyticum (UU) in infertile women. Methods: A comparative, and applied research with a non-experimental, case-control, contemporary-transactional and field design, including 60 women, separated into two groups matched according whether they were infertile (cases) or fertile (controls), in which was took a sample of endocervical swabs for molecular diagnosis of CT or UU and underwent hysterosalpingography to assess the permeability of the fallopian tubes. Results: It was detected in infertile and fertile women a prevalence of CT or UU infection of 18% and 35%, respectively; being higher detection among infertile women, although this difference was significant only for UU (p <0.05). Also detected more tubal permeability in fertile patients that in infertile (80% vs. 40%), being higher in engagement tubal in infertility patients (p<0.05). By associating the diagnosis of both CT and UU with hysterosalpingography's 32 REV CHIL OBSTET GINECOL 2013; 78(1): 32 -43

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“…The manifestations of PCOS may differ among different ethnic populations (5). It is recognized that Asian women are rarely hirsute (5).…”

Section: Introductionmentioning

confidence: 99%

“…The manifestations of PCOS may differ among different ethnic populations (5). It is recognized that Asian women are rarely hirsute (5). The enzyme 5α-reductase is responsible for the conversion of testosterone to the more potent androgen dihydrotesterone (DHT) (1).…”

Section: Introductionmentioning

confidence: 99%

Ethnic differences in Rotterdam criteria and metabolic risk factors in a multiethnic group of women with PCOS studied in Denmark

Glintborg

Mumm

Hougaard

et al. 2010

Clinical Endocrinology

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To cite this version:Dorte Glintborg, Hanne Mumm, David Hougaard, Pernille Ravn, Marianne Andersen. Ethnic differences in Rotterdam criteria and metabolic risk factors in a multiethnic group of women with PCOS studied in Denmark. Clinical Endocrinology, Wiley, 2010, 73 (6) Design: Retrospective trans-sectional study.Patients: 1002 premenopausal women with the diagnoses hirsutism or PCOS were divided according to ethnicity: Caucasian (CA, n=784), Middle East (ME, n=190), Asian (n=14), other (n=14).Measurements: Clinical evaluation (hirsutism, BMI, waist, blood pressure), hormone analyses (testosterone, sex hormone binding globulin, prolactin, lipids, insulin, glucose), and transvaginal ultrasound. Oral glucose tolerance tests (OGTT) (n = 499) and ACTH tests (n = 434) were performed in a subgroup of patients.Results (CA vs. ME women): CA women were older [32(25-37) vs. 25(18-32) years, median (quartiles)]and had increased BMI compared to ME women. After correcting for age and BMI CA women were less hirsute, but had increased testosterone levels compared to ME women. The Rotterdam criteria were fulfilled in 56% of both populations but PCO was diagnosed in 47% CA vs. 29% ME women, p<0.01. CA women had increased blood pressure and smoked at a higher frequency (40 vs. 23%), whereas area under the curve for insulin during OGTT was decreased, all p<0.001. Prolactin levels were significantly lower in CA women compared to ME women [7(5-10) vs. 9(6-12) µg/l] and were inversely associated with smoking status. Conclusion:CA women had a more adverse cardiovascular profile than ME women, whereas insulin sensitivity was higher. The prevalence of the individual Rotterdam criteria differed significantly in the two study populations.

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Racial and ethnic disparities in reproductive endocrinology and infertility

Cited by 100 publications

References 75 publications

The simplified SART embryo scoring system is highly correlated to implantation and live birth in single blastocyst transfers

The simplified SART embryo scoring system is highly correlated to implantation and live birth in single blastocyst transfers

Infertilidad tubárica e infección genital por Chlamydia trachomatis-Ureaplasma urealyticum

Ethnic differences in Rotterdam criteria and metabolic risk factors in a multiethnic group of women with PCOS studied in Denmark

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