Race and fertility

Yesterday I watched Falcon 9 launch from the Kennedy Space Centre.  It was emotional.  It was emotional as I remembered watching the Challenger explode in 1986.  It was emotional as I am so impressed at what science can achieve. It was emotional thinking about the bravery of those in the Dragon capsule.  Then when the rocket landed back on the pad in the ocean I was blown away.

 

With money, brilliant minds and a common will, humans can do anything.

 

One thing we can’t seem to do is defeat the poison of racism.  Why? Why don’t things get better for people of colour, particularly Black Americans? Black Americans are systemically mistreated on the street, in their schools, in their hospitals, in their work places… everywhere.

 

In health, Black people have a lower life expectancy and are more likely to get COVID and die from it.

 

In fertility, Black people have lower IVF pregnancy rates.  Black people have more severe disease when they present for care to a fertility clinic. Some of the explanation for lower IVF pregnancy rates is the higher prevalence of obesity in the black community. Other explanations include lifestyle factors like smoking and poor diet which are more common in lower socioeconomic groups, like sadly Black Americans are more likely to be included in.  Fibroids are also much more common in Black women than in Non-black women.

 

If you take Black Americans who undergo IVF, and you control for weight, age, and diagnosis, they are still less likely to have a live birth than non-Black women.  Why?  Truthfully we don’t know.  Very few studies examine race and most studies include Caucasian and Asian women - very few studies have large Black or Hispanic populations.  This should change.

 

I suspect that the difference in pregnancy rates between Blacks and non-Blacks has very little to do with biology and everything to do with socioeconomic factors that impact health: egg quality, sperm quality, dietary influence on the uterus, and such.

 

Since Jeff Bezos just made an extra $24 billion during the pandemic. Many other billionaires incomes are similarly sky rocketing. Can’t we share the wealth to improve health for all?

 

With money, brilliant minds and a common will, humans can do anything.  We clearly have money and brilliant minds, now we need the common will to correct the disparities faced by Black Americans in all aspects of their lives including fertility.

Dr. Beth Taylor MD, FRCSC
Reproductive Endocrinology & Infertility