By Allen Gray
NDG Special Contributor
There is no racism when it comes to in vitro fertilization (IVF), per se. But when you take into consideration everything all together, all at once you will find that there is a grave racial disparity in the number of white IVF babies compared to number of Black IVF babies.
Since 1978, when the first successful IVF cycle was performed, the number of American families who have taken advantage of fertilization technology number in the millions. Yet, in 2024 there is an enormous difference drawn upon racial lines in the number of mothers who have full access to reproductive medicine. And for the Black and Hispanic mothers who do gain access, there remains a gap in the number of successful IVF live births.
Data collected by the Society for Assisted Reproductive Technology Clinical Outcomes Reporting System (SART CORS) for the years 1999 and 2000, showed that the live-birth rate for white women is 26.3%, which far outpaced the live-birth rate for Black women who had successful IVF cycles of only 18.7%. The study concluded that being Black was an independent risk factor for not achieving a live birth. A subsequent data analysis performed from 2004 to 2006 showed that things have not changed much. Numerous other studies produced comparable results.
Because of such findings, the American Society for Reproductive Medicine (ASRM) was moved to do something about those racial inequities. The ASRM then analyzed SART CORS data from 2014 to 2016. Of the 122,721 IVF cycles available for study, on 13,717 were from Black women. White women, on the other hand, accounted for 109,004 of the cycles studied. It should come as no shock that Black women also had a lower livebirth rate than white women.
No. There is no known Great White Breeding Conspiracy where white folk are subduing the birthrate of Black and Hispanics. Data on U.S. birthrates shows that quite the opposite has been happening. In recent years, people of color have been as fruitful as ever, if not more fruitful.
In 2022 for instance, a US Census fertility rate analysis showed that for every 1,000 Native Hawaiian women an estimated 64 children would be born. That is the highest fertility rate for all races. The fertility rate for white women, on the other hand, was hovering next to last with only 51 children per 1,000 women. The fertility rate for Black women were somewhere in the middle with 53 births per 1,000 women.
Fertility rates, however, should never be confused with birthrates. Whereas, a birthrate is an accounting of live births, a fertility rate is merely an estimate of the number of children who might be born to a woman of childbearing years—ages 15 to 44 years old. Know, too, that the fertility rates for industrialized nations (like America) always run lower than less industrialized nations.
The offset for this fertility shortfall comes with a high price tag.
Depending on the fertility clinic, IVF care can cost as much as $30,000. Also realize that miscarriages are to be expected with the IVF process, so costs can easily be doubled or even tripled.
This disparity in IVF numbers is not due to a selective process that is barring Black babies from being created. The lopsided numbers are due to the greatest and most effective segregationist tool of them all—finance.
There are only two ways to pay for IVF treatment. The most obvious is to pay cold-hard cash. (If you do not have the cash, you might charge it on a credit card, or take a home equity loan, or attempt to get an IVF grant.) The only other way to cover the costs is with insurance coverage.
Yes. There is insurance available, but not for everyone and not in every state.
In September 2023, the National Infertility Association reported that 21 states along with DC passed fertility insurance coverage laws. Laws that include IVF coverage were present in 15 of those state mandates, and fertility preservation coverage was included for families that experience a medically induced (iatrogenic) infertility. At least 16 of those 21 states have some form of mandated coverage, Texas is one of those states.
In Texas, a single IVF cycle will cost approximately $10,600, plus any additional costs that normally begin at around $6,600. It is most probable that there could be several cycles before a couple achieves a successful pregnancy and live birth. Typically, insurance coverage for IVF treatment is usually limited to three cycles per lifetime. Coverage in Texas requires a qualifying patient couple to have an infertility history of at least 5 years; or the couple must have a specified medical condition resulting in infertility.
An advocate for IVF procedures will tell you that IVF replicates the natural childbirth process. But when you consider all a woman must endure you will find that there is nothing natural about it.
To start, a woman undergoing the IVF process is injected with gonadotropins (synthetic hormones), so her ovaries are stimulated to produce multiple eggs. The eggs are then retrieved by a physician so they can be delivered to an embryologist who inseminates the eggs with the patient’s choice of sperm. Now, the patient must wait a few days for the embryos to develop.
About five days later, the embryos are transferred into the woman’s uterus occurs; or her spare embryos might be frozen for later implantation.
Then it is a waiting game to see if a viable pregnancy occurs. If the attempt to impregnant fails—or in the case of an ensuing miscarriage—the woman must repeat the cycle from the start.
When IVF was created, it was designed for women with damaged or blocked tubes that prevented the sperm from meeting the egg. Now, with the advancement of technology and more successful pregnancies, IVF treatment has been made available to women with other contributing infertility factors.
Prospective parents who are good candidates for IVF treatment can now be those whose doctor has diagnosed them with: blocked fallopian tubes, low sperm count, severe endometriosis, or any other unexplained infertility issue.
Despite technological advancements, IVF treatment is still a haphazard endeavor. The participating clinicians can, however, provide a patient with statistics based on a couple’s age, ovarian reserve, the sperm quality of a partner or donor, and other relevant medical factors.
Still, a hopeful parent must accept that miscarriages are part of the IVF process.
Data shows that after 7 weeks of gestation, with a fetal heart activity detected, almost 10% of women who are younger than 33 years old suffer an IVF miscarriage. Then as a woman grows older the miscarriage rate gets worse. For women aged 33-34 years old the rate of miscarriage is over 11%; women aged 35-37 suffer miscarriages at a rate of nearly 14%; the rate is close to 20% for women aged 38-40; for women aged 41-42 the rate is close to 30%; and, for women over 42 years old the miscarriage rate is almost 37%.
It is an accepted rule that childbearing years for women caps-out at age 49…but increasingly that capstone rule is being ignored as women who are desperate to have a child push the rule beyond its limits.
On September 1, 1946, Erramatti Mangamma was born. On September 5, 2019, Erramatti gave birth to twin girls. Erramatti was 73 years old at the time.
Theoretically, any woman who can afford it can have a child of her very own—that is as long as Republicans who oppose a woman’s right to life decisions stays out of her way.
Recent Republican generated legislation like the Life at Conception Act (January 2023) have caused fear and panic for both IVF patients and physicians, because with the hypocrisy surrounding the right to life issues, they are not sure if a mistake in the handling of an embryo might not land them in prison.
Most recently, 35-year-old Sarah Houston, an Alabama nurse and radical cancer survivor, wanted to expand her family by having her healthy IVF embryos transferred to a surrogate. Houston was aghast when she received a call from the IVF clinic saying that her entire process had been put on hold because of their fear of repercussion and the liability that could be associated with the new Republican-generated legislation.
In Mid-March 2024, U.S. Senator Richard Blumenthal (Democrat) spoke in support of IVF treatment for our nation’s veterans. His backing was for the Veteran Families Health Services Act, which was introduced by U.S. Senator Patty Murray (Democrat).
Blumenthal, a right to life advocate, declared that oppositional Republican politicians are, “…in favor of IVF. But not against laws that restrict IVF.” At most, the Republican stance on IVF, says Blumenthal, conflicts with constitutional law and moral principles.
Lost amid this political rancor are the reproductive rights of Black women to have equitable access to IVF treatment, because their infertility might be greater than that of white women.
A sample analysis of nearly 500 non-surgically sterile women, showed that 48% of the group’s Black women reported infertility compared to only 31% of white women. Ironically, the Black women were younger than the white women, less likely to have been married, had never given birth to a child (nulliparous), and more often of lower income and education.
The thing that separates a prospective Black mother from a white mother is the unfortunate fact that being Black in this case, too, continues to be a foretelling factor for the livebirth rate as a result of IVF treatment. The nuanced economic and social factors found in reproductive medicine and the U.S. healthcare system at large—and the implicit biases found in those structures—also contribute to the failure to allow Black women access to IVF treatment.
Despite the immeasurable reward IVF might provide to families, it is important to note that only about 2% of all live births in the U.S. are the result of IVF treatment.
