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Lower IVF Pregnancy Rates in African American Women Due to Genetic Predisposition Toward Autoimmune Disease
Even though success rates for in vitro fertilization (IVF) have greatly improved over the years, the disparities have actually increased among different races and ethnicities. Now researchers at a New York City fertility clinic have found that IVF success rates are related to specific genotypes (the genetic makeup of individuals), and they suggest that a genetic predisposition toward autoimmune disease may be the cause for lower IVF success rates among women of African descent.
The specific genotype — FMR1 gene sub-genotype het-norm/low — is found in higher rates among African American women. “The association of FMR1 genotypes and risk for autoimmunity presents evidence that autoimmunity may be associated with lower pregnancy rates in IVF in general,” says Norbert Gleicher, M.D., one of the study’s authors and Medical Director of the Center for Human Reproduction, a New York, NY, fertility clinic. “Autoimmunity may, thus, also be at least partially responsible for the racial/ethnic disparities in infertility prevalence and treatment outcomes.”
In general, African American women experience infertility more frequently and have lower IVF pregnancy rates compared to Asian and Caucasian patients. However, the causes for the differences in IVF success rates among African American, Caucasian and Asian women have not been clear.
This new study, published in the medical journal PLoS, involved 339 Caucasian, Asian and African American women. The researchers found the following.
- Even after controlling for age and body mass index (BMI), there were significantly lower IVF success rates for African American women compared with Asian and Caucasian women.
- African American patients demonstrated the highest rates of the FMR1 gene sub-genotype het-norm/low. The same group of researchers has found FMR1 het-norm/low to be statistically highly associated with autoimmunity.
- Asian women, who had the lowest prevalence of het-norm/low, experienced the highest pregnancy rates after IVF.
The researchers had previously associated the specific FMR1 sub-genotype het-norm/low with an approximately 50 percent reduction in IVF pregnancy chances, according to David Barad, M.D., M.S., one of the study’s senior authors, and Clinical Director of ART at the Center for Human Reproduction. “This new finding is in line with our previous studies on this specific FMR1 sub-genotype.”