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Guendelman, Sylvia, and Laura Stachel. “Infertility Status and Infertility Treatment: Racial and Ethnic Disparities.” Reducing Racial/Ethnic Disparities in Reproductive and Perinatal Outcomes: The Evidence From Population Based Interventions, 2011, 1–25.


This article summarizes and critiques published medical and public health literature on infertility prevalence and treatment utilization, comparing white women and women of color. The article delves into the complexities of measuring population-level infertility, a key component of determining unmet need and assessing the accuracy of smaller studies reporting a range of differences in outcomes among black, Latina, and white women participants. A number of factors, such as environment, history of sexually transmitted infection (STI), alcohol and other drug use, tobacco use, diet, and biology all help determine people’s fertility. Infertility is more common among low-income and low-education populations; consequently in the U.S., infertility is higher among black women and Latinas as compared to white women. However, utilization of assisted reproductive technology (ART) and in vitro fertilization (IVF) is much lower among women of color. Drawing on data from the Department of Defense, the authors show that when health insurance and quality of care is not part of the equation, black women utilize higher ART and IVF, in line with their estimated rates of infertility. Smaller studies show a complicated picture, suggesting that more research is needed before conclusions can be drawn about potential differences in health outcomes for women of color and their IVF-conceived infants. An excellent review of existing studies on the topic, this article is an essential read for advocates, students, scholars, and practitioners working in reproductive health and reproductive technology. This article offers key contributions to understanding how the decision and means to bear a child can be fraught with injustice, inequities, and challenges deeply connected to long histories of racism and stereotypes in the U.S. Using medical evidence and format, this article speaks to researchers and policy makers in the field, calling for more information on why women who are in greater need of infertility treatment are left without access to these interventions.


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Race/ethnicity: African American/Black   Assisted reproductive technology   Race/ethnicity: Latina/Hispanic   Race/ethnicity: European American/white   Health disparities