Objective

To assess the causes of infertility and artificial reproductive technology (ART) outcomes in women of African descent living in the Caribbean and Bermuda.

Design

Cross-sectional study composed of a questionnaire administered to providers who care for women undergoing ART in the Caribbean and Bermuda.

Material and methods

A questionnaire from the Deerfield Institute was adapted to meet the aims of our study with their permission. Eight infertility clinics in the Caribbean and Bermuda were identified. The primary physician at each site was contacted via email and invited to participate in the study. Questionnaires were completed via interview or electronically. Responses were collected in a REDCap database for statistical analysis.

Results

There were five respondents from Barbados, Bermuda (× 2), Puerto Rico, and the Bahamas. The most commonly reported etiologies of infertility among Afro-Caribbean patients were female-male factor and uterine factor. In vitro fertilization (IVF) combined with intracytoplasmic sperm injection (ICSI) is performed more often than conventional IVF. The cumulative live birth rates (LBR) after ART for those ages ≤ 34, 35–37, 38–42, and > 42 were 52%, 40%, 22%, and 12%, respectively. The cumulative live birth rate was 31.5% for total patients.

The factors reported to be most important in hindering patients from cycling were coping emotionally with poor ovarian response and cost. The biggest restraints to infertility care were costs and a lack of local IVF centers on all islands.

Conclusion

Afro-Caribbean women receiving infertility care in the Caribbean may have better ART outcomes compared to African-American women in the United States (US).

中文翻译：

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加勒比非洲裔妇女的不孕不育和辅助生殖技术成果。

 客观的

评估生活在加勒比海和百慕大的非洲裔妇女不孕的原因和人工生殖技术 (ART) 的结果。

 设计

横断面研究包括向在加勒比海和百慕大接受抗逆转录病毒疗法的妇女提供护理的提供者进行的问卷调查。

 材料与方法

经迪尔菲尔德研究所 (Deerfield Institute) 许可，对问卷进行了修改以满足我们的研究目的。加勒比海和百慕大群岛有八家不孕不育诊所已被确定。我们通过电子邮件联系了每个中心的主治医师并邀请其参与该研究。调查问卷通过访谈或电子方式完成。反馈被收集到 REDCap 数据库中进行统计分析。

 结果

有五名受访者来自巴巴多斯、百慕大 (× 2)、波多黎各和巴哈马。加勒比非洲裔患者中最常见的不孕病因是女性-男性因素和子宫因素。体外受精 (IVF) 与胞浆内单精子注射 (ICSI) 相结合的情况比传统 IVF 更常见。年龄≤ 34、35-37、38-42 和> 42 的患者接受 ART 后的累积活产率 (LBR) 分别为 52%、40%、22% 和 12%。总患者的累计活产率为 31.5%。

据报道，阻碍患者骑自行车的最重要因素是情绪上应对卵巢反应不佳和费用。不孕不育护理的最大限制是费用以及所有岛屿上缺乏当地的试管受精中心。

 结论

与在美国 (US) 的非裔美国女性相比，在加勒比地区接受不孕不育护理的非洲裔加勒比女性可能会获得更好的 ART 效果。