Objective

To evaluate if racial/ethnic differences in pregnancy outcomes persisted in frozen-thawed embryo transfer (FET) cycles on a national level.

Design

Retrospective cohort study.

Setting

Clinic-based data.

Patient(s)

A total of 189,000 Society for Assisted Reproductive Technology FET cycles from 2014–2016 were screened, of which 12,000 cycles had available fresh cycle linkage information and ultimately, because of missing data, 7,002 FET cycles were included. Cycles were stratified by race (White, Black, Asian, and Hispanic).

Intervention(s)

None.

Main Outcome Measure(s)

The primary outcome was live birth rate. Secondary outcomes were implantation rate, clinical pregnancy rate, multiple pregnancy rate, and clinical loss rate (CLR).

Result(s)

Live birth rate was significantly lower in the Black vs. White and Asian, but not Hispanic group. Implantation rate was also significantly lower and CLR higher in the Black group compared with all other groups (all P<.01). Black women had a lower risk of live birth (adjusted risk ratio, 0.82; 95% confidence interval [CI], 0.73–0.92) and a higher risk of clinical loss (adjusted risk ratio, 1.59; 95% CI, 1.28–1.99) compared with White women. There was no significant difference between groups in clinical pregnancy rate or multiple pregnancy rate. When the analysis was limited to preimplantation genetic testing FET cycles, there remained a significantly lower implantation rate in the Black group compared with all other groups (all P<.01).

Conclusion(s)

Black race remains an independent predictor of reduced live birth rate in FET cycles, likely because of higher CLR.

中文翻译：

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黑人种族与冷冻解冻囊胚移植周期中较低的活产率相关：对辅助生殖技术协会 7,002 个冷冻解冻囊胚移植周期的分析

 客观的

评估全国冻融胚胎移植（FET）周期中妊娠结局的种族/民族差异是否持续存在。

 设计

回顾性队列研究。

 环境

 基于临床的数据。

 患者）

共筛选了 2014 年至 2016 年辅助生殖技术协会 189,000 个 FET 周期，其中 12,000 个周期具有可用的新周期链接信息，最终由于数据缺失，纳入了 7,002 个 FET 周期。周期按种族（白人、黑人、亚洲人和西班牙裔）分层。

 干预措施

 没有任何。

 主要成果衡量标准

主要结果是活产率。次要结局是着床率、临床妊娠率、多胎妊娠率和临床流产率（CLR）。

 结果）

黑人的活产率显着低于白人和亚洲人，但西班牙裔群体则不然。与所有其他组相比，黑人组的着床率也显着较低，CLR 较高（所有P <.01）。黑人女性的活产风险较低（调整后风险比，0.82；95% 置信区间 [CI]，0.73–0.92），临床损失风险较高（调整后风险比，1.59；95% CI，1.28–1.99）与白人女性相比。各组间临床妊娠率或多胎妊娠率无显着差异。当分析仅限于植入前基因检测 FET 周期时，与所有其他组相比，黑人组的植入率仍然显着较低（所有P <.01）。

 结论

黑人种族仍然是 FET 周期中活产率降低的独立预测因素，可能是因为 CLR 较高。