Does your ethnicity affect your IVF success rate?
Almost every patient starting any fertility treatment expects the best chance of success. Above all with IVF or ICSI treatment. As the science is progressing, there is an increasing number of interventions available to maximise the IVF (In Vitro Fertilisation) or ICSI (Intracytoplasmic Sperm Insemination)success rates.
Despite this, the IVF or ICSI success rates are much further away from assuring a successful outcome for every patient. Hence, studies are looking into factors that influence the outcome of this treatment. These factors could be:
- Female partner’s age
- Ovarian reserve
- Body mass index (BMI)
- Egg, sperm or embryo quality
Recently, The British Journal of Obstetrics and Gynaecology reported an interesting study. It suggests that the ethnicity can also influence the IVF success rate.
This study looked into the live birth rate of 38,709 women who went through an IVF or ICSI cycle between 2000 and 2010 in the UK. They collected the outcome only for the first IVF or ICSI treatment cycle. Then scientists excluded treatments to prevent the introduction of bias into the collected data. The Human Fertilisation and Embryology Authority ( HFEA ) offered the data.
It appears that women of certain ethnic groups had much lower live births rate. They had fewer eggs collected, higher chance of not being able to reach the embryo transfer stage. This means a lower chance of achieving pregnancy.
The study has its limitations. There is much information that was not available for analysis such as body mass index, FSH (Follicle Stimulating factor ), lifestyle and socio-economic factors.
Do socio-cultural factors modify the outcomes of an IVF or ICSI cycle?
Despite the study’s limitations, I believe that there are some clinical and socio-cultural factors that may be responsible for the variations in the outcomes of an IVF or ICSI cycle. For example, polycystic ovarian syndrome or PCOS is more prevalent in the South Asian women.
Women with PCOS may have an unpredictable response during ovarian stimulation using fertility drugs. This is due to the existing hormonal imbalance and the insulin resistance. They are more likely to develop ovarian hyperstimulation syndrome or OHSS.
Depending on the severity of OHSS, fertility specialists may decide to freeze the embryos and cancel the fresh embryo transfer. It is necessary to minimise the risks and complications that may follow if the OHSS worsens.
Similarly, Vitamin D deficiency is more prevalent in some geographic regions with limited sunlight. But, it may be more common in certain ethnic populations due to socio-cultural factors. There is ample evidence to suggest that vitamin D deficiency may lead to low implantation rate of the embryos. It may also affect the response to the ovarian stimulation.
Effects of consanguinity and other factors
Consanguinity is prevalent more in certain ethnic groups. Specialists believe that women born to consanguineous parents may be less fertile. In fact, they associate consanguinity with fertility and reduced ovarian reserves. It can also lead to higher chances of genetic disorders in the embryos.
The number of chromosomal abnormalities will affect the implantation of the embryo. Moreover, depends on the severity of conditions arising from these chromosomal abnormalities.
There are other factors such as dietary habits, obesity, smoking and other lifestyle factors that may reduce fecundity and also the IVF or ICSI success rates. Overall, this study has provided significant data that is far from perfect. But, this should form the basis for other well-designed studies. Scientists will explore the factors that may be responsible for affecting the outcome of the IVF or ICSI treatment. It will be helpful to understand the extent to which these factors may be affecting the outcome.