Asian ethnicity is associated with decreased pregnancy rates following intrauterine insemination.

Asian ethnicity has been associated with decreased pregnancy outcomes in patients undergoing IVF. The objective of this study was to determine if a difference exists in pregnancy rates between Asian and Caucasian patients undergoing intrauterine insemination (IUI). A retrospective cohort of Asian and Caucasian patients treated with IUI between December 2002 and 2006 was analysed, including 2327 IUI cycles among 814 patients. Baseline characteristics were similar between Asian and Caucasian women. A significantly greater proportion of Asians (43.9%) presented for treatment after more than 2 years of infertility compared with Caucasians (24.6%) (P < 0.0001). Unadjusted analysis showed a trend towards decreased pregnancy rates associated with Asian ethnicity (odds ratio (OR) 0.71, 95% CI 0.50-1.01, not significant). Age, stimulation protocol, differences in gravity and parity, and duration of infertility did not account for this difference (adjusted OR 0.68, 95% CI 0.47-0.98, P = 0.039). Asian ethnicity is associated with lower pregnancy rates in IUI treatment. The increased duration of infertility in Asians does not explain the reduced pregnancy rates.

Asian ethnicity in anonymous oocyte donors is associated with increased estradiol levels but comparable recipient pregnancy rates compared with Caucasians.

OBJECTIVE: To determine if differences exist in ovarian response and pregnancy rates between Asian and Caucasian donors. DESIGN: Retrospective cohort study. SETTING: University-based clinic. PATIENT(S): Anonymous oocyte donors of self-reported Asian (n=63) or Caucasian (n=156) ethnicity who began ovarian stimulation between February 2000 and March 2008 and their matched recipients. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Recipient pregnancy rates and oocyte donor ovarian responsiveness. RESULT(S): Baseline characteristics were similar between Asian and Caucasian donors. Asian donors had peak serum estradiol levels that were 23% higher than their Caucasian counterparts (3715±220 vs. 3013±114 pg/mL). Adjusted estradiol levels per follicle measured and per oocyte retrieved were elevated in Asian donors (17% and 23% higher, respectively), and these differences were unchanged after adjusting for body mass index. No differences were noted in implantation rates (47.4% vs. 40.9%), clinical pregnancy rates (60.3% vs. 62.4%), or live-birth rates (55.5% vs. 59.9%) achieved using Asian vs. Caucasian oocyte donors. CONCLUSION(S): In contrast to autologous fresh in vitro fertilization cycles, Asian ethnicity is not associated with a lower pregnancy rate in recipient women using controlled hormone replacement when anonymous donor oocytes are used. Asian donors achieved statistically significantly higher serum estradiol levels during gonadotropin stimulation, suggesting an ethnic difference in steroid production and/or metabolism.

Is antral follicle count a genetic trait?

OBJECTIVE: The aim of this study was to determine the relationship between maternal age of menopause and antral follicle count. METHODS: This was a cross-sectional study of 124 women aged 25 to 48 years presenting with infertility. Women reported their mother's age of menopause and underwent transvaginal ultrasound to assess antral follicle count. Participant age, age greater than 37 years, and maternal age of menopause, as well as interactions among these, were incorporated into a multiple linear regression model to predict antral follicle count. Three different ages of maternal menopause were inputted into this model to illustrate the relationship between maternal age of menopause and rate of decline in antral follicle count. RESULTS: Women with a lower maternal age of menopause have lower antral follicle counts but also a slower decline until the age of 37 years. CONCLUSIONS: Maternal age of menopause predicts antral follicle count and its decline, indicating a genetic component to this trait.