Oftentimes, during discussions about Black maternal health, it is in the context of Black women’s experiences while giving birth. And just as we must continue to shed light on the sometimes fatal disparities Black mothers face in those situations, it’s important to understand that the gaps in Black maternal healthcare extend far beyond the birthing process—from conception to postpartum. Now, researchers at the University of Pennsylvania are exploring the disparities Black women face with In Vitro Fertilization (IVF), a common and complex treatment for infertility that can lead to pregnancy.
For years, experts have underlined that Black women have lower live birth rates after IVF than their white counterparts. However, the cause for this persistent gap remains unclear. The new study published in “Fertility and Sterility” offers a bit more insight into years of inconsistent findings that have sought to explain these discrepancies. To do so, the group compared how women of different racial and ethnic backgrounds responded to ovarian stimulation drugs by analyzing 246,000 ovarian stimulation cycles, of which 7% (18,334) were in Black women.
Researchers found that Black participants in the study’s eggs produced high-quality embryos and responded slightly better to ovarian stimulation drugs. Yet, this same group has a lower birth rate (45%) compared to white women in the study (60%).
“There’s clearly something happening that’s a roadblock to getting to the ultimate goal of bringing home a baby,” Dr. Iris Tien-Lynn Lee, an ob-gyn at UPenn and the lead author of the study, told Scientific American.
“It’s important to know it’s not the [ovary] stimulation drugs, but a lot more work needs to be done to understand the other factors and the implicit biases that may still exist,” Tarun Jain, a professor of obstetrics and gynecology at Northwestern University, added.
While Dr. Lee hypothesizes implementation being the root issue, the study’s authors also note how Black communities have an increased risk for uterine fibroids, exposure to endocrine-disrupting chemicals found in hair relaxers, and environmental contaminants could have an effect on these infertility treatments.
However, as Dr. Tia Jackson-Bey, a reproductive endocrinologist at Reproductive Medicine Associates of New York, explained, while these findings are useful, “the most frustrating thing is that we don’t know what, exactly,” is causing this gap.
Beyond the science, there are nonmedical factors that contribute to these disparities, like racism, financial and health insurance inequalities, and more. In fact, in 2025, the American Society for Reproductive Medicine Practice Committee noted that Black women are older than their white counterparts when they first see a fertility doctor and, as a result, more likely to be diagnosed with a diminished ovarian reserve as their egg quality and quantity decline with age.
The ASRM committee’s statement is further explained by the findings of a 2020 study in which Black women (14.7%) were more likely to report that their race, in addition to income, was a barrier to getting fertility treatment, more than any other racial and ethnic group.
“Black women in health care experience worse outcomes in general, whether it’s maternal mortality, infertility treatment, or preterm birth,” Dr. Jain shared. “We need to address these inequities at a broader level.”
