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State-based analysis reveals Hispanic ethnicity is linked with worse fertility outcomes

Opinion
Video

"When controlling for demographic and clinical factors, the number of live births was reduced for Hispanic men," says Devon M. Langston, MD.

In this video, Devon M. Langston, MD, and Joshua J. Horns, PhD, share notable findings from the Urology study “Hispanic Ethnicity and Fertility Outcomes.” Langston is a urology resident at University of Utah Health in Salt Lake City and Horns is a biostatistician at University of Utah Health.

Transcription:

What were some of the notable findings? Were any of them surprising to you and your coauthors?

Langston: Of the 11,400 men roughly that we had in our database, 8% of them were Hispanic and 10% of that group were from the lowest socioeconomic status. We used the Area Deprivation Index as a surrogate for how we could control and understand the neighborhood-level socioeconomic deprivation for our patients. And then, when controlling for demographic and clinical factors, the number of live births was reduced for Hispanic men. Even though fertility treatment overall had a positive effect on our cohort, in our competing risk models, we saw that Hispanic men were less likely to use fertility treatment.

Horns: A kind of cool result that came out of his or a kind of interesting result, I should say, that came out of this [is] whenever you do disparities research, it's incredibly complex, because things like ethnicity and income and education and occupation are so linked together and intertwined with each other that prizing those things apart is really difficult. Like Devon's saying, we found that Hispanic men were maybe less likely to seek fertility treatment. So we were looking not only at, how likely are these men to have a child, but how likely are they to get treatment? And how likely is that treatment to work? And how likely are they to come back for a second treatment? And so there are lots of different components that go into this. But we're able to throw all those things together to come up with 1 predicted value. And when you combine all these factors together, so far as we can tell, out of a group of 100 random men, Hispanic men will have about 14 fewer children per year than non-Hispanic men.

Langston: This was so surprising because as we moved through the data, we observed no major differences in semen analysis parameters, so it can't be because they have less motile sperm or because they're just not having a high enough quantity of sperm. And this difference persisted even if we isolated the patients who could afford to use assisted reproductive technology, we still observe the same reduction in successful fertility outcomes.

This transcription was edited for clarity.

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