Moving toward Narrowing the United States Gap in Assisted Reproductive Technology (ART) Racial and Ethnic Disparities in the Next Decade

Author:

Mahabamunuge Jasmin1ORCID,Seifer David B.1

Affiliation:

1. Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA

Abstract

The Disparities in Assisted Reproductive Technology (DART) hypothesis, initially described in 2013 and further modified in 2022, is a conceptual framework to examine the scope and depth of underlying contributing factors to the differences in access and treatment outcomes for racial and ethnic minorities undergoing ART in the United States. In 2009, the World Health Organization defined infertility as a disease of the reproductive system, thus recognizing it as a medical problem warranting treatment. Now, infertility care is largely recognized as a human right. However, disparities in Reproductive Endocrinology and Infertility (REI) care in the US persist today. While several studies and review articles have suggested possible solutions to racial and ethnic disparities in access and outcomes in ART, few have accounted for and addressed the multiple complex factors contributing to these disparities on a systemic level. This review aims to acknowledge and address the myriad of contributing factors through the DART hypothesis which converge in racial/ethnic disparities in ART and considers possible solutions to effect large scale societal change by narrowing these gaps within the next decade.

Publisher

MDPI AG

Reference78 articles.

1. The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009;Adamson;Hum. Reprod.,2009

2. Human Rights Approaches to Reducing Infertility;Shah;Int. J. Gynecol. Obstet.,2023

3. United Nations. General Assembly (1948). Universal Declaration of Human Rights, United Nations.

4. Ethics Committee of the American Society for Reproductive Medicine (2021). Disparities in Access to Effective Treatment for Infertility in the United States: An Ethics Committee Opinion. Fertil. Steril., 116, 54–63.

5. (2024, February 01). ASRM Task Force on Diversity, Equity and Inclusion. Statement of Interest and Concern. Available online: https://www.asrm.org/globalassets/_asrm/about-us/committees/asrm-dei-task-force-report-11-30-2020.pdf.

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