Racial differences in self-reported infertility and risk factors for infertility in a cohort of black and white women: The CARDIA Women's Study

ObjectiveTo determine racial differences in self-reported infertility and in risk factors for infertility in a cohort of black and white women.DesignA cross-sectional analysis of data from the longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) Study, a prospective, epidemiologic investigation of the determinants and evolution of cardiovascular risk factors among black and white young adults and from the ancillary CARDIA Women's Study (CWS).SettingPopulation-based sample from four US communities (Birmingham, AL; Chicago, IL; Minneapolis, MN; Oakland, CA).Patient(s)Women aged 33–44 years who had complete data (n = 764).Intervention(s)None.Main Outcome Measure(s)Self-report of ever having unprotected sexual intercourse for at least 12 months without becoming pregnant.Result(s)Among nonsurgically sterile women, blacks had a twofold increased odds (95% confidence interval [CI] 1.3–3.1) of infertility compared with whites after adjustment for socioeconomic position (education and ability to pay for basics), correlates of pregnancy intent (marital status and hormonal contraceptive use), and risk factors for infertility (age, smoking, T, fibroid presence, and ovarian volume). The corresponding odds ratio among all women was 1.5 (95% CI 1.0–2.2). Difficulty paying for basics and ovarian volume were associated with infertility among black but not white women.Conclusion(s)In this population-based sample, black women were more likely to have experienced infertility. This disparity is not explained by common risk factors for infertility, such as smoking and obesity, and among nonsurgically sterile women, it is not explained by gynecologic risk factors such as fibroids and ovarian volume.