19. Infertility Disparities: Unpacking Racialized Perspectives with Swetha Armruthur Khan

In this episode, we delve into the complex realm of infertility and its disparities, particularly focusing on the racialized lens through which it is often viewed. Join us as we explore the research, statistics, and perspectives that shed light on the impact of ethnicity on fertility outcomes. Infertility is a prevalent issue affecting 10% of women aged 15-44 in the U.S. (CDC, 2019). Approximately 7.4 million women and their partners grapple with fertility-related challenges in the U.S. Dr. Meera Shah, a double board-certified OB GYN and reproductive endocrinologist, joins us to discuss the significance of ovarian reserve, measured by AMH (anti-Mullerian hormone). A study conducted at UCSF in 2013 examined AMH levels across different ethnic groups, revealing notable differences. Striking variations in IVF outcomes were observed among Black, Hispanic, Asian, and white women. Studies comparing Caucasians and East Asians adjusted for key factors, yet East Asian women exhibited significantly lower live birth rates. Dr. Sandra Bärnreuther's research highlights how South/Asian-ness is framed as an independent risk factor in infertility and IVF practice (Social Science & Medicine, 2021). Narratives such as Indian women experiencing a rapid decline in ovarian reserve contribute to a racialized reproductive panic. The Hindustan Times' 2015 article amplifies the urgency around ovarian aging in India, although it relies on non-scientific data. Dr. Bärnreuther emphasizes the need to broaden perspectives on infertility, moving beyond biomedical and racial/ethnic lenses to address and explain disparities. As we conclude this episode, we reflect on the importance of dismantling racialized perspectives in infertility research and practice. Understanding the broader context and embracing a more inclusive approach is crucial for addressing and rectifying disparities in fertility outcomes. Stay tuned for more discussions on health, science, and society in future episodes.