Skip to main content
SpringerLink
Log in

Racial and ethnic differences in self-reported satisfaction with fertility clinics and doctors

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To investigate if differences in self-reported satisfaction with fertility clinics and doctors differ by race/ethnicity.

Study design

We used cross-sectional survey data from FertilityIQ online questionnaires completed by patients receiving US. fertility care from July 2015 to December 2020. Univariate and multivariate logistic and linear regression analyses were performed to assess association of race/ethnicity on patient-reported clinic and physician satisfaction.

Results

Our total sample size included 21,472 unique survey responses (15,986 Caucasian, 1856 Black, 1780 LatinX, 771 East Asian, 619 South Asian, 273 Middle Eastern, 187 Native American self-reported). When adjusting for potential confounders (demographic and patient satisfaction), we found that Black patients rated their doctors more highly (odds ratio (OR) 1.30, 95% confidence interval (CI) 1.04–1.62 p = 0.022 logistic and Coefficient 0.082, 95% CI 0.013–0.15 p = 0.02 linear), while other ethnic groups did not show significant differences compared to Caucasian patients. East Asians had borderline lower satisfaction with clinic satisfaction in logistic regression (OR 0.74 95% CI 0.55–1.00 p = 0.05), while significant differences were not found for other ethnic groups for clinic satisfaction.

Conclusions

In summary, some but not all minority groups differed in their self-reported perception of satisfaction with fertility clinic and doctors compared to Caucasian patients. Cultural differences towards surveys may contribute to some of these findings, and satisfaction by racial/ethnic group may also be modified by results of care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

The participants of this study did not give written consent for their data to be shared publicly, so due to the nature of the research supporting data is not publically available.

References

  1. Quinn M, Fujimoto V (2016) Racial and ethnic disparities in assisted reproductive technology access and outcomes. Fertil Steril 105:1119–1123

    Article  PubMed  Google Scholar 

  2. Wellons MF, Fujimoto VY, Baker VL, Barrington DS, Broomfield D, Catherino WH et al (2012) Race matters: a systematic review of racial/ethnic disparity in society for assisted reproductive technology reported outcomes. Fertil Steril 98:406–409

    Article  PubMed  PubMed Central  Google Scholar 

  3. Seifer DB, Frazier LM, Grainger DA (2008) Disparity in assisted reproductive technologies outcomes in black women compared with white women. Fertil Steril 90:1701–1710

    Article  PubMed  Google Scholar 

  4. Makhijani R, Godiwala P, Grady J, Christy A, Thornton K, Grow D et al (2022) Black race associated with lower live birth rate in frozen-thawed blastocyst transfer cycles: an analysis of 7002 Society for assisted reproductive technology frozen-thawed blastocyst transfer cycles. Fertil Steril 117:360–367

    Article  PubMed  Google Scholar 

  5. Liu Y, Hipp HS, Nagy ZP, Capelouto SM, Shapiro DB, Spencer JB et al (2021) The effect of donor and recipient race on outcomes of assisted reproduction. Am J Obstet Gynecol 224(374):e1–e12

    Google Scholar 

  6. Fujimoto VY, Luke B, Brown MB, Jain T, Armstrong A, Grainger DA et al (2010) Racial and ethnic disparities in assisted reproductive technology outcomes in the United States. Fertil Steril 93:382–390

    Article  PubMed  Google Scholar 

  7. Palep-Singh M, Picton HM, Vrotsou K, Maruthini D, Balen AH (2007) South Asian women with polycystic ovary syndrome exhibit greater sensitivity to gonadotropin stimulation with reduced fertilization and ongoing pregnancy rates than their Caucasian counterparts. Eur J Obstet Gynecol Reprod Biol 134:202–207

    Article  CAS  PubMed  Google Scholar 

  8. Shahine LK, Lamb JD, Lathi RB, Milki AA, Langen E, Westphal LM (2009) Poor prognosis with in vitro fertilization in Indian women compared to Caucasian women despite similar embryo quality. PLoS ONE 4:e7599

    Article  PubMed  PubMed Central  Google Scholar 

  9. Galic I, Negris O, Warren C, Brown D, Bozen A, Jain T (2021) Disparities in access to fertility care: who’s in and who’s out. F S Rep 2:109–117

    PubMed  Google Scholar 

  10. Shandley LM, Hipp HS, Anderson-Bialis J, Anderson-Bialis D, Boulet SL, McKenzie LJ et al (2020) Patient-centered care: factors associated with reporting a positive experience at United States fertility clinics. Fertil Steril 113:797–810

    Article  PubMed  Google Scholar 

  11. Mourad SM, Nelen W, Akkermans RP, Vollebergh JHA, Grol R, Hermens R et al (2010) Determinants of patients’ experiences and satisfaction with fertility care. Fertil Steril 94:1254–1260

    Article  PubMed  Google Scholar 

  12. Dancet EA, Nelen WL, Sermeus W, De Leeuw L, Kremer JA, D’Hooghe TM (2010) The patients’ perspective on fertility care: a systematic review. Hum Reprod Update 16:467–487

    Article  CAS  PubMed  Google Scholar 

  13. Schmidt L, Holstein BE, Boivin J, Tjornhoj-Thomsen T, Blaabjerg J, Hald F et al (2003) High ratings of satisfaction with fertility treatment are common: findings from the copenhagen multi-centre psychosocial infertility (COMPI) research programme. Hum Reprod 18:2638–2646

    Article  CAS  PubMed  Google Scholar 

  14. Gonen LD (2016) Satisfaction with in vitro fertilization treatment: patients’ experiences and professionals’ perceptions. Fertil Res Pract 2:6

    Article  PubMed  PubMed Central  Google Scholar 

  15. Liao L, Chung S, Altamirano J, Garcia L, Fassiotto M, Maldonado B et al (2020) The association between Asian patient race/ethnicity and lower satisfaction scores. BMC Health Serv Res 20:678

    Article  PubMed  PubMed Central  Google Scholar 

  16. Pinder RJ, Ferguson J, Moller H (2016) Minority ethnicity patient satisfaction and experience: results of the national cancer patient experience survey in England. BMJ Open 6:e011938

    Article  PubMed  PubMed Central  Google Scholar 

  17. Woods SE, Bivins R, Oteng K, Engel A (2005) The influence of ethnicity on patient satisfaction. Ethn Health 10:235–242

    Article  PubMed  Google Scholar 

  18. Reichheld FF (2003) The one number you need to grow. Harv Bus Rev 81(46–54):124

    PubMed  Google Scholar 

  19. Feinberg EC, Larsen FW, Catherino WH, Zhang J, Armstrong AY (2006) Comparison of assisted reproductive technology utilization and outcomes between Caucasian and African American patients in an equal-access-to-care setting. Fertil Steril 85:888–894

    Article  PubMed  Google Scholar 

  20. Purcell K, Schembri M, Frazier LM, Rall MJ, Shen S, Croughan M et al (2007) Asian ethnicity is associated with reduced pregnancy outcomes after assisted reproductive technology. Fertil Steril 87:297–302

    Article  PubMed  Google Scholar 

  21. Baker VL, Luke B, Brown MB, Alvero R, Frattarelli JL, Usadi R et al (2010) Multivariate analysis of factors affecting probability of pregnancy and live birth with in vitro fertilization: an analysis of the society for assisted reproductive technology clinic outcomes reporting system. Fertil Steril 94:1410–1416

    Article  PubMed  Google Scholar 

  22. Shapiro AJ, Darmon SK, Barad DH, Albertini DF, Gleicher N, Kushnir VA (2017) Effect of race and ethnicity on utilization and outcomes of assisted reproductive technology in the USA. Reprod Biol Endocrinol 15:44

    Article  PubMed  PubMed Central  Google Scholar 

  23. Langen ES, Shahine LK, Lamb JD, Lathi RB, Milki AA, Fujimoto VY et al (2010) Asian ethnicity and poor outcomes after in vitro fertilization blastocyst transfer. Obstet Gynecol 115:591–596

    Article  PubMed  Google Scholar 

  24. Seifer DB, Zackula R, Grainger DA, Society for Assisted Reproductive Technology Writing Group R (2010) Trends of racial disparities in assisted reproductive technology outcomes in black women compared with white women: society for assisted reproductive technology 1999 and 2000 vs. 2004–2006. Fertil steril 93:626–635

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors wish to acknowledge the fertility patients who have provided valuable information by filling out surveys on FertilityIQ.

Funding

There are no funding sources to report for this study.

Author information

Authors and Affiliations

  1. Division of Reproductive Endocrinology and Infertility, University of California, 499 Illinois Street, 6th Floor, San Francisco, CA, 94158, USA

    Ange Wang, Jerrine R. Morris, Jamie Corley & Victor Fujimoto

  2. FertilityIQ, San Francisco, CA, USA

    Jake Anderson-Bialis, Deborah Anderson-Bialis, Lauren Citro & Muhammad Esa Seegulam

Authors
  1. Ange Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jake Anderson-Bialis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jerrine R. Morris
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jamie Corley
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Deborah Anderson-Bialis
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lauren Citro
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Muhammad Esa Seegulam
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Victor Fujimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AW: Protocol/project development, DATA collection or management, data analysis, manuscript writing/editing. JA-B: Protocol/project development, data collection or management, manuscript writing/editing. JRM: Protocol/project development, data collection or management, data analysis, manuscript writing/editing. JC: Data analysis, manuscript writing/editing. DA-B: Protocol/project development, manuscript writing/editing. LC: Protocol/project development, manuscript writing/editing. MES: Manuscript writing/editing. VF: Protocol/project development, data analysis, manuscript writing/editing.

Corresponding author

Correspondence to Ange Wang.

Ethics declarations

Conflict of interest

None.

Ethical approval

An Institutional Review Board (IRB) through UCSF has determined that this research study does not involve human subjects and is therefore exempt.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 35 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, A., Anderson-Bialis, J., Morris, J.R. et al. Racial and ethnic differences in self-reported satisfaction with fertility clinics and doctors. Arch Gynecol Obstet 308, 239–253 (2023). https://doi.org/10.1007/s00404-023-07043-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-023-07043-3

Keywords

Search

Navigation