A CONTROLLED ASSESSMENT OF THE IN-VITRO FERTILIZATION PERFORMANCE OF BRITISH WOMEN OF INDIAN ORIGIN COMPARED WITH WHITE WOMEN

Objective: To compare the reproductive performance of Indian versus wh ite women in IVF. Design: Controlled comparative clinical study. Setti ng: In vitro fertilization center based in university department in la rge tertiary level hospital. Patients: Results from first IVF treatmen t cycles in 44 Indian patients were compared with results from 88 whit e patients, matched by age and body mass index, over the same treatmen t year. The patients were selected from a prospectively collected IVF databank. Interventions: Standard luteal-phase start long GnRH analogu e regime. Ovarian stimulation with FSH and hMG. Transvaginal ultrasoun d-guided oocyte recovery. In vitro fertilization and ET following esta blished protocols. Main Outcome Measures: Rates of abandoned cycles, e gg retrievals, ETs, clinical pregnancies, miscarriages, and live birth s were compared in the first IVF treatment cycle. Cumulative pregnancy rates (PRs) over three cycles in the two groups of patients were also compared. Results: More cycles were abandoned in the Indian than in t he white group: 22.7% versus 9.1%. The Indian live birth rate per cycl e was worse: 9.1% versus 22.7%. The performance of the two groups was otherwise similar: ovarian stimulation with hMG and FSH required 26.0 ampules in the Indian group versus 24.6 ampules in the white group, me an number of follicles on the day of egg retrieval 8.7 versus 8.7, mea n number of eggs 5.9 versus 5.8, fertilization rate 82.4% versus 82.5 %; ET rate 73.5% versus 82.5, mean number of embryos transferred 2.1 v ersus 1.8, and clinical PR per cycle started 18.2% versus 27.3%. Concl usions: Under the same IVF regime, Indians performed worse than whites at the stage of ovarian stimulation (higher rate of abandoned cycles for poor response) and in live birth rate. Cumulative conception and l ive birth rates also tended to be worse in Indians than in whites.