Mason-Otey, A., & Seifer, D. B. (2025). United States racial/ethnic disparities in PGT-A use: an analysis of 2014-2020 SART CORS database. Reproductive biology and endocrinology : RB&E. https://doi.org/10.1186/s12958-025-01399-8
Mason-Otey A, Seifer DB. United States racial/ethnic disparities in PGT-A use: an analysis of 2014-2020 SART CORS database. Reproductive biology and endocrinology : RB&E. 2025. doi:10.1186/s12958-025-01399-8
Mason-Otey, A., and D. B. Seifer. "United States racial/ethnic disparities in PGT-A use: an analysis of 2014-2020 SART CORS database." Reproductive biology and endocrinology : RB&E, 2025.
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Black and Hispanic women used PGT-A less often than White women
A cohort study of 438,583 initial US ART cycles from 2014 to 2020 found that Black and Hispanic women used PGT-A less often than White women. PGT-A, a chromosome screen of embryos, appeared in 24 out of 100 cycles for Black women, 31 for Hispanic women, 33 for White women and 44 for Asian women.
Key Findings
Overall PGT-A use rose from 11.5 to 49.0% (p < 0.001) over seven years. Black women had the largest rise, going from 6.8% in 2014 to 38.8% in 2020 (5.7 times).
PGT-A appeared in 33% of cycles for White women, 24% for Black women, 31% for Hispanic women and 44% for Asian women (p < 0.001).
After adjustment for age, BMI and AMH, Black women were 35% less likely than White women to use PGT-A (aOR = 0.65, 95% CI 0.63–0.67).
Hispanic women were 16% less likely (aOR = 0.86, 95% CI 0.84–0.88) and Asian women 41% more likely (aOR = 1.41, 95% CI 1.39–1.44) than White women to use PGT-A.
Women 35 and older were 71% more likely than women younger than 35 to use PGT-A (aOR = 1.71, 95% CI 1.69–1.74).
Interpretation
The study is a retrospective cohort analysis of cycles reported to the SART CORS registry. It describes who used PGT-A and reports no pregnancy or live birth outcomes. The authors name two limitations: 35% of the initial sample had no race or ethnicity recorded, and the registry did not specify the PGT method. They suggest provider bias in who gets counseling and the added cost of testing as possible explanations for the lower use. The model adjusted for age, BMI and AMH. Only initial cycles using the patient's own eggs were analyzed.
RRM Context
Restorative reproductive medicine looks for the cause of infertility in both partners. PGT-A screens embryos created in IVF and does not investigate why conception has not occurred. The paper's background cites a review of nine randomized trials with 3,334 women. The review found PGT-A was not associated with an increase in live birth rate.
Our editorial summary of this paper, not the article's abstract.
Abstract
Background
The use of preimplantation genetic testing for aneuploidy (PGT-A) allows for the selection of euploid embryos and has been thought to improve outcomes in ART, particularly in women ≥ 35 years old. However, little is known regarding PGT-A utilization among minority women in the United States (US). The objective of this study was to determine the trend of utilization of PGT-A in the US among minority women.
Methods
We conducted a retrospective cohort study using the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) database. We included initial autologous ART cycles performed between 2014 and 2020. We assessed the rate of PGT-A utilization by race/ethnicity.
Results
This study included 150,604 PGT-A and 287,979 non-PGT-A initial autologous cycles. The overall trend of PGT-A utilization, regardless of race/ethnicity, increased from 11.5 to 49.0% (p < 0.001) over seven years. Of all ART cycles, 33% of White women used PGT-A, in comparison to 24% of Black women, 31% of Hispanic women, and 44% of Asian women (p < 0.001). Multiple Logistic Regression (MLR) determined race/ethnicity as an independent predictor of PGT-A utilization when adjusting for age, BMI, and AMH (p < 0.001). Compared to White women, MLR showed that Black and Hispanic women were 35% and 16% less likely to use PGT-A (aOR = 0.65, 95% CI 0.63-0.67, and aOR = 0.86, 95% CI 0.84-0.88, respectively, p < 0.001). In contrast, Asian women were 41% (aOR = 1.41, 95% CI 1.39-1.44) more likely to use PGT-A (p < 0.001). Overall, regardless of race/ethnicity, women 35 and older were 71% (aOR = 1.71, 95% CI 1.69-1.74) more likely to use PGT-A compared to women younger than 35 (p < 0.001).
Conclusion
Despite a significant increase in overall PGT-A utilization in the US over 7 years, utilization has been consistently less in ART cycles for Black and Hispanic women, in comparison to White women. This is in marked contrast to an increase in PGT-A utilization in cycles for Asian women.
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