Black women are 43% less likely to seek fertility care and have 29-36% lower IVF live birth rates than white women

Non-Hispanic Black women experience infertility at higher rates than white women but are 43% less likely to visit a doctor for fertility help, wait a median of two years (vs. one year for white women) before seeking treatment, and when they do access IVF, have significantly lower live birth rates (OR 0.71) and cumulative live birth rates (OR 0.64) compared to white women. Why it matters: Black women already face higher baseline infertility rates due to conditions like uterine fibroids (which affect Black women 2-3x more frequently), so delayed treatment means eggs are older and outcomes are worse when treatment finally begins, so lower IVF success rates combined with the same per-cycle costs mean Black patients spend more money for fewer babies, so Black women report 3.75x more psychological stress during IVF than white women and are 3x more likely to discontinue treatment, so the racial fertility gap compounds across generations as family-building becomes systematically harder for Black families regardless of income. The structural root cause is that the infertility field was built around white patient populations (clinical trials, dosing protocols, reference ranges for hormones and semen analysis are calibrated to white bodies), there is a severe shortage of Black reproductive endocrinologists (fewer than 4% of REI fellows are Black), and cultural stigma around infertility in Black communities reduces help-seeking behavior while the medical system lacks culturally competent outreach.