Racial and ethnic differences in assisted reproduction treatment outcomes: the benefit of racial admixture

A Systematic Review of Genetics and Reproductive Health Outcomes: Asian Perspective

In the last four decades, advances in assisted reproductive technology (ART) have offered hope to individuals with fertility problems to conceive. However, a closer examination of the clinical outcomes of ART shows a stark contrast in Asian women compared to Caucasians, with majority of studies reporting lower reproductive success among Asian women. We performed a systematic review to elucidate the genes associated with ART clinical outcomes, with a focus on Asian ethnicities. We completed a database search to identify all studies associated with reproductive outcomes in women of different ethnic backgrounds. Following PRISMA, 128 studies were analyzed. Pathway analysis of gene sets was done using Cytoscapev3.4.0. We observed that age at menarche (AAM) was correlated with the timing of the first pregnancy, with Hawaiians having the lowest age (22.2 years) and Japanese the highest age (25.0 years). LIN28 mutations were associated with AAM and prevalent in both Chinese and American populations. FMR1 was most associated with ovarian reserve. Network analysis highlighted a close association between FMR1, FSHR, ESR1, BMP15, and INHA, through biological functions affecting menstrual cycle and hypothalamic-pituitary axis and therefore ovarian follicle development. Leveraging these findings, we propose the development of a personalized, ethnic-specific biomarker panel which would enhance patient stratification to address every woman's unique reproductive potential.

Racializing infertility: How South/Asian-ness has been constituted as an independent risk factor in infertility research and IVF practice

Since the 1990s, scientific studies have explored possible correlations of "race/ethnicity" with ovarian aging and, by extension, the outcome of In Vitro Fertilization (IVF) procedures. Relying on a close reading of English-language scientific publications about "Asian" or "South Asian" women, corroborated by interviews with selected authors in 2018 and 2021 as well as ethnographic research in India conducted between 2010 and 2017, I analyze processes and practices of racializing infertility over time and across space. In a first step, I explore the socio-political configurations through which South/Asian race/ethnicity became a relevant variable in infertility research between the 1990s and 2010s. Further, I interrogate how South/Asian race/ethnicity has been scientifically mobilized and problematized by examining publications from the US, the UK, and India/Spain. I argue that South/Asian race/ethnicity has been constituted as an independent risk factor for ovarian aging and/or IVF outcome by invisibilizing possible alternative explanations for inequalities with regard to infertility and by establishing comparability and continuity between contexts. Inquiring why researchers actively try to make a seemingly universal notion of South/Asian race/ethnicity present in their work, I point to global scientific hierarchies and postcolonial power dynamics that characterize this body of literature. Finally, I explore the implications that the notion of South/Asian-ness as risk has in medical practice in India and illustrate how it contributes to bringing the (in)fertility of bodies racialized as "South Asian" into new realms of capital accumulation.