Neighborhood deprivation in relation to ovarian reserve and outcomes of ovarian stimulation among oocyte donors

Tanvi Suresh; Sarah LaPointe; Jaqueline C Lee; Zsolt P Nagy; Daniel B Shapiro; Michael R Kramer; Heather S Hipp; Audrey J Gaskins

doi:10.1016/j.fertnstert.2024.03.002

Neighborhood deprivation in relation to ovarian reserve and outcomes of ovarian stimulation among oocyte donors

Fertil Steril. 2024 Mar 8:S0015-0282(24)00172-9. doi: 10.1016/j.fertnstert.2024.03.002. Online ahead of print.

Authors

Tanvi Suresh¹, Sarah LaPointe¹, Jaqueline C Lee², Zsolt P Nagy³, Daniel B Shapiro³, Michael R Kramer¹, Heather S Hipp², Audrey J Gaskins⁴

Affiliations

¹ Department of Epidemiology, Emory University Rollins School of Public Heath, Atlanta, Georgia.
² Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia.
³ Reproductive Biology Associates, Sandy Springs, Georgia.
⁴ Department of Epidemiology, Emory University Rollins School of Public Heath, Atlanta, Georgia. Electronic address: audrey.jane.gaskins@emory.edu.

PMID: 38461907
DOI: 10.1016/j.fertnstert.2024.03.002

Abstract

Objective: To study the relationship between neighborhood deprivation index (NDI) and markers of ovarian reserve and outcomes of controlled ovarian stimulation among young, healthy oocyte donors.

Design: Retrospective cohort study.

Patients: A total of 547 oocyte donors who underwent 905 oocyte retrieval cycles (2008-2020) at a private fertility center in Sandy Springs, Georgia, United States.

Interventions: Neighborhood deprivation index was calculated using principal component analysis applied to census-level measures of poverty, employment, household composition, and public assistance, which was then standardized and linked to donor information on the basis of donor residence.

Main outcome measures: Markers of ovarian reserve, including antral follicle count (AFC) and antimüllerian hormone (AMH) levels, and outcomes of controlled ovarian stimulation including number of total and mature oocytes retrieved and ovarian sensitivity index (OSI) (defined as the number of oocytes retrieved/total gonadotropin dose × 1,000). Multivariable generalized estimating equations with Poisson and normal distribution were used to model the relationship between NDI and outcome measures adjusting for age, body mass index, and year of retrieval.

Results: The mean (SD) age of donors was 25.0 (2.8) years and 29% of the donors were racial or ethnic minorities. There were no associations between donor NDI and ovarian reserve markers. For every interquartile range increase in NDI, there was a reduction of -1.5% (95% confidence interval: -5.3% to 2.4%) in total oocytes retrieved although the effect estimate was imprecise. Associations of NDI with a number of mature oocytes retrieved and OSI were in a similar direction. We observed evidence for effect modification of the NDI and OSI association by donor race. There was a suggestive positive association between NDI and OSI in Black donors but no association in White donors.

Conclusion: In this cohort of young, healthy, racially diverse oocyte donors, we found little evidence of associations between NDI and markers of ovarian reserve or outcomes of ovarian stimulation.

Keywords: Neighborhood deprivation; oocyte donor; ovarian reserve; ovarian stimulation; socioeconomic status.

Grants and funding

R01 ES032446/ES/NIEHS NIH HHS/United States