Hispanic Ethnicity and Fertility Outcomes

Devon M Langston; Kiarad Fendereski; Joshua Halpern; Ijeoma N Ika; Kenneth Aston; Joemy M Ramsay; Joshua J Horns; James Hotaling

doi:10.1016/j.urology.2024.03.040

Hispanic Ethnicity and Fertility Outcomes

Urology. 2024 Apr 23:S0090-4295(24)00287-5. doi: 10.1016/j.urology.2024.03.040. Online ahead of print.

Authors

Devon M Langston¹, Kiarad Fendereski², Joshua Halpern³, Ijeoma N Ika², Kenneth Aston², Joemy M Ramsay², Joshua J Horns², James Hotaling⁴

Affiliations

¹ Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA. Electronic address: Devon.Langston@hsc.utah.edu.
² University of Utah, Salt Lake City, UT.
³ Northwestern University Feinberg School of Medicine, Chicago, IL.
⁴ Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.

PMID: 38663587
DOI: 10.1016/j.urology.2024.03.040

Abstract

Objective: To assess the association between ethnicity and fertility outcomes for men in a statewide cohort.

Design: We linked data from the Utah Population Database (UPDB) and Subfertility Health Assisted Reproduction and Environment (SHARE) database, to comprise a cohort of sub-fertile men who underwent semen analysis (SA) between 1998-2017 in Utah. A multivariable Cox proportional hazard model was constructed to understand the impact of ethnicity on fertility outcomes in our cohort.

Results: 11,363 men were included. 1,039 (9.1%) were Hispanic. 39.7% of men in the lowest socioeconomic status group (SES) were Hispanic (p<0.001). When controlling for demographic and clinical factors, the number of live births was reduced for Hispanic men (HR=0.62 [0.57-0.67], p<0.001). Though fertility treatment (FT) had a positive effect (HR 1.242 [1.085-1.421], p<0.001), in competing risks models, Hispanic men were less likely to use FT (HR=0.633 [0.526-0.762], p<0.001).

Conclusion: Hispanic ethnicity is significantly associated with a lower likelihood of successful fertility outcomes in Utah. Hispanic men had nearly a 40% reduced likelihood of live births when controlling for sociodemographic factors. Our results indicate that, depending on age, Hispanic men have up to approximately 14 fewer live births per 100 men per year, pointing to a significant disparity in fertility outcomes in the state of Utah. Given 15.1% of Utah's population identifies as Hispanic and 18.7% of the United States population identifies as Hispanic on the 2020 Census, better understanding of the association of ethnicity and fertility outcomes is imperative.