IFLG-Disparities-Remain-for-Black-Women-Living-with-Infertility-Rich-Vaughn

Disparities Remain for Black Women Living with Infertility

Although Black History Month is a time to highlight and celebrate achievements in the Black community, it is also a time to acknowledge where we have come from, as Americans and as human beings, and how we can work together to create a more just and equitable world. In the fertility world, much work remains to be done.

The reality is Black women are more likely than women of other ethnicities to face fertility challenges. According to the National Library of Medicine, Black women “had a two-fold increased odds” of infertility compared to their white counterparts even after an adjustment for socioeconomic position. Disparities in outcomes and access to services for Black women in the infertility world have taken a back seat for too long. Word about this inequity is finally spreading among reproductive health professionals, and studies are being conducted to see why these disparities exist. Why are Black women suffering from infertility more than white women, and why are we only just now talking about it?

Black Women Seek Fertility Care at an Older Age

Age is the number one contributor to fertility issues. In general, infertility is clinically described as the inability to become pregnant after 12 months of unprotected intercourse for women under 35 and six months for women over 35. On average, Black women spend longer periods of time dealing with infertility before they reach out to a doctor for help. Parents.com discussed the issue in 2022, stating that white women between the ages of 25 and 44 were twice as likely to seek out fertility treatments earlier compared to only 8 percent of Black women who seek out treatments during child-bearing years. 

Black women are also more likely to suffer in silence for longer periods of time before they seek help.  Parents.com goes on to explain a strange but ongoing persistent myth in which Black women are super-fertile, perpetuating a lack of understanding of infertility issues and creating a level of shame within the community. Some Black women do not feel as though they can talk to their families or doctors, which results in more Black women seeking help later in life, or not seeking help at all.

Ijeoma Kola, Ph.D., a Nigerian American entrepreneur with a doctoral degree in the history of public health, struggled with infertility and suffered in silence for many months, even avoiding talking to her own mother about it. She tells Glamour, “Black women are presented as hypersexual. We get pregnant like this; we’re welfare queens. There’s this perception of an African woman having 10 kids and being hyper-fertile. That can be difficult to push back against if you’re struggling to get pregnant.”

Struggling to overcome such stereotypes can also affect Black women’s care. “When a Black woman comes in for her annual visit, infertility may be the last thing that is discussed,” Lynae Brayboy, M.D., an African American ob-gyn who specializes in reproductive endocrinology and infertility, also tells Glamour. She goes on to say that the loss of infertility can indicate other underlying issues.  Women are scared to talk about it and, as a result, don’t seek help until age becomes an added factor.

Black Women Are More Likely to Suffer from Uterine Issues

In addition to seeking care at an older age, uterine issues including fibroid tumors are more common and more severe among Black women, according to Science Direct. Fibroids tend to be more numerous and painful leading to more drastic treatment, often including hysterectomies. 

Diane, a friend who is now in her late forties and using a pseudo-name for privacy, has lived this nightmare. She says that every woman in her family has developed some type of uterine issue over time. Diane knew that she had painful periods as a teenager, but never really thought anything about it until she was in her 30s and doing crunches on the floor one day when a large lump protruded from her abdomen. At that point, she knew she needed to see a doctor, who eventually confirmed she had a grapefruit-sized fibroid growing inside her. The fibroid, which was in the lining of her uterus, ended up being risky to take out, so her surgery to remove it at that time failed, prompting her doctor to recommend a hysterectomy. Diane, however, wasn’t ready to give up her dream of motherhood and continued to endure painful periods and a swollen abdomen in hopes that she still may be able to have a baby in the future. 

Finally, in her forties, Diane agreed to a hysterectomy as she couldn’t take the pain anymore and knew her age was also becoming a factor in infertility. Looking back, Diane says, “I wish I had acted on having a baby sooner, maybe in my 20s. I was just waiting for the right time. But, once I realized the hysterectomy meant that I would never have a baby, I cried and cried and cried like I have never cried before. Red face, eyes full of tears, and gobs of tissues for a long time. I went to a therapist, and she told me that I needed to grieve it, and I did. I went through a depression not only knowing a baby would never happen for me now but also, I don’t know why I just didn’t try and have a baby sooner before it got too bad. I still wrestle with it sometimes. I didn’t know it would get so bad and mean I couldn’t have a baby.” Diane goes on to say that her story was a catalyst in her niece’s decision to have her children at a very young age in case she began to have issues too.

Diane is not alone, as uterine issues affect a lot of Black women, and yet the lack of public knowledge and understanding heightens the stigma of infertility as a taboo topic in the Black community. This combination means some Black women don’t seek treatment until later in life, and by then it is sometimes too late.

Black Women Have Lower IVF Implantation Rates and Higher Cycle Cancellation Rates

Black women have higher cycle cancellation rates, decreased implantation rates, and are less likely to have a live birth after an IVF cycle compared to white women, according to a study published in the National Library of Medicine. Although age and uterine issues contribute to some of these statistics, scientists are still working on answers for lesser implantation and live birth rates.

According to WebMD, a study at the University of Chicago analyzing more than 4,000 IVF cycles over two years found that miscarriage after IVF occurred twice as often among Black women than white women. Black women also experience a significantly lower embryo implantation rate when compared to white women.

Dr. Edward Illions, a reproductive endocrinologist at Montefiore Medical Center in Hartsdale, N.Y., tells WebMD that he has observed the same disparities in his own practice. He says that in some studies higher BMIs could be a factor as women with higher BMIs tend to have worse outcomes.  However, Illions goes on to add that although BMIs could be a potential factor, successful implantation rates have “to do with uterine receptivity.” This leads to the possibility that uterine issues and seeking care at an older age continue to be big predictors of infertility. 

With so many questions still out there as to why racial disparities exist in IVF, with no concrete answers, it is evident that large-scale research is still needed.

Advocacy Groups Help Empower Black Women with Infertility

As questions persist, and access to information and social media platforms continue to grow, a number of advocacy groups have emerged to help educate and empower women of color struggling with infertility.

The Broken Brown Egg is a nonprofit organization that exists to inform, empower, and advocate for intended parents experiencing fertility issues with its focus on the Black community. It encourages women to begin the important dialogue about their reproductive health and to be open about their infertility struggles.

Sister Girl Foundation provides awareness education and advocacy for women suffering from chronic and debilitating diseases, with an emphasis on endometriosis and breast and ovarian cancers. The foundation helps bring awareness to Black communities through educational resources, workshops, and events that bring the community together.

Fertility for Colored Girls, a national organization, provides education, awareness, support, and encouragement to Black women and other women of color seeking to build their families. Their emphasis is on empowering women to take charge of their own reproductive health by providing emotional support and financial assistance for infertility treatments.

Tinina Q. Cade Foundation is a nonprofit organization that provides education and grants of up to $10,000 to intended parents from diverse communities seeking fertility treatments. The foundation has helped over 170 families with financial support for adoption and fertility treatments.

As modern technology and IVF continue to evolve, so must our demand for better research and legislative and policy support for better reproductive healthcare for women of color. Not only does there need to be more education for healthcare professionals on this topic, but also more outreach programs designed to educate and empower Black communities to discuss infertility and to advocate for equitable solutions to disparities in access and outcomes.

Black History Month provides all of us with a special vehicle from which to recognize and acknowledge continuing disparities in reproductive health needs, access to care and outcomes. But it’s important that we don’t confine the conversation to just one month out of the year. Here at IFLG, we make it our 365-day-a-year commitment to work toward the time when everyone benefits equally from the life-giving miracle of assisted reproductive technology and advanced fertility medicine.

 

 

Richard Vaughn
rich@iflg.net

Attorney Rich Vaughn is founder and principal of International Fertility Law Group, one of the world’s largest and best-known law firms focused exclusively on assisted reproductive technology, or ART, including in vitro fertilization (IVF), surrogacy, sperm donation or egg donation. Rich is co-author of the book “Developing A Successful Assisted Reproduction Technology Law Practice,” American Bar Association Publishing, 2017.

Peiya Wang
PEIYA WANG(王培娅)
Paralegal (律师助理)

Peiya Wang joined IFLG as a paralegal in 2015, where she manages surrogacy, egg donation and parental establishment cases and provides translation services for many of IFLG’s international clients. Peiya moved to the United States in 2012 to attend Northeastern University in Boston, Massachusetts, receiving a Master of Science degree in Global Studies and International Affairs in 2014. Peiya moved to Los Angeles in 2015, received her paralegal certification from UCLA Extension, and obtained her second Master of Science degree in Legal Studies from Loyola Law School. Peiya relocated back to her hometown, Beijing, China in 2019 and works from IFLG’s Beijing office. When away from the office, Peiya is a dragon boat paddler and a ballroom dancer, where she favors Rumbas and Cha-chas. She is fluent in Mandarin and English.

Luis Sosa
LUIS SOSA
Paralegal

Luis R. Sosa joined IFLG as a paralegal in 2016, where he enjoys pursuing his passion for family and reproductive law. While working toward his bachelor’s degree at Florida International University which he received in 2013, Luis worked as a paralegal and legal assistant for family law litigation firms in Miami and Washington, D.C. As a paralegal and case manager for IFLG, Luis, who is bilingual in English and Spanish, manages surrogacy, egg donation and other reproductive law cases. Luis has worked for IFLG in both Los Angeles as well as San Francisco, and is currently based in Dallas, Texas. In addition to spending time with husband Randy and dog Marty, Luis enjoys being outdoors and appreciating the arts.

Toni Hughes
TONI BOONE
Paralegal

After receiving her B.S. in Business Management, Toni joined IFLG to pursue her dream of working in the legal field. As a Paralegal with over 10 years of experience in the assisted reproduction technology field, Toni is our Managing Paralegal, responsible for training and managing our paralegal staff. From drafting legal documents to assisting our clients with post-birth matters, Toni embraces the challenge of learning something new in this field each day. Besides spending time with her son, Jordan, Toni enjoys exploring new things, cooking, spending time with family and friends, and serving as a Youth Advisor for “Next Generation.”

Kim
KIM LETZKUS
Paralegal

Kim has over 30 years of experience in the legal field and has worked exclusively in surrogacy and assisted reproduction law since 1999. Kim is a senior case manager responsible for managing parental establishment cases and interacting with IFLG’s Of Counsel attorneys across the country. With three children of her own, Kim understands the importance of family and finds working in this area of law a rewarding experience.

Rich Vaughn
RICHARD B. VAUGHN
Founder

Attorney Rich Vaughn combined his personal passion as a father of twin boys born via assisted reproductive technology (ART) with more than 20 years of experience in business and technology law to build International Fertility Law Group. Today IFLG is one of the most successful and best-known law firms in the world focused exclusively on fertility law, helping thousands of intended parents through empathetic listening, compassionate guidance, and unmatched legal expertise. As an advocate for reproductive freedom, Rich also contributes his knowledge and time to improving the understanding and practice of ART law, most recently as a founder of and speaker at the first Cambridge University International Surrogacy Symposium held in June 2019, as immediate past chair of the American Bar Association ART Committee, and as a popular presenter to law schools, faculty and advocacy organizations all over the world.

Elizabeth Tamayo
ELIZABETH TAMAYO
Paralegal

Elizabeth received her Bachelors of Science degree in Criminal Justice from California State University of Los Angeles. Shortly after graduating, she continued her education at the University of California, Los Angeles where she obtained her Paralegal certificate. Elizabeth is fluent in Spanish and has been in the legal field since 2009. She is excited to be a part of the IFLG Team helping families realize their dreams.

Sunny Chien
SUNNY CHIEN
Paralegal

Sunny joined IFLG as a paralegal in 2017, where she manages surrogacy, egg donation and parental establishment cases for many of IFLG’s international clients. She holds a Bachelor of Arts degree in Philosophy from California State University of Los Angeles, where she graduated cum laude. Sunny is bilingual in English and Mandarin and has extensive experience as a legal assistant and paralegal at Los Angeles-area law firms. She is excited to be part of the IFLG team. In her spare time, Sunny enjoys spending time with her family and their dog, going to the beach, cooking, and being outdoors.

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Phone:  +1 844 400 2016

Email:  info@iflg.net

Website:  www.iflg.net

Molly O'Brien
MOLLY O'BRIEN
Partner

Fertility law attorney Molly O’Brien began working in the field of assisted reproduction technology (ART) in 2005, at an egg donation agency and a surrogacy agency where she became familiar with all aspects of in-vitro fertilization, egg donation and the financial aspects of surrogacy. Since becoming an attorney in 2011, Molly has drafted and negotiated surrogacy, egg donation, sperm donation embryo donation agreements for hundreds of her clients all over the world.

Phoebe Sadler
PHOEBE S. SADLER
Associate

Fertility law attorney Phoebe Sadler has a background in family law and has been practicing exclusively in the area of assisted reproduction technology (ART) law since 2018.

Rubina Aslanyan
RUBINA ASLANYAN
Paralegal

Rubina has an extensive background in the legal field as a paralegal in Family Law and has worked in surrogacy and assisted reproduction law since 2012. Her area of focus is in managing and assisting clients with surrogacy, egg donation, and parental establishment cases for many of IFLG’s domestic and international clients. During her spare time, Rubina enjoys spending time with her family and dog Bella, traveling and cooking.

Alexander Espinoza
ALEXANDER ESPINOZA
Legal Assistant

Alexander joined IFLG as a legal assistant in 2019, where he manages surrogacy, egg donation and parental establishment cases. Alex is bilingual in English and Spanish and has been in the legal field for 23 years. Alex is excited to join the IFLG team and pursuing his will to help others in the reproductive law process. In his spare time he loves spending time with his family and friends, being outdoors, road trips, loves music and dancing.

Cara Stecker
CARA STECKER
Senior Paralegal

After receiving her paralegal certificate in 2005, Cara began working in assisted reproductive law. During the fifteen years Cara has worked in this field, she has gained a wide range of experience and knowledge that she uses to help better assist clients and those involved in the assisted reproductive journey. Cara’s primary roles involve managing parental establishment matters and coordination with IFLG’s Of Counsel attorney network, drafting contracts and parental establishment court documents and providing support to other team members. Cara finds great joy in being a small part of a team of caring people who help others achieve their dream of having a family. In her spare time, Cara enjoys spending time with her husband and three children, watching her children play the sports they love, and she enjoys, running, cycling and exploring the outdoors in the sun.

Stephanie Kimble
STEPHANIE KIMBLE
Paralegal

Stephanie received her BS in History and Political Thought from Concordia University Irvine in 2015 and her Paralegal Certificate from University of San Diego later that same year. She has been working as a Paralegal since 2016 in Family and Reproductive Law. She is excited to be part of International Fertility Law Group working on managing Surrogacy, Egg donation and Parental Establishment Cases.

Trish Pittman
TRISH PITTMAN
Assistant Financial Coordinator

With more than 20 years of experience in the field of accounting, Trish joined the IFLG team in 2019 as Assistant Financial Coordinator. Her client-facing focus at IFLG is to assist with all client trust accounting. Trish is the mother of two daughters and enjoys spending time teaching and learning new things from them. In her free time, she loves long walks in the park and reading suspense and mystery novels.

Katie Deaquino
KATIE DEAQUINO
Senior Paralegal

Katie is a Senior Paralegal with IFLG and has dedicated over sixteen years to the areas of surrogacy and reproductive law. She received her Paralegal Certificate from Coastline Community College and has worked with some of the top law firms in the assisted reproduction community. Katie is also a commissioned Notary Public. With IFLG, Katie manages Surrogacy, Egg Donation, and Parental Establishment cases and provides support to other IFLG team members. Katie truly enjoys helping others build their families through assisted reproduction and is thankful she has had the rewarding experience of assisting IFLG clients. Katie often spends her free time with her Husband, four young children and her bulldog “Bella”.

Elsa Jimenez
ELSA JIMENEZ
Legal Assistant

Elsa joined IFLG as a Legal Assistant in 2019, bringing more than 35 years of experience working in the legal profession (concentrating in tort and litigation matters). At IFLG she assists surrogates with their surrogacy and parental matters. The oldest of five siblings, born and raised in East Los Angeles to Mexican immigrant parents, Elsa loves “seeing the beauty of families forming” through assisted reproductive technology. She and her husband Carlos have four children and one grandson. Elsa enjoys jazz and ’80s music, being outdoors in nature, collecting teacups and tea pots, and spending time with her close-knit family.