I am a black woman who has been an infertility patient since 2013. I’ve had 3 different REs and 1 NaPro GYN. I’ve had two cycles of timed intercourse, 3 IUIs, 4 ICSI cycles and 4 FETs. Finally, I’ve an 1 ectopic pregnancy, 2 chemical pregnancies, 2 miscarriages, a missed miscarriage that resulted in a D&C, and most painful of all, the birth and death of my micropreemie son due to cervical insuffiency. I have a clean RPL panel and my only diagnosis (beyond the recent IC and even more recent Ashermans Syndrome because my sons placenta wouldn’t detach) is endometriosis.
I strongly believe that a cornerstone of all of this failure is racism. I’ll never forget one IUI I had was two hours late because a woman and her 4 kids came in after me, but was called back before me. Before anyone asks, no she did not have an appointment because I heard them clearly tell her she was at the wrong branch, but they took her back anyways. Or the time when I miscarried my PGS normal embryo right after seeing the heartbeat, and my RE came in shrieking “what did you do?!” The worst case of all of course was my baby boy. I self referred to a high risk clinic, knowing that with my extensive loss and infertility history, things were going to be an uphill battle. My MFM actively saw my cervix change and did NOTHING, even when Iisted off and begged for several common interventions for IC (cerclage, 17p, progesterone suppositories). She smirked at me and told me to come back in 2 weeks, my son was born less than a week later.
So many of the experiences I have suffered through are backed up by evidence and are experienced by other black women. For instance, on average, black women tend to have their AMH decline faster than their nonblack counterparts. The RE who told me I was young and had time vastly overestimated the time I had; since I’ve started treatments my AMH is less than half the value it was when I did my first cycle of IVF in 2016. Or IC, it’s well documented that black women are at an increased risk for incompetent cervix but my perinatologist didn’t think to explore the adjusted average of occurrence amongst black pregnant women, instead she went with the overall average. Lastly, black women have the lowest rates of ART success and the highest rates of miscarriage and preterm birth when they do conceive. Even amongst fertile black women, the maternal and infant mortality rate disparity is an acknowledged health epidemic in the United States.