Fecundability in Association With Everyday and Lifetime Discrimination
Ugochinyere Vivian Ukah1, Sharonda M Lovett2, Renée Boynton-Jarrett3
1Department of Medicine, McGill University, Montreal, Quebec, Canada.
JAMA Network Open
|July 14, 2025
Summary
Experiences of everyday and lifetime discrimination were linked to lower fecundability, the probability of conception. These findings highlight the reproductive health impacts of unfair treatment and the need for further research.
Area of Science:
- Reproductive Health
- Social Epidemiology
- Psychosocial Factors in Fertility
Background:
- Racial and socioeconomic disparities in fertility outcomes are well-documented.
- The association between discrimination and fecundability remains understudied.
Purpose of the Study:
- To examine the association of self-reported experiences of everyday and lifetime discrimination with fecundability.
Main Methods:
- A prospective preconception cohort study (Pregnancy Study Online) included 6578 female participants attempting pregnancy.
- Everyday and lifetime discrimination were measured using validated scales.
- Proportional probabilities regression models estimated fecundability ratios (FRs), adjusting for confounders and stratifying by race/ethnicity.
Main Results:
- Everyday discrimination was associated with reduced fecundability (FR, 0.82 for very high vs. none).
- Lifetime discrimination was also linked to decreased fecundability (FR, 0.93 for any vs. none), particularly discrimination in healthcare and employment.
- Reduced fecundability was observed in White participants with high everyday discrimination and minority individuals with any lifetime discrimination.
Conclusions:
- Everyday and lifetime discrimination are associated with reduced fecundability.
- The impact of discrimination on fertility varies by type, frequency, and attribution.
- Further research is needed to understand the reproductive health effects of unfair treatment.
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