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Aim: To determine the role of ethnicity on IVF/ICSI outcomes between Indian and white Caucasian women., Settings and Design: Retrospective cohort study., Materials and Methods: White Caucasian and Indian women undergoing IVF/ICSI treatment cycles. Total 5549 self, non-donor, fresh IVF cycles conducted from January 2014 to March 2015, out of which, 4227 were white Caucasian and 1322 were Indian. Data were collected on baseline characteristics, IVF cycle parameters and outcomes. Ongoing pregnancy rate (OPR) was measured as main outcome., Results: Indian women differed significantly from white Caucasian women in baseline characteristics like age (30.6 ± 0.2 versus 37.6 ± 0.1 years; p < 0.001), BMI (22.3 ± 0.2 versus 26.6 ± 1.0 kg/m 2 ; p < 0.05), duration of infertility (6.9 ± 3.0 versus 2.5 ± 0.1 years; p < 0.001) and antral follicle count (AFC) (8.9 ± 0.4 versus 7.5 ± 0.2; p < 0.001). Indian women had lower implantation rate (30.1% versus 39.6%: p < 0.001) and OPR (35.1% versus 41.7%: p < 0.001) compared with white Caucasian women. Regression analysis proved independent effect of ethnicity on OPR (OR 0.944; 95% CI 0.928-0.961: p < 0.001) Conclusions: OPR was significantly lower among Indian ethnic group following IVF/ICSI suggest that ethnicity, like age, is a major and an independent predictor of IVF outcome.

In the context of ready access to contraceptives, we sought to determine which individual and socio-cultural factors were most important in the dramatic fertility decline seen in an impoverished rural Balinese community. The study built on a 2002 longitudinal survey of 1528 Balinese reproductive-age married women that four years later found a significant proportion did not meet their expressed fertility aspirations. Four case studies of women whose expressed fertility intentions evolved over the study period are described. Culturally specific contextual factors (notably son preference), in interaction with increasing poverty, helped explained when and why their expressed fertility intentions changed. Moreover, many categorized in the second survey as not having meet their previously reported fertility aspirations were, in fact, intentionally spacing births. Although many women opted for smaller families than they actually wanted, and a decades-long, aggressive, two-child government campaign helped make them socially acceptable, contraception enabled the women to engage in strategic birth planning. We conclude that it is unrealistic to expect women in such settings, or indeed any setting, to give meaningful answers to questions in demographic surveys regarding future fertility aspirations.

This paper examines the personal and social ramifications of infertility in an African urban population with low fertility. The study was conducted in Moshi, Tanzania, a multi-ethnic community with relatively high levels of education and a well developed health services infrastructure. The major question to be addressed was whether in a low fertility urban population, both primary and secondary infertility bring about serious personal ramifications for women similar to those in rural areas. The methodology included a survey of 2,019 women and in-depth interviews with 25 fertile and 25 infertile women. Of the 1,549 sexually active women in a regular union, 2.7% had never had a child in spite of trying to conceive for at least two years. Of the 1,352 women who had previously had a child, an additional 6.1% were subsequently infertile. The most important finding from the qualitative analysis concerns the major difference between childlessness and subsequent infertility (or primary and secondary infertility) in terms of implications for the effected women. These findings underline the importance of bearing a child in sub-Saharan African populations.