Acute cardiovascular changes in women undergoing in vitro fertilisation (IVF), a systematic review and meta-analysis

Fujitake, Eri; Jaspal, R.; Monasta, Lorenzo; Stampalija, Tamara; Lees, C.

doi:10.1016/j.ejogrb.2020.01.033

Cited by 16 publications

(10 citation statements)

References 19 publications

(44 reference statements)

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“…Author details 1 Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Du Cane Rd, London W12 0HS, UK. 2 Imperial College London, South Kensington, London, UK. 3 Erasmus Medical Centre, Rotterdam, The Netherlands.…”

Section: Abbreviationsmentioning

confidence: 99%

“…Disordered cardiovascular adaptation in pregnancy is associated with pre-eclampsia and growth-restricted babies [1]. The known acute effects of IVF on maternal haemodynamics are limited [2] and no gold-standard method for non-invasively measuring CO in this population exists. In fresh IVF cycles, ovarian stimulation leads to acutely supra-physiological oestradiol [3], not experienced in spontaneous conception.…”

Section: Introductionmentioning

confidence: 99%

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Validation of Non-invasive Measurement of Cardiac Output: Using Whole-Body Bio-impedance Versus Inert Gas Rebreathing in Healthy Women Undergoing In Vitro Fertilisation

et al. 2022

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Background Haemodynamic assessment in and before pregnancy is becoming increasingly important in relation to pregnancy complications and outcomes. Different methodologies exist but there is no gold-standard technique for non-invasive measurement of cardiac output (CO). We sought to assess two methods of CO measurement in healthy women undergoing in vitro fertilisation cycles (IVF). This was a prospective longitudinal study of 71 women aged 18–44 years planning IVF undergoing CO measurements obtained via inert gas rebreathing (IGR) using Innocor™ and whole-body bio-impedance (WBI) using Nicas™ to assess the reproducibility between the methods. Four visits occurred at which both techniques were used: initial assessment, embryo transfer, day of pregnancy test and 4 weeks post-transfer (regardless of whether conception occurred). Cross-sectional agreement of the methods was assessed using the calculation of bias, percentage error and limits of agreement (LOA) via the Bland–Altman analysis. Longitudinal agreement of the methods was assessed using a 4-quadrant plot with concordance rate, angular bias and radial limits of agreement (%). Results One hundred and thirteen measurements from 44 participants were suitable for cross-sectional (Bland–Altman) analysis. IGR (Innocor™) Mean CO was 4.61 L/min and 5.05 L/min with WBI (Nicas™). The bias was 0.44 L/min. The percentage error was 76% and intra-correlation coefficient was 0.135 (95% CI −0.43–0.306). Fifty-nine measurements from 28 participants were suitable for longitudinal (4Q-plot) analysis. The concordance rate was 64.4%, angular bias – 0.14, and radial limits of agreement + − 13.25°. Conclusion There was poor cross-sectional and longitudinal agreement between inert gas rebreathing and whole-body bio-impedance techniques. These techniques cannot be used interchangeably when measuring CO in women undergoing IVF, and these results may be more generalizable.

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Section: Abbreviationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Validation of Non-invasive Measurement of Cardiac Output: Using Whole-Body Bio-impedance Versus Inert Gas Rebreathing in Healthy Women Undergoing In Vitro Fertilisation

et al. 2022

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“…In one study, investigators found that venous thromboembolism occurred in 4.2 per 1,000 women after IVF compared with 2.5 per 1,000 in women with natural pregnancies ( 8 ). One meta-analysis also found that IVF was associated with acute changes in hemodynamic parameters, with the most profound changes occurring around the days of embryonic implantation when GnRH agonist protocols are used ( 9 ). Furthermore, to obtain oocytes for ART, women must undergo controlled ovarian hyperstimulation, which can be complicated by ovarian hyperstimulation syndrome (OHSS).…”

Section: Introductionmentioning

confidence: 99%

Assisted Reproductive Technology Outcomes in Women With Heart Disease

Quien

Hausvater

Maxwell

et al. 2022

Front. Cardiovasc. Med.

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BackgroundWomen with infertility and heart disease (HD) are increasingly seeking assisted reproductive technology (ART). There is only one other study that examines the safety profile of ART in this population. This study aims to evaluate the cardiac, reproductive, and obstetric outcomes of ART in women with HD.MethodsWe conducted a retrospective case-control study of women with underlying congenital or acquired HD who underwent ART at a single University fertility center from 1/2010–3/2019. Women undergoing in-vitro fertilization (IVF), oocyte cryopreservation (OC) or embryo banking (EB) with HD were included. Cases were matched 3:1 with age-, cycle type- and cycle start date- matched controls without HD. Outcomes included cardiovascular (CV), reproductive, and obstetric complications during or following ART.ResultsTwenty women with HD were included. 15 (75%) had congenital HD, 1 (5%) had valvular disease, 1 (5%) had acquired cardiomyopathy, and 3 (15%) had arrhythmias. 90% were New York Heart Association class I. 55% of HD cases were modified WHO (mWHO) risk classification 1-2, 40% were mWHO 2-3 or 3, 5% were mWHO 4. Cases underwent 25 IVF, 5 OC, and 5 EB cycles and were compared with 79 controls who underwent 174 cycles. No CV complications or deaths occurred amongst cases following ART or pregnancy. There was no difference in risk of ART or obstetric outcomes amongst cases versus controls.ConclusionFor women with HD in this small, low -risk cohort, ART posed few risks that were similar in frequency to healthy controls.

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“…While ART offers an effective and life-changing option to achieve a viable pregnancy, observational studies with limited data have raised concerns for increased maternal risk of cardiovascular disease (CVD) after use of ART . This may, in part, be due to receipt of high-dose hormonal stimulation with ART compared with a pregnancy without ART . Conversely, epidemiologic studies have identified infertility as a sex-specific risk factor for CVD, and individuals with infertility are also more likely to have CVD risk factors (eg, obesity and hypertension) that precede the pregnancy and, thus, be at higher risk for CVD independent of ART use.…”

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confidence: 99%

“…2 This may, in part, be due to receipt of high-dose hormonal stimulation with ART compared with a pregnancy without ART. 3 Conversely, epidemiologic studies have identified infertility as a sex-specific risk factor for CVD, 4 and individuals with infertility are also more likely to have CVD risk factors (eg, obesity and hypertension) that precede the pregnancy and, thus, be at higher risk for CVD independent of ART use. Therefore, it is unclear whether the use of ART is simply a marker of latent CVD risk or is itself a causal contributor toward subsequent risk of CVD.In this issue of JAMA Cardiology, Magnus et al 5 present important new data from the Committee of Nordic ART and Safety collaboration, which linked data on all deliveries registered in…”

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confidence: 99%

Assisted Reproductive Technologies and Cardiovascular Disease Risk in Birthing Adults—When Null Results Matter

2023

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Acute cardiovascular changes in women undergoing in vitro fertilisation (IVF), a systematic review and meta-analysis

Cited by 16 publications

References 19 publications

Validation of Non-invasive Measurement of Cardiac Output: Using Whole-Body Bio-impedance Versus Inert Gas Rebreathing in Healthy Women Undergoing In Vitro Fertilisation

Validation of Non-invasive Measurement of Cardiac Output: Using Whole-Body Bio-impedance Versus Inert Gas Rebreathing in Healthy Women Undergoing In Vitro Fertilisation

Assisted Reproductive Technology Outcomes in Women With Heart Disease

Assisted Reproductive Technologies and Cardiovascular Disease Risk in Birthing Adults—When Null Results Matter

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