Arterial stiffness during controlled ovarian hyperstimulation and early pregnancy in women exposed to assisted reproduction

Abstract

Introduction: Female sex hormones have vasorelaxing effects in non-pregnant and pregnant women. We aimed to investigate the effect of controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF), and early pregnancy, on arterial stiffness as assessed by digital pulse wave analysis (DPA), hypothesizing reduced arterial stiffness as an effect of increased estrogen levels. Material and methods: A total of 68 women undergoing IVF were examined with DPA before conception and during IVF treatment with COH and embryo transfer (ET), and in gestational week seven in 19 women who became pregnant. Heart rate (HR), mean arterial pressure (MAP) and the DPA variables cardiac ejection elasticity index (EEI), b/a, dicrotic index (DI), d/a and aging index (AI) were measured. Results: HR was significantly increased at all measuring points (p ≤ 0.003) but MAP only at ET (p 0.007). DPA variables representing large arteries (EEI, b/a) and peripheral arteries (DI, but not d/a), and the global variable AI, indicated increased arterial stiffness at ET compared with baseline (p ≤ 0.035). No DPA variable was significantly changed at pregnancy measurements compared to baseline. Conclusion: During COH for IVF treatment, DPA showed no changes in arterial stiffness during the follicular phase or in early pregnancy, but increased arterial stiffness in central and peripheral arteries in the early luteal phase. The result suggests a hormonal hemodynamic activation counteracting the effects of estrogen. ARTICLE HISTORY

Is Heart Rate a Confounding Factor for Photoplethysmography Markers? A Systematic Review

“…Their outcomes recommend that the SDPPG-b/SDPPG-a index might be useful to identify high-risk subjects for cardiovascular heart disease. The SDPPG-b/SDPPG-a ratio increased with an increment of age [34,37]. The SDPPG-d/SDPPG-a ratio demonstrates the intensity of reflecting pulse waves from peripheral arteries [34].…”

“…The SDPPG-b/SDPPG-a ratio increased with an increment of age [34,37]. The SDPPG-d/SDPPG-a ratio demonstrates the intensity of reflecting pulse waves from peripheral arteries [34]. Takazawa et al [35] revealed that the increasing SDPPG-d/SDPPG-a ratio represented a reduction of arterial stiffness; therefore, the SDPPG-d/SDPPG-a ratio decreased with increasing age and higher arterial stiffness [34,37].…”

“…Aging index (AGI @ AI) is proposed to signify the distensibility of large arteries [35]. AGI demonstrates the overall vascular stiffness, and it increases by age [34]. AGI can be calculated by the following formula: [(SDPPG-b)-(SDPPG-c)-(SDPPG-d)-(SDPPG-e)]/(SDPPG-a) [34,35].…”

“…AGI demonstrates the overall vascular stiffness, and it increases by age [34]. AGI can be calculated by the following formula: [(SDPPG-b)-(SDPPG-c)-(SDPPG-d)-(SDPPG-e)]/(SDPPG-a) [34,35]. Revised aging index (RAGI) is clarified as a novel SDPPG index [38].…”

“…The comparative heights of these waves (SDPPG-b/SDPPG-a, SDPPG-c/SDPPG-a, SDPPG-d/SDPPG-a and SDPPG-e/SDPPG-a ratios), mainly the SDPPG-b/SDPPG-a ratio, are associated with aging and carotid distensibility [32] and are used in computing the aging index [33]. A high SDPPG-b/SDPPG-a ratio indicates an increase in cardiovascular risk or atherosclerosis [34]. Takazawa et al [35] revealed that the SDPPG-b/SDPPG-a ratio indicates raised arterial rigidity, and the SDPPG-b/SDPPG-a ratio rose with age.…”