Infertility, fertility treatment, and risk of hypertension

Farland, Leslie V.; Grodstein, Francine; Srouji, Serene S.; Forman, John P.; Rich‐Edwards, Janet W.; Chavarro, Jorge E.; Missmer, Stacey A.

doi:10.1016/j.fertnstert.2015.04.043

Cited by 35 publications

(28 citation statements)

References 26 publications

(19 reference statements)

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“…The study revealed that at a median follow-up of 9.7 years post-delivery, women who had used FTs (n ¼ 6979) had fewer cardiovascular events than those who had not (n ¼ 1,186,753). 8 More specifically studying hypertension, the Nurses' Health Study II, involving 116,430 women, reported that the incidence of hypertension is not higher among women who had previously undergone FT. 44 In contrast, a Swedish study by Westerlund et al found higher rates of hypertension among 23,498 women who had undergone IVF compared with 116,960 individually matched mothers from the Medical Birth Register. 45 One explanation for this could be a baseline difference in incidence or risk factors for hypertension among the sub-fertile population.…”

Section: Long-term Cardiovascular Risk Of Ftsmentioning

confidence: 89%

Pregnancy and cardiovascular risk: A review focused on women with heart disease undergoing fertility treatment

Rossberg

Stangl

2016

Eur J Prev Cardiolog

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A growing number of women with heart disease are considering pregnancy with the help of assisted reproductive technology (ART). Although an ever-increasing amount of knowledge exists on pregnancy in both congenital and acquired heart disease patients, little information is available on fertility treatments specifically in these women. This review seeks to provide an overview of the existing data and explores areas in need of research in this field. Changes in the hormonal environment seen in ART patients initially entail an increase then a decrease in blood pressure and peripheral vascular resistance. A shift in the thrombotic-thrombolytic balance towards coagulation is observed. Compared to normal pregnancy, ART-conceived pregnancies exhibit an increased adverse event rate for both the mother and foetus, including a higher incidence of hypertensive disorders and an increase in thromboembolic events during the first trimester. Ovarian hyperstimulation syndrome in particular can cause dramatic haemodynamic changes and an increase in upper body thrombosis. Viewing these findings within the context of women with an underlying heart disease reveals indications that maternal and neonatal complications after fertility treatments are higher. Pre-pregnancy risk assessment is essential to identifying women with heart disease for whom ART may be dangerous and therefore inappropriate.

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Section: Long-term Cardiovascular Risk Of Ftsmentioning

confidence: 89%

Pregnancy and cardiovascular risk: A review focused on women with heart disease undergoing fertility treatment

Rossberg

Stangl

2016

Eur J Prev Cardiolog

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“…In a prior study, attempts were made to elucidate the effect of infertility diagnosis vs infertility treatment by comparing those who reported infertility and received treatment to those who did not; however, the authors were focused on long-term and not pregnancy-specific risks [27]. While it is still unknown whether it is infertility status or infertility treatment that confers increased risk of hypertensive disorders, there are a few hypotheses that could explain the link.…”

Section: Discussionmentioning

confidence: 99%

Hypertensive disorders of pregnancy and infertility treatment: a population-based survey among United States women

Monseur

Morris

Hipp

et al. 2019

J Assist Reprod Genet

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Purpose To explore associations between infertility treatment and hypertensive disorders of pregnancy. Methods We collated multi-year as well as multi-state data from a national representative survey examining the association between self-reported infertility treatment (i.e., medication, intrauterine insemination, or assisted reproductive technology) and hypertensive disorders of pregnancy (i.e., high blood pressure, pregnancy-induced hypertension (PIH), preeclampsia, and toxemia). Data were analyzed using logistic regression. A total of 21,884 women in the United States (U.S.), from the Centers for Disease Control and Prevention's (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS) survey (2009-2015), participated in the study. Results In our analysis, 12.91% women reported a history of infertility treatment and 15.19% reported a history of hypertensive disorder of pregnancy. Compared with women who had never had infertility treatment, women who reported infertility treatment had 1.18 (adjusted OR, 95% confidence interval (CI) 1.05, 1.33) higher odds of reporting hypertensive disorder of pregnancy. Neither types of infertility treatment nor proximity of treatment to pregnancy were independently associated with hypertensive disorder of pregnancy. Conclusions Our results suggest that among U.S. women, the treatment of infertility may be associated with hypertension disorder of pregnancy regardless of type of treatment.

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“…It is estimated that more than 6 million individuals have been conceived using ART worldwide [81]. Earlier studies did not show an apparent increase in hypertension risk among infertile women or among those with previous fertility treatment [82]. More recently, women who conceived through ART have been shown to be at increased risk of hypertensive disorders in pregnancy.…”

Section: Assisted Reproductive Technologies (Art)mentioning

confidence: 99%

Hypertension and Reproduction

et al. 2020

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Purpose of Review Many aspects of reproduction have been associated with increased blood pressure and impaired glucose metabolism that reveals a subsequent increased risk of cardiovascular disease. The aim of this review is to assess reproductive life factors associated with an increased risk of hypertension and cardiovascular disease, e.g., early life programming, sexual, and reproductive health in men and women. Recent Findings Impaired fetal growth, with low birth weight adjusted for gestational age, has been found associated with hypertension in adulthood. Erectile dysfunction, currently considered an early diagnostic marker of cardiovascular disease preceding the manifestation of coronary artery disease by several years, frequently coexisting with hypertension, could also be exacerbated by some antihypertensive drugs. Male hypogonadism or subfertility are associated with increased cardiovascular risk. Hypertensive disorders in pregnancy including preeclampsia represent a major cause of maternal, fetal and neonatal morbidity, and mortality. The risk of developing preeclampsia can be substantially reduced in women at its high or moderate risk with a low dose of acetylsalicylic acid initiated from 12 weeks of gestation. An increased risk of hypertension in women following invasive-assisted reproductive technologies has been newly observed. Blood pressure elevation has been noticed following contraceptive pill use, around the menopause and in postmenopausal age. Furthermore, drug treatment of hypertension has to be considered as a factor with a potential impact on reproduction (e.g., due to teratogenic drug effects). Summary In summary, a deeper understanding of reproductive life effects on hypertension and metabolic abnormalities may improve prediction of future cardiovascular disease.

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Infertility, fertility treatment, and risk of hypertension

Cited by 35 publications

References 26 publications

Pregnancy and cardiovascular risk: A review focused on women with heart disease undergoing fertility treatment

Pregnancy and cardiovascular risk: A review focused on women with heart disease undergoing fertility treatment

Hypertensive disorders of pregnancy and infertility treatment: a population-based survey among United States women

Hypertension and Reproduction

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