Infertility treatment and cardiovascular diseases

Infertility therapy linked to stroke risk

Denis Strigun, Naked Science

Canadian scientists have concluded that unsuccessful infertility treatment increases the risk of cardiovascular diseases in women. The article is published in The Canadian Medical Association Journal (CMAJ) – Jacob A. Udell, Failure of fertility therapy and consequent adverse cardiovascular events.

Existing methods of infertility treatment are often cyclical and are not absolutely safe. For example, women are often prescribed hormonal drugs that are designed for ovarian hyperstimulation. However, the long-term effects of such therapy have not been sufficiently studied, in addition, it is unclear how these procedures affect health in case of unsuccessful pregnancy.

Past work has shown that infertility treatment may be associated with an increased risk of cardiovascular disease. At the same time, the statistics are such that the experience of receiving such therapy is sometimes used by doctors as a specific cardiological stress test. However, until now, the correlation between infertility and diseases of the cardiovascular system has not been studied in large samples.

To fill in the gap, scientists from the University of Toronto analyzed the cases of 28,442 women under the age of 50 who underwent infertility treatment between 1993 and 2011 and were observed until 2015. The information was obtained from the database of the Ontario health insurance program OHIP: infertility experience was detected by specialists on two or more observations of menopausal gonadotropin deficiency or gonadotropin-releasing hormone. The researchers assessed the sociodemographic parameters two years before the end of therapy. This category included data on the place of residence, pregnancy history, smoking, obesity, coronary heart disease and heart failure, as well as the number of in vitro fertilization (IVF) procedures.

The frequency of cardiovascular pathologies and deaths after an unsuccessful
single or multiple infertility treatment (from an article in CMAJ)

The results showed that within a year after the final treatment, 32.9% of women managed to get pregnant and 67.1% of women failed, while the majority of patients (73.1%) underwent cyclic therapy. Conception occurred less often in older women who lived in poor areas, had diabetes mellitus, hypertension, and also did not have miscarriages. Neoplasms, depression, hypercholesterolemia were more common among women who failed to get pregnant after treatment.

Meanwhile, during the observation period, primary cardiovascular diseases were diagnosed among patients who did not undergo childbirth, 2.5 times more often than in women in labor. The annual increase in the indicator for women whose infertility treatment was unsuccessful was 19 percentage points. Venous thromboembolism, ischemic and hemorrhagic stroke, ischemic heart disease and heart failure were most often detected in this case. The correlation between unsuccessful therapy and ischemic (but not hemorrhagic) stroke and heart failure was statistically significant.

According to the authors, this relationship may be explained by artificial stimulation of the hormonal, in particular renin-angiotensin, system of the body that regulates blood volume and blood pressure. Thus, a violation of the humoral balance probably leads to a decrease in the internal volume of blood vessels and swelling of interstitial (neighboring) tissues, which increases the risk of cardiovascular diseases during and after pregnancy. It is planned to clarify this mechanism in further studies.

Portal "Eternal youth" http://vechnayamolodost.ru  13.03.2017