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Fertility treatment and heart health: study finds no long-term risks

Women who have used fertility therapy to add to their families need not worry about the effects of those treatments on their long-term heart health.

A research study found no link between fertility treatment and excess cardiovascular risk later in life. In fact, mothers who conceived using fertility treatment had significantly lower cardiovascular risks than other mothers.

“It’s a reassuring finding,” says Dr. Jacob Udell, lead study author and a cardiologist at Women’s College Hospital (WCH). “We don’t need to sound any alarm bells, and that should reassure practitioners and patients.”

Potential risks

As the researchers point out in the introduction to their study, the focus of fertility treatment is to get pregnant. That short-term goal is the priority – not necessarily long-term health. However, there are some potential risks associated with fertility treatment. It is associated with short-term risk of blood clots, and with increased risk for high blood pressure in pregnancy and diabetes in pregnancy.

“All of which could lead to long-term cardiovascular disease,” says Dr. Udell.

Possible long-term health risks of fertility treatment are becoming more relevant as older mothers become more common. More women are delaying pregnancy until they are older and more at risk of developing heart disease.

“In those women who need to use fertility therapy, sometimes you need to use it several times, for several cycles, before it’s successful,” Dr. Udell says. “No one had looked at this before: whether or not there were any long-lasting cardiovascular effects of fertility drugs in these women.”

Reassuring results

For the study, Dr. Udell and his colleagues looked at births in Ontario hospitals from 1993 to 2010. They included 1,186,753 mothers. Of those, 6,979 had received fertility treatment within two years of delivering a baby. Fertility treatments included intrauterine insemination, in-vitro fertilization (IVF), and other types of stimulated ovulation.

Then they tracked the women’s cardiovascular health for an average of 10 years. They looked at which women were hospitalized or died from heart attack, heart failure or stroke.

The study did not find any excess cardiovascular risk among the women who had fertility therapy. In fact, those who had fertility treatments actually had 45 per cent lower cardiovascular risks than those who did not.

“We found that very reassuring. We delved a little deeper and realized that these women were likely leading very healthy lifestyles after fertility therapy,” Dr. Udell says.

The study did not include women who used fertility therapy but did not give birth.

“It’s important to look at that group, and that’s our next study,” Dr. Udell says, adding that women may undergo fertility treatment multiple times without a successful pregnancy.

Increased complications and risks

Although they had no long-term cardiovascular risks, the women who had fertility therapy did have an increased incidence of pregnancy complications. They were more likely to have diabetes in pregnancy, placental disorders and pre-eclampsia.

The average age of women who received fertility treatment was 34, compared to 29 for those who did not.

“Women going into fertility therapy were on average five years older than the general population getting pregnant, and also had established risk factors of high blood pressure, diabetes and obesity going into pregnancy,” Dr. Udell says, adding that the research team hopes that the study draws attention to risk factors that may get overlooked after pregnancy.

“At Women’s College Hospital we advocate for a preventive cardiology approach, especially in women,” Dr. Udell says.

“I hope this is a call to those people who do notice that they have risk factors to get some preventive attention and care, either with their family doctor, with an internist or a cardiologist.”

The research from WCH and the Institute for Clinical Evaluative Sciences (ICES) was published in the Journal of the American College of Cardiology.

This information is provided by Women’s College Hospital and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: Oct. 28, 2014

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