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Assisted Reproductive Technology and Cardiovascular Risk in Women

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Abstract

Purpose of Review

To summarize what is currently known regarding the impact of assisted reproductive technology (ART) on the cardiovascular health of women, both during treatment and long-term, and to highlight specific at-risk subgroups and treatment considerations.

Recent Findings

Women utilizing ART are already at increased risk for cardiovascular pathology, and the association between ART and adverse pregnancy outcomes makes disentangling the individual contribution of ART to CVD risk challenging. Pregnancies conceived from ART are at increased risk for several complications including maternal venous thromboembolism and hypertensive disorders. The use of frozen embryo transfer and trophectoderm biopsy for preimplantation genetic testing appear to significantly increase the risk of hypertensive disorders of pregnancy. Though limited, current available evidence suggests ART does not appear to be associated with an increased risk for long-term cardiovascular morbidity and mortality. Women with pre-existing cardiac disease require specialized care from a multi-disciplinary team but can be considered candidates for ART with use of a gestational carrier even if pregnancy is not deemed safe due to their underlying conditions.

Summary

More high-quality evidence is needed to better assess the short and long-term effects of ART on the cardiovascular health of women. ART for special populations, including those with pre-existing cardiac conditions, requires special consideration to minimize complications.

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Abbreviations

HR:

Hazard ratio

RR:

Relative risk

OR:

Odds ratio

CVD:

Cardiovascular disease

BMI:

Body mass index

ART:

Assisted reproductive technology

IVF:

In vitro fertilization

ICSI:

Intracytoplasmic sperm injection

FET:

Frozen embryo transfer

PGT:

Preimplantation genetic testing

HDP:

Hypertensive disorders of pregnancy

OHSS:

Ovarian hyperstimulation syndrome

RCT:

Randomized controlled trial

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Funding

WRHR NIH NICHD Award # K12 HD103036, PI Andrew Satin, RD James Segars.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility, Johns Hopkins University School of Medicine, 10751 Falls Road, Suite 280, Lutherville, MD, 21093, USA

    Katherine Cameron & Valerie L. Baker

  2. Department of Obstetrics, Gynecology and Reproductive Biology, Michigan State University, 965 Fee Rd., East Lansing, MI, USA

    Barbara Luke

  3. Reproductive Endocrinology and Infertility, Spring Fertility, 550 Lakeside Drive Sunnyvale, Sunnyvale, CA, USA

    Gaya Murugappan

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  1. Katherine Cameron
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  2. Barbara Luke
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  4. Valerie L. Baker
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Correspondence to Valerie L. Baker.

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Conflict of Interest

Katherine Cameron, Barbara Luke, and Gaya Murugappan declare that they have no conflict of interest.

Valerie Baker receives support from the NICHD grant R01HD100341 to study the risk of hypertensive disorders following frozen embryo transfer.

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Cameron, K., Luke, B., Murugappan, G. et al. Assisted Reproductive Technology and Cardiovascular Risk in Women. Curr Cardiovasc Risk Rep 18, 1–11 (2024). https://doi.org/10.1007/s12170-023-00732-3

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