- Among the women who undergo treatment for fertility only a small proportion deliver and the remaining fail to conceive.
- The risk of long-term cardiovascular diseases in such women, who fail to get pregnant is found to be higher.
- Women who fail to become pregnant after fertility treatment should stay mindful of their health and remind their physician about any fertility therapy years earlier.
Women who undergo fertility therapy, but do not get pregnant, have a higher risk of developing long-term cardiovascular disease, compared with women who become pregnant.
"We found that two-thirds of women never became pregnant after being managed for fertility treatment and these women also had worse long-term cardiovascular risk, specifically higher risks of stroke and heart failure, compared with the remaining third of women who did become pregnant and delivered a baby," says Dr. Jacob Udell, lead author of the study, scientist at the Institute for Clinical Evaluative Sciences (ICES) and cardiologist at the Peter Munk Cardiac Centre and Women's College Hospital.
‘Women who fail to get pregnant after fertility therapy should be reviewed for risk factors for future heart diseases and ways to protect them should be discussed.’
Women who fail to get pregnant are often prescribed fertility therapy. Doctors often recommend repeated cycles of treatment that are a mix success and possible short-term metabolic risks.
But there is a lack of data on the long-term health effects of fertility therapy, especially in women who do not conceive.
Failure of fertility therapy may be an early indicator of future cardiovascular risk by acting as a unique cardiometabolic stress test.
The researchers studied 28,442 women under 50 years who underwent fertility therapy in Ontario during the study (April 1993 through March 2011).
Their average age was 35 years and 83% or 23,575 had no previous deliveries.
The women were followed until March 31, 2015, for adverse cardiovascular effects.
Around 9349 or one-third of the women gave birth within 1 year of final treatment, while the remaining two-thirds did not give birth.
Fertility therapy failure was associated with a 19% increased risk of adverse cardiovascular events, especially, heart failure.
The findings stressed that the absolute risk of cardiovascular events were 10 events per 1000 women after 10 years among those who had failed fertility therapy compared to 6 events per 1000 women for those who became pregnant and delivered a child after fertility therapy.
"These findings are consistent with the hypothesis that fertility therapy may represent an early indication for future cardiovascular disease because it represents a unique cardiometabolic stress test," write the authors.
"We don't want to alarm women who undergo fertility therapy; we are instead suggesting that as women age, they should stay mindful of their health and remind their physician about any fertility therapy years earlier," states Dr. Donald Redelmeier, co-author of the study and senior scientist at ICES.
"It can be an opportunity for their doctor to review other risk factors for heart disease and discuss ways to protect against future cardiac problems." Redelmeier added.
The study is published in CMAJ (Canadian Medical Association Journal)
- Jacob Udell et al. Failure of fertility therapy and subsequent adverse cardiovascular events. Canadian Medical Association Journal; (2017) doi: 10.1503/cmaj.160744