No link between fertility treatment and cardiovascular disease in later life

06 August 2013

A new study should reassure women undergoing fertility treatment that their cardiovascular health in later life is unlikely to be affected.

Dr Jacob Udell, a cardiologist at Women's College Hospital in Canada and lead author of the latest study, said it is unsurprising that concerns have been raised about possible links between fertility treatment and future cardiovascular disease.

He pointed out that "more women are waiting until an older age to have children, when they are at greater risk of developing heart disease".

However, Dr Udell's study - which is published in the Journal of the American College of Cardiology - indicates that while medications used during infertility treatment can cause short-term complications during pregnancy, they do not increase the risk of cardiovascular disease later on in life.

Importantly, the study involved a large number of women who had recently given birth - 1.1 million - and followed them for 17 years to shed light on the long-term risks of fertility treatment.

Analysis revealed that the use of fertility treatments increased five-fold between 1993 and 2010 in Ontario, with older women in particular opting to have this type of therapy.

The researchers confirmed that fertility treatment was associated with an increase in pregnancy complications.

For instance, there was an almost 30 per cent increase in gestational diabetes, a 16 per cent rise in placental disorders and a ten per cent higher rate of pre-eclampsia among women who underwent infertility treatment.

However, longer-term outcomes were favourable. Women who gave birth following successful fertility treatment were about half as likely to die during the follow-up period as those who did not have the therapy.

They also had nearly half the risk of major cardiovascular events - such as stroke, heart attack and heart failure - and showed no increase in their risk of developing breast or ovarian cancer in the future.

Furthermore, women who had fertility treatment were less likely to experience mental ill-health than those who gave birth without therapy. This included significantly reduced rates of depression and self-harm.

"Our findings provide some reassurance that fertility therapy does not appear to increase long-term risk of cardiovascular events following successful pregnancy," said Dr Donald Redelmeier, study co-author and a senior scientist at the Institute for Clinical Evaluative Sciences.

Commenting on the reduced rates of cardiovascular events among women who gave birth following infertility treatment, Dr Redelmeier argued that this is unlikely to be a direct effect of fertility medications.

Instead, the researchers believe women who undergo fertility treatment may be more likely to maintain a healthy lifestyle in general.

Dr Redelmeier explained: "Those with successful outcomes may have a powerful and durable change to their lifestyle. Unknown protective mechanisms may also contribute."

Dr Udell concluded that the findings help to explain the full impact of fertility treatment on women's health, but that more research is needed.

"With a better understanding of the long-term health effects associated with fertility therapy, we can help inform decision-making and reduce potential health risks to women," he concluded.

Posted by Jeanette Royston


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