Women who experience infertility are more likely to develop heart and blood vessel conditions later in life, with younger women and those who undergo fertility treatments at a greater risk. The findings, presented at the first Joint Congress between the European Society of Paediatric Endocrinology (ESPE) and the European Society of Endocrinology (ESE), highlight the importance of considering a woman's reproductive history when assessing her long-term heart health.
Approximately one in every six people of reproductive age worldwide is estimated to experience infertility in their lifetime. Treatment of infertility often involves in-vitro fertilisation (IVF) and other types of assisted reproductive technology (ART). While previous studies have shown infertility may be an early marker of cardiovascular risk, the data have been conflicting and no comprehensive review has yet provided a broad assessment of the possible impact of medically assisted reproduction.
In this study, Greek researchers from the National and Kapodistrian University of Athens looked at 21 studies, involving 178,828 women with infertility and 3,398,781 women without fertility issues, that associated female infertility with cardiovascular disease later in life. The researchers found that women with infertility have a 14% increased risk of developing conditions affecting the heart or blood vessels, a 17% increased risk of heart disease and a 16% increased risk of a stroke when compared to women without an infertility history. In addition, the risk of cardiovascular disease increased by 20% in younger women with infertility, especially those under 40, and by 4% in women who underwent assisted reproductive technology treatments.
"This is the largest meta-analysis to not only examine the potential link between a history of infertility in women and cardiovascular risk but also the impact of assisted reproductive technologies on their likelihood of developing future cardiovascular events," said lead researcher Dr Elena Armeni. "By gathering data from many studies, our work adds strong evidence to a growing field and suggests that infertility could be an early warning sign for future heart health issues."
Dr Armeni added: "Recognising infertility as a potential early marker for cardiovascular disease could help doctors identify women who may need closer monitoring or preventive strategies earlier in life. It also raises important questions about the long-term effects of fertility treatments like assisted reproductive technology (ART) treatments."
"Some earlier studies did not find a strong association between infertility and heart disease, so in our meta-analysis we addressed this by including only high-quality studies and performing sensitivity analyses based on study design and participant age," said Dr Armeni.
The researchers now plan to follow women with and without infertility over time to improve understanding of how fertility history impacts their heart health. "We aim to create a well-designed prospective study that will closely examine the relationship between different causes of infertility, exposure to assisted reproductive technologies and long-term cardiovascular outcomes," said Dr Armeni.
"We hope to clarify the biological mechanisms behind these associations and identify which groups are at greatest risk. Ultimately, this will help shape future guidelines for early prevention strategies and improve cardiovascular care for women with a history of infertility."
