Do Fertility Treatments Raise Heart Disease Risks in Women?

METHODOLOGY:

Researchers analysed Norwegian registry data on women born between 1965 and 2000 who were alive and living in Norway in 2009 to see whether the number of ART cycles was linked to later hypertension and CVD.
They included over 1.61 million women and identified ART cycles from pharmacy prescription records between 2004 and 2020, with cycles classified as either fresh (70.57%) or frozen (29.43%).
Among women who underwent ARTs, 28.70% had one cycle, 20.86% had two cycles, 15.92% had three cycles, and 34.52% had four or more cycles by the end of follow-up.
Researchers compared the occurrence of chronic hypertension and CVD using two reference groups: women unexposed to ARTs and ART users who underwent one cycle.
Total follow-up exceeded 15 million person-years in the analysis comparing ART users with non-users and exceeded 175,000 person-years in the analysis restricted to ART users comparing additional cycles with one cycle.

Each additional ART cycle was associated with a small rise in the risk for CVD compared with no ART (adjusted hazard ratio [aHR], 1.07; 95% CI, 1.04-1.10), with no clear dose-response relationship; no such association with chronic hypertension was reported.
The excess risk for CVD was mainly driven by deep vein thrombosis (aHR, 1.18; 95% CI, 1.11-1.25) and pulmonary embolism (aHR, 1.17; 95% CI, 1.06-1.29).
Among ART users, each additional cycle was associated with a 7% increased risk for CVD (aHR, 1.07; 95% CI, 1.02-1.13). Compared with exposure to one cycle, exposure to four or more cycles showed a larger but imprecise increase in the risk (aHR, 1.34; 95% CI, 0.99-1.81).
Each additional programmed frozen ART cycle was linked to an increased risk for CVD (aHR, 1.35; 95% CI, 1.18-1.55), with a clear dose-response relationship as aHRs ranged from 2.95 to 5.64 as the number of cycles increased.

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