Women over 35 may be especially at risk for heart and pregnancy complications after fertility treatments
A new study published in the Journal of the American Heart Association today found a notable increase in heart and pregnancy complications in people who became pregnant using fertility treatments.
The risks increased with maternal age — but there are still lots of questions to ask and a lot more research to be done about why this correlation exists and what it means for those trying to get pregnant with assistance.
Assistive reproductive technology (ART) is the umbrella term for a number of treatments and procedures that increase a person’s odds of getting pregnant, including medication to control ovulation and in vitro fertilization, where embryos are created in a laboratory and then transferred into the uterus.
The study examined data from over 106,000 deliveries of babies conceived using assistive reproductive technology, and over 34 million deliveries of babies conceived without it.
The vascular complications (those related to the circulatory system) that the study looked at included acute kidney injury and arrhythmia, which means an irregular heartbeat. The pregnancy complications which the study examined included preterm delivery, C-section, and placental abruption, in which the placenta separates from the wall of the uterus before the baby is born.
Researchers found that when a pregnancy was achieved using ART, the pregnant person was more that 2.5 times as likely to suffer acute kidney injury at the time of delivery, and that they were 65% more likely to be diagnosed with arrhythmia. In terms of obstetric outcomes, people who became pregnant using ART were at at 57% increased risk of placental abruption, a 38% increased chance of C-section, and a 26% increased chance of delivering preterm (prior to 37 weeks).
The study also found that people who used ART tended to be older and have more pre-pregnancy health conditions like diabetes, obesity, and high blood pressure. Indeed, the study found that people with these pre-exisiting conditions were at even greater risk of complications.
However, an increase in complications was also found in people who used ART and did not have these health conditions prior to pregnancy.
“We were surprised that assisted reproductive technology was independently associated with these complications, as opposed to being associated with only the existence of pre-existing health conditions or only among older women undergoing infertility treatment,” said Pensée Wu, M.B.Ch.B., M.D., senior lecturer and honorary consultant obstetrician and subspecialist in Maternal Fetal Medicine at Keele University School of Medicine in Staffordshire in a statement.
Potential weaknesses of this study include that it was retrospective, meaning that the data were not collected specifically for the study but gathered later from medical records. Another concern is that the study didn’t differentiate between types of ART, such that someone who used medication to induce ovulation once and got pregnant was placed in the same group as someone who underwent multiple rounds of IVF.
It’s also important to note that the study did not determine the cause of each complication. It’s possible that underlying conditions, such as PCOS, that cause infertility may also increase a person’s risk of cardiovascular disease.
If you’re trying to get pregnant using ART, or are pregnant after ART, you likely have plenty to worry about already, thank you very much. Remember that every individual’s risk of pregnancy complications is influenced by multiple factors, and engage in open communication with your healthcare provider about your cardiovascular health and any concerns that you may have.
Pregnant or not, getting regular healthcare and successfully managing conditions like high blood pressure and diabetes is critical to staying healthy.
And remember: even if this study is replicated and backed in the future, it will only help us make fertility treatments safer and more successful in the future.