do infertility treatments pose a risk to women’s health?
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researchers found that assisted reproductive technology (art), which has contributed to the birth of more than five million babies worldwide since 1978, can take a heavy toll on women. getty
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a new study says that the infertility treatments that increase the odds of conception may also raise the risk of women suffering from vascular and pregnancy-related problems.
the research, published in the journal of the american heart association, found that assisted reproductive technology (art), which has contributed to the birth of more than five million babies worldwide since 1978, can take a heavy toll on women. as the range of treatments, which involve handling eggs or embryos to improve the odds of conception, grow increasingly popular, researchers are cautioning that this success may come at a cost — especially as age becomes a factor.
“older women are increasingly turning to assisted reproductive technology, said pensée wu, study author of the study and senior lecturer and honorary consultant obstetrician and subspecialist at keele university school of medicine in staffordshire, u.k. “however, advancing maternal age — specifically being age 35 and older — increases the risk of having or developing conditions, such as chronic high blood pressure, that increase the risk of pregnancy complications.
‘high blood pressure risk factor for cardiovascular disease’
“adverse pregnancy complications such as high blood pressure during pregnancy have now been established as risk factors for future cardiovascular disease. all of this has raised concerns about adverse pregnancy outcomes associated with assisted reproductive technology, yet studies on the topic are few and have inconsistent findings.”
to better ascertain the risk, the team studied data from the u.s. national inpatient sample, a database of all hospital discharges between jan. 1, 2008 and dec. 31, 2016. focusing on delivery admissions that used assisted reproductive technology and those that included cardiovascular and pregnancy-related complications, they ended up with a pool of more than 106,000 deliveries conceived using art and more than 34,167,000 that did not.
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from this, they determined that women who used assisted reproductive technology were seven years older on average than those who did not (35 vs. 28) and had more pre-existing health conditions, including chronic hypertension, diabetes and obesity. women using art were 2.5 times more likely to experience acute kidney damage and had a 65 per cent higher risk of developing arrhythmia (an irregular heartbeat).
art was also associated with increased odds of placental abruption (57 per cent), cesarean delivery (38 per cent) and preterm birth (26 per cent). these risks were evident even among women with no pre-existing cardiovascular risks. the hospital bill was, on average, $18,705 for those who used art and $11,983 for those who did not.
“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,” wu said.
it also lays bare the importance of discussing these risks with women considering using assisted reproductive technology. “especially patients with existing cardiovascular risk factors should be counselled about the potentially long-term cardiovascular implications and risks associated with art,” wu said. “it’s important for women to know that assisted reproductive technology carries a higher risk of pregnancy complications, which require close monitoring, particularly during delivery. primary and specialist health-care professionals should ensure these risks are communicated and strategies to mitigate them are discussed and implemented.”
the study was limited by its retrospective nature, meaning it relied on data that was compiled for reasons other than research and may be subject to some errors, including misdiagnosis or misclassification. according to wu, it also lays the groundwork for subsequent inquiry.
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“future research should examine how optimizing cardiovascular risk prior to assisted reproductive technology impacts pregnancy complications and long-term cardiovascular health,” he said.
dave yasvinski is a writer with healthing.ca
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