Fertility appears unaffected by simple to moderate parental congenital heart disease
Click Here to Manage Email Alerts
Using Danish registry data of more than 1.3 million residents, researchers observed no association between simple to moderate congenital heart disease and infertility, according to a study in the Journal of the American Heart Association.
Individuals with congenital heart disease were more often childless, but those who became parents had a similar number of children compared with Danish residents without congenital heart disease.
Source: Adobe Stock
“Despite infertility being recognized as a global public health issue by the World Health Organization, it remains unknown whether infertility is more common in patients with congenital heart disease compared with unaffected individuals,” Louise F. Udholm, MD, of the department of cardiothoracic surgery at Copenhagen University Hospital, Denmark, and colleagues wrote. “In women with other cardiac defects, it is stated that their fertility is most likely comparable with the female background population; however, these claims are unreferenced. Although several case studies report higher rates of menstrual abnormalities and spontaneous abortions in women with severe heart defects, less is known about women with more simple lesions.”
Therefore, Udholm and colleagues evaluated the fertility in men and women with congenital heart disease compared with a background population of unaffected individuals. Using Danish health registries, the researchers identified 1,385,895 individuals born between 1977 and 2000, of whom 0.6% had congenital heart disease (50.9% simple defect; 34.1% moderate defect; 7% complex defect; 8% unspecified defect). The same registries were used to collect data on infertility and live-born children.
Fertility and congenital heart disease
Researchers observed that men and women with congenital heart disease had similar risk for infertility compared with the background population after follow-up for approximately 10 years (adjusted HR for men = 1.04; 95% CI, 0.9-1.19; aHR for women = 1; 95% CI, 0.88-1.14). Results were similar when restricted to individuals aged 34 to 41 years with the longest follow-up time, according to the study.
Among participants with complex defects, there was nonsignificant trend of higher risk for infertility, but the researchers wrote that more data are needed.
Live births and parental congenital heart disease
Among women with congenital heart diseases, 73.6% became mothers compared with 80.4% of women in the background population. The smallest proportion of women with congenital heart disease who became mothers were those with complex defects (66.7%).
Although women with congenital heart disease were more often childless compared with the background population, those who became mothers gave birth to a similar number of children compared with the background population, irrespective of disease severity.
Similarly, men with congenital heart disease were more often childless compared with the background population, with approximately 53% becoming fathers. Among men with congenital heart disease who became fathers, average number of children was similar compared with fathers in the background population.
“In both sexes, we found no evidence for an increased risk of infertility when comparing individuals with simple and moderate congenital heart disease with individuals without congenital heart disease,” the researchers wrote. “For men and women with complex defects, we could neither reject nor confirm an association because of imprecise estimates. Regardless of defect severity, birth rates were lower than rates from the background population, but patients with congenital heart disease who had children reached the same number of children compared with unaffected parents.
“In Denmark, the free and equal health care system ensures early diagnosis and intervention in children presenting with congenital heart disease and therefore improves their long-term outcomes,” the researchers wrote. “Results from the present study may therefore only be generalized to populations with similar health care systems.”
Collapse
Click Here to Manage Email Alerts