History of infertility associated with increased risk for heart disease
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Women with a history of infertility have an increased risk for CHD, but not stroke, according to a study published in the Journal of the American Heart Association.
“Overall, we observed that women with infertility were at increased risk of CHD, and this risk was strongest among women who experienced infertility at a younger age,” Leslie V. Farland, ScD, assistant professor in the department of epidemiology and biostatistics at the University of Arizona Mel & Enid Zuckerman College of Public Health, and colleagues wrote. “When we investigated differences by cause-specific infertility, we observed that the greatest risk of CHD was observed among women whose infertility was attributed to ovulatory disorders or endometriosis.”
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Using data from the Nurses’ Health Study II, the researchers identified participants who were experiencing infertility or had a history of infertility, including those who eventually became pregnant.
Participants were asked to self-report the cause of their infertility, whether it was tubal blockage, ovulatory disorder, endometriosis, cervical mucus factors, male factor infertility, not investigated, not found or other.
In follow-up questionnaires, patients were asked to report any new diagnosis of MI, stroke, CABG or PCI.
Among the cohort, 27.6% reported infertility, of whom 782 had incident MIs, 984 had incident revascularization events and 762 had incident stroke events.
The researchers found that women with a history of infertility were at greater risk for CHD than those who never experienced infertility (HR = 1.13; 95% CI, 1.01-1.26). However, those who experienced infertility were not at greater risk for stroke (HR = 0.91; 95% CI, 0.77-1.07).
Farland and colleagues also found that women who first reported infertility at age 25 or younger were at higher risk for CHD (HR = 1.26; 95% CI, 1.09-1.46) than those who were older when they reported infertility.
When the researchers analyzed CHD risk according to specific infertility diagnoses, they found the risk was greatest among women with ovulatory disorders, including polycystic ovary syndrome (HR = 1.28; 95% CI, 1.05-1.55) or endometriosis (HR = 1.42; 95% CI, 1.09-1.85).
“Future research should continue to investigate informative heterogeneity by infertility symptom presentation, as this may lead to a better understanding of mechanisms of association and identify groups that may benefit from targeted screening or interventions,” Farland and colleagues wrote.
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