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Some infertility treatments may raise risk for pregnancy complications

  1. New research suggests that a growing number of infertility treatment options for older women could increase the likelihood of complications, particularly if there are pre-existing cardiovascular risk factors.The Journal of the American Heart Association published the study Tuesday, which examined the risk of complications for women who had conceived via assisted reproductive technology (ART). The study found a higher risk of vascular complications such as irregular heartbeats or kidney injuries in hospitalized women who had ART treatment, as well as pregnancy complications such as placental separation, cesarean birth, or preterm births, than those who did not use ART.

    ART is a group of infertility treatments that manipulate eggs or embryos in order to increase a woman’s chance of getting pregnant. This includes medication that controls ovulation, as well as procedures that surgically remove eggs, fertilize them, and then implant them into the uterus.

    According the Centers for Disease Control and Prevention (CDC), such procedures have doubled their use in the past decade and are particularly popular with older women trying to conceive.

    “However, the risk of developing or having conditions such as chronic high blood sugar, which can increase the risk for pregnancy complications, increases with increasing maternal age, specifically being 35 years old,” Dr. Pensee Wu, the study author, stated in a press release. Wu is a senior lecturer at Keele University School of Medicine, Staffordshire, United Kingdom. He is also a subspecialist in maternal and fetal medicine.

    Wu stated that adverse pregnancy complications such as high blood pressure during pregnancy have been identified as risk factors for future heart disease.

    The authors point out that maternal deaths due to cardiovascular disease are the most common cause. However, there is little evidence and inconsistent research on this topic. 

    New study looked at hospital discharge records for 2008-2016 for approximately 106,248 births for babies with ART and 34.2 million for those who were not. The study found that women who had ART conceived were seven years older than those who did not. Pre-existing conditions such as diabetes, high blood pressure, and obesity were also more common in these women.

    Infertility treatment for women to conceive was more than 2.5x more likely to cause kidney failure. There were also a 65% greater chance of developing irregular heartbeats, which is known as an arrhythmia.

    These women were also more likely to experience pregnancy complications. The ART group had a 57% higher chance of placental abruption (a serious condition where the placenta splits from the uterus lining); a 38% greater risk of having a Cesarean section; and a 26% greater risk of having their baby prematurely delivered. The risk of complications was higher for women who had cardiovascular risk factors. However, it was not the highest for those who did.

    Wu stated that it was surprising that assisted reproductive technology was not only associated with pre-existing conditions, or among older women who are undergoing treatment.

    Women who had ART performed also received more hospital charges than women who had a normal pregnancy. The average charge was $18,705, while the average cost for a non-ART conceive was $11,983.

    Wu stated that these findings highlight the importance of counseling women about the dangers associated with infertility treatment.

    Wu stated that ART should be discussed with anyone with existing cardiovascular risk factors. It is important that women are aware that assisted reproductive technology can increase the risk of complications during pregnancy. This will need to be closely monitored, especially during childbirth. These risks should be communicated to specialists and primary health care providers. Strategies to reduce them should also be discussed and implemented. 

    Email editor@heart.org if you have any questions or comments.

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