Pregnancy and Vascular Risks Surge With Infertility Treatments

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Highlights:

• Use of assisted reproductive technology (ART) has been doubled during the past decade
• Although ART offers wide range of benefits for infertility problems, it has equal risk of pregnancy and vascular complications
• Astoundingly, these higher risks were independently associated even among those without pre-existing comorbidities

Risks for pregnancy and vascular complications may heighten with common infertility treatments (assisted reproductive technology) as per a study published in a special Go Red for Women� issue of the Journal of the American Heart Association, open access, peer-reviewed journal of the American Heart Association.

What is Assisted Reproductive Technology?

Assisted reproductive technology (ART) is an umbrella term for all infertility treatments where the timing of ovulation is controlled by administering medications to improve the odds of pregnancy.

This also includes various procedures like in vitro fertilization (IVF) or intracytoplasmic sperm injection where a woman's eggs (ovum) are retrieved surgically to fertilize them in a laboratory followed by implantation into the uterus.

Prevalence of ART

The use of assisted reproductive technology is found to be more than doubled during the past decade as per the 2019 statistics from the U.S. Centers for Disease Control and Prevention.

‘Assisted reproductive technology (ART) is found to be associated with various pregnancy related complications and systemic risks like acute kidney failure, and irregular heartbeat.’

Annually, more than 2% of U.S.-born infants through assisted reproductive technology. ART has allowed for more than 5 million infants to birth globally since 1978.

"Older women are increasingly turning to assisted reproductive technology. 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," says study author Pens�e 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, United Kingdom.

Study on Assisted Reproductive Technology

The study team examined U.S. National Inpatient Sample data that included all hospital discharges between January 1, 2008, and December 31, 2016, from which records specifying the use of assisted reproductive technology and related cardiovascular and pregnancy-related complications were extracted.

The study also involved more than 106,000 deliveries conceived with assisted reproductive technology and more than 34,167,000 deliveries conceived without ART.

"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. A better understanding of the potential impact of assisted reproductive technology on women's risks for cardiovascular- and pregnancy-related outcomes will help inform women considering assisted reproductive technology and is valuable after birth to develop cardiovascular risk reduction strategies," says Wu.

Pregnancy and Vascular Complications

Following were found by the study:

• Assisted reproductive technology was opted by older women of average age 35 years as compared to women of 28 years who conceived without ART.
• A higher number of pre-existing health conditions like chronic hypertension, obesity, and diabetes were prevalent among those who conceived with assisted reproductive technology.
• Prevalence of acute kidney failure (or acute kidney damage) was more than 2.5 times and the risk for arrhythmia (irregular heartbeat) was 65% higher among the women who were conceived using assisted reproductive technology.
• The study also noted a 57% higher risk of placental abruption (serious complication where the placenta separates from the lining of the uterus), 38% increased risk of Cesarean delivery, and a 26% higher risk for preterm birth among pregnancies conceived with assisted reproductive technology.
• Women who had conceived with assisted reproductive technology also had an average hospital expense of $18,705 when compared to $11,983 for those who conceived without ART.

"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," says Wu.

Need for Better counselling for ART

The present study thereby highlights the significance of counseling patients about health, pregnancy, and postpartum-related risks, who opt for assisted reproductive technology.

"Especially patients with existing cardiovascular risk factors should be counseled about the potentially long-term cardiovascular implications and risks associated with ART. 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," says Wu.

As the study was retrospective in nature, further records are needed to overcome the limitation of the study.

Reference :

1. Common infertility treatments may increase risks for pregnancy, vascular complications - (https:newsroom.heart.org/news/common-infertility-treatments-may-increase-risks-for-pregnancy-vascular-complications?preview=8a6a)

Source: Medindia

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