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Review
. 2023 Sep 15;6(2Part B):142-152.
doi: 10.1016/j.cjco.2023.09.008. eCollection 2024 Feb.

Change of HeART: Cardiovascular Implications of Assisted Reproductive Technology

Elaha Niazi  1   2   3 , Sandra M Dumanski  1   2   3
Affiliations
Review

Change of HeART: Cardiovascular Implications of Assisted Reproductive Technology

Elaha Niazi et al. CJC Open. .

Abstract
in English, French

Cardiovascular (CV) disease is the leading cause of death in women, and it may manifest differently than in men, in part related to sex-specific CV risk factors. In females, assisted reproductive technologies (ARTs) are commonly used to treat infertility, and they utilize controlled ovarian stimulation involving the administration of exogenous sex hormones. ARTs, and especially controlled ovarian stimulation, have been associated with an increased pregnancy and short-term CV risk, although the long-term CV implications of these treatments in individuals treated with ARTs and their offspring remain unclear. This review endeavors to provide a comprehensive examination of what is known about the relationship between ART and CV outcomes for females treated with ARTs, as well as their offspring, and recommendations for future research. Novel insights into female-specific CV risk factors are critical to reduce the disproportionate burden of CV disease in Canadian women. ART has revolutionized reproductive medicine, offering hope to millions of individuals with infertility worldwide, and a further understanding of the CV implications of this important sex-specific CV risk factor is warranted urgently.

Les maladies cardiovasculaires représentent la principale cause de décès chez les femmes, chez qui elles peuvent se manifester différemment, en partie en raison des facteurs de risque cardiovasculaire spécifiques au sexe. Chez les femmes, des technologies de procréation assistée (TPA) sont couramment utilisées pour traiter l’infertilité et font appel à la stimulation ovarienne contrôlée qui comporte l’administration d’hormones sexuelles exogènes. Les TPA, et particulièrement la stimulation ovarienne contrôlée, ont été associées à une hausse du risque cardiovasculaire pendant la grossesse et à court terme, alors que les implications cardiovasculaires à long terme de ces traitements chez les patientes traitées et leurs enfants demeurent nébuleuses. Cette analyse vise à brosser un portrait complet des connaissances acquises sur le lien entre les TPA et les issues cardiovasculaires chez les femmes qui y ont recours, ainsi que chez leurs enfants, et de formuler des recommandations pour de futures recherches. Il est essentiel d’avoir de nouveaux éclairages sur les facteurs de risque cardiovasculaire spécifiques aux femmes pour réduire le fardeau disproportionné des maladies cardiovasculaires chez les Canadiennes. Les TPA ont révolutionné la médecine de la reproduction, offrant de l’espoir à des millions de personnes touchées par l’infertilité dans le monde; il est toutefois urgent de mieux connaître les implications cardiovasculaires de ces importants facteurs de risque cardiovasculaire spécifiques au sexe.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Cardiovascular (CV) outcomes throughout the assisted reproductive technology (ART) timeline. COS, controlled ovarian stimulation; HDP, hypertensive disorders of pregnancy; OHSS, ovarian hyperstimulation syndrome; RAAS, renin-aldosterone angiotensin system.
See this image and copyright information in PMC

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