Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2025 Feb 21;46(8):687-698.
doi: 10.1093/eurheartj/ehae886.

Cardiovascular safety of assisted reproductive technology: a meta-analysis

Carlo Andrea Pivato  1   2 , Annalisa Inversetti  1   2 , Gianluigi Condorelli  1   2 , Alaide Chieffo  3 , Paolo Emanuele Levi-Setti  1   2 , Alessia Chiara Latini  1   2 , Andrea Busnelli  1   2 , Martina Messa  1   2 , Martina Cristodoro  1   2 , Renato Maria Bragato  1   2 , Marco Francone  1   2 , Luisa Zuccolo  4   5 , Francesca Ieva  5   6 , Emanuele Di Angelantonio  5   7   8   9   10   11 , Giulio Stefanini  1   2 , Nicoletta Di Simone  1   2
Affiliations
Meta-Analysis

Cardiovascular safety of assisted reproductive technology: a meta-analysis

Carlo Andrea Pivato et al. Eur Heart J. .

Abstract

Background and aims: The increasing use of assisted reproductive technology (ART) has raised concerns regarding its long-term cardiovascular safety due to potential hormonal imbalances and pro-thrombotic states. This study aimed to assess the long-term cardiovascular risk associated with fertility treatments in women.

Methods: Following PRISMA guidelines, a systematic review and meta-analysis was conducted in MEDLINE (via PubMed) from inception to January 2024. Randomized, cohort, or case-control studies were included if fulfilling the following criteria: the association between ART and the subsequent cardiovascular outcome was reported and adjusted for confounding factors (at least age); the presence of a control group; and minimum 1-year follow-up. Effect size (ES) estimates of the association between fertility therapy and subsequent cardiovascular disease were pooled using the DerSimonian and Laird random-effects model. Heterogeneity was assessed with the I2 index. This study is registered on PROSPERO (CRD42024505605).

Results: Of the 7298 articles screened, 10 studies were included, encompassing 500 664 women undergoing ART and 36 395 240 controls. The analysis found no significant increase in the long-term risk of major adverse cardiovascular events [ES 1.04, 95% confidence interval (CI) 0.88-1.23, I2 87.61%, P = .63], coronary heart disease (ES 0.88, 95% CI 0.71-1.10, I2 24.36%, P = .26), stroke (ES 1.21, 95% CI 0.92-1.59, I2 70.40%, P = .17), venous thromboembolism (ES 0.95, 95% CI 0.70-1.28, I2 49.13%, P = .73), hypertension (ES 1.08, 95% CI 0.88-1.32, I2 94.63%, P = .46), or diabetes (ES 1.03, 95% CI 0.86-1.22, I2 78.44%, P = .77). Assisted reproductive technology was associated with a lower risk of heart failure (ES 0.75, 95% CI 0.60-0.94, I2 0.00%, P = .01).

Conclusions: Assisted reproductive technology use does not appear to be significantly associated with an increased long-term risk of cardiovascular diseases in women. While these findings suggest the cardiovascular safety of fertility treatments, further research is warranted.

Keywords: In vitro fertilization; Assisted reproductive technology; Cardiovascular disease; Meta-analysis; Metabolic disease; Systematic review.

PubMed Disclaimer

MeSH terms