Cardiac Function in Women with and Without Previous Assisted Reproductive Technology: A Prospective Observational Cohort Study

Abstract

Background: Previous research has linked hypertensive disorders of pregnancy (HDP) and long-term cardiovascular disease (CVD) with assisted reproductive technology (ART). It is not clear whether this reflects the background population cardiovascular profiles or whether ART independently increases the long-term risk for CVD and alters cardiovascular function. Furthermore, CVD has been associated with pathological cardiovascular function before and after the establishment of the disease. The aim of this study was to compare cardiac function in women attending for ART between those who had previous treatment and those who had not after controlling for demographic characteristics which have been shown to affect cardiovascular function. Methods: This was a prospective observational cohort study at a London fertility clinic. Women were consecutively enrolled between May 2021 and March 2022. Maternal demographics and cardiac function using transthoracic echocardiography were assessed before the current treatment cycle in the mid-luteal phase of the menstrual cycle. Maternal demographics included age, body mass index, smoking, race, and parity. Cardiovascular parameters included blood pressure and indices of left-ventricular systolic and diastolic function. Differences between cardiac variables after controlling for maternal demographics and history of previous ART were assessed by multivariate linear regression. Results: There were 232 healthy women who agreed to participate in the study; of those, 153 (58%) had undergone previous ART. After controlling for maternal demographic characteristics, previous assisted reproductive technology was not an independent predictor of cardiac function. Conclusions: Previous ART is not associated with significant changes in cardiac function.