Does Fertility Treatment Have Long Term Side Effects?

A new study published in the Canadian Medical Association journal reports a greater risk of heart failure and stroke in women who did not become pregnant after undergoing gonadotropin-based fertility treatment. The study looked at over 28,000 women, who underwent fertility treatment with injectable medications between 1993 and 2011 in Ontario, Canada.  Women who did not conceive with treatment had a 19% higher chance of having a cardiovascular event compared to women who did get pregnant.

For the thousands of women who undergo fertility treatment every year, this study is obviously concerning.  When looking at the data more closely though, it seems that the overall findings need to be taken with a grain of salt.  The overall risk of having a cardiovascular event was still low for women who did not conceive.  The data showed an absolute risk of 10 cardiovascular events per 1,000 women over 10 years for those who did not conceive.  This was only a modest increase from the 6 cardiovascular events per 1,000 women over 10 years for women who did get pregnant after fertility therapy.

Additionally, it has to be pointed out that this study did not look at baseline risk factors for heart disease, such as blood pressure and cholesterol levels.  It’s possible that the women who did not conceive had a higher risk for cardiovascular disease before they even started fertility treatment.  From other studies we know that overall health is linked to fertility treatment success.  The healthier you are, the higher your chance of success will be with fertility treatment. So, maybe the women who did not conceive had an overall lower baseline health status.  It may not have been the fertility treatment at all that caused the increased risk of heart failure and strokes.  Instead the culprit was more likely the women’s underlying health.

Given the limitations of this study, I don’t think it should deter women from undergoing fertility treatment.  Instead, women should use this study as a motivator to achieve good health prior to and during fertility treatment.  It can also open the door to having a candid discussion with your physician about the impact of your overall health on fertility.

Additionally, women who fail more conservative fertility treatments may want to move on to gonadotropin treatment and IVF to conceive.  As our previous post reports, having kids is associated with an increase in life expectancy, especially as we age.

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