Risk of hospitalization for early onset of cardiovascular disease among infertile women: a register-based cohort study

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  • Ane Berger Bungum, Bispebjerg University Hospital
  • ,
  • Clara Helene Glazer, Bispebjerg University Hospital
  • ,
  • Linn Håkonsen Arendt
  • Lone Schmidt, Københavns Universitet
  • ,
  • Anja Pinborg, Københavns Universitet
  • ,
  • Jens Peter Bonde, Bispebjerg University Hospital
  • ,
  • Sandra Søgaard Tøttenborg, Bispebjerg University Hospital
STUDY QUESTION: Is female infertility predictive of a woman’s future risk of early cardiovascular disease (CVD)?
SUMMARY ANSWER: Female infertility does not seem to be predictive of early CVD during a mean follow-up of 9 years.
WHAT IS KNOWN ALREADY: Associations between infertility and comorbidity have been found in several studies, but data on the
association between female infertility and risk of CVD are scarce and inconclusive.
STUDY DESIGN, SIZE, DURATION: In this nationwide cohort study, we included 87 221 women registered in the Danish National IVF
register, undergoingmedically assisted reproduction (MAR) between 1st of January 1994 and 31st of December 2015. The cohort was followed
for incident hospitalization due to CVD in the Danish National Patient Register from enrollment to 31 December 2015.Women with a history
of CVD prior to enrollment were excluded. Cox proportional hazard models with age as the underlying time scale were used to estimate
hazard ratios (HR) with 95% CI of CVD among women with an infertility diagnosis, compared to women without an infertility diagnosis. All
analyses were adjusted for educational attainment.
PARTICIPANTS/MATERIALS, SETTING, METHODS: Female infertility and the reason for infertility was diagnosed and registered in
the IVF register by specialists in Danish public and private fertility clinics since 1st of January 1994. In our cohort, 53 806 women (61.7%) were
diagnosed with female factor infertility, while 33 415 (38.3%) did not have a female factor infertility diagnosis and made up the reference group.
MAIN RESULTS AND THE ROLE OF CHANCE: A total of 686 (1.3%) infertile women were hospitalized for CVD compared to 250
(0.7%) among women without an infertility diagnosis during a mean follow-up time of 9 years.We found no increased risk of early CVD in our
analyses (adjusted HR 0.98, 95% CI: 0.85;1.14). Likewise, analyses stratified by specific infertility diagnosis, showed no risk difference.
LIMITATIONS, REASONS FOR CAUTION: We were unable to adjust for confounding parameters such as body mass index, cigarette
smoking or alcohol consumption. These results may not be generalizable to infertile women who do not seek out fertility treatment, or infertile
women with other lifestyle characteristics than Danish women.
WIDER IMPLICATIONS OF THE FINDINGS: Diagnosing female infertility or the time of MAR does not seem to be a window of
opportunity where early screening for cardiovascular disease risk factors can have a prophylactic potential.
STUDY FUNDING/COMPETING INTEREST(S): This study is part of the ReproUnion collaborative study, co-financed by the European
Union, Interreg V ÖKS. None of the authors declare any conflict of interest.
OriginalsprogEngelsk
TidsskriftHuman reproduction (Oxford, England)
Vol/bind34
Nummer11
Sider (fra-til)2274-2281
Antal sider8
ISSN0268-1161
DOI
StatusUdgivet - nov. 2019

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