A new study published in Journal of the American Medical Association it suggests that infertility treatments may increase the risk of hemorrhagic and ischemic stroke (CVA). in women who have given birth, by up to 66%. The risk of stroke hospitalization was increased for up to 12 months after birth, being evident as early as the first month after birth.
Informing patients about the risk of stroke should be part of the counseling process before initiation of infertility treatment. Patients should be advised to reduce the impact of risk factors such as smoking and obesity through lifestyle changes.
Also read: 17% of women with infertility of unknown cause carry genetic variants associated with cardiovascular disease or cancer
They collected data from 28 US states between 2010 and 2018 and analyzed hospitalization rates for hemorrhagic and ischemic stroke from 31 million pregnant women aged 15 to 54.
There were 37 hospitalizations for stroke per 100,000 in the group treated for infertility, compared with 29 hospitalizations per 100,000 in the group that included women who conceived naturally. The risk of hemorrhagic stroke was higher than that of ischemic stroke (66% vs 55%).
The authors explained that although the number of hospitalizations is low at the population level, for those with fertility problems, a 66% increased risk is significant.
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Several explanations have been proposed for the association between infertility treatment and stroke. Certain physiological changes, damage to the endothelium, and the induction of a prothrombotic state in the context of treatment may increase the risk of stroke.
However, the authors note the importance of interpreting the results with caution. It is possible that some of the patients had pre-existing conditions such as hypertension, diabetes, obesity, known risk factors for stroke. Many women with infertility have, for example, polycystic ovary syndrome or endometriosis, both associated with a higher risk of cardiovascular disease. These observations point to the need for further studies to assess whether the treatments themselves contribute to the risk or whether there are other, more complex reasons.
A growing number of studies demonstrate the importance of understanding women’s reproductive history to assess cardiovascular disease risk. Difficulty getting pregnant, pregnancy progress, menopause, all key stages in a woman’s life influence cardiovascular health.
It is possible that women with infertility are prone to stroke for the same reason they suffer from infertility.
Although it was known that women with fertility problems have a higher risk of cardiovascular disease, until now the contribution of the genetic component was not clear. In this context, another study, recently published in NEJM, showed that 17% of women with infertility of unknown cause have genetic variants associated with a significantly increased risk of cardiovascular disease or cancer. Whole-exome sequencing of women with infertility revealed a threefold higher prevalence of clinically actionable pathogenic variants compared to the general population.
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2023-09-08 10:48:56
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