ART Cycles and Cardiovascular Risk in Women: Norwegian Registry Insights

Overview

This Norwegian registry study found that women undergoing assisted reproductive technology (ART) cycles have a modestly increased risk of cardiovascular disease (CVD), primarily driven by thromboembolic events, with no clear increase in hypertension risk. The risk was notably higher in women exposed to programmed frozen ART cycles.

Background

Assisted reproductive technologies (ART) usage is rising globally, but long-term cardiovascular consequences for women remain unclear. Prior research links ART pregnancies to higher rates of pregnancy-induced hypertension and pre-eclampsia, conditions associated with increased maternal CVD risk. Women undergoing ART also often have pre-existing cardiovascular risk factors and infertility-related disorders such as PCOS. Previous studies have been limited by inability to assess risk by number and type of ART cycles, necessitating large-scale population studies with extended follow-up.

Data Highlights

Key Findings

• Each additional ART cycle was associated with a modestly increased risk of cardiovascular disease (HR 1.07; 95% CI: 1.04–1.10).
• No clear increased risk of chronic hypertension was observed with increasing ART cycles (HR 1.02; 95% CI: 1.00–1.04).
• The elevated CVD risk was mainly driven by thromboembolic events, specifically pulmonary embolism and deep vein thrombosis.
• Women undergoing four or more ART cycles showed weak evidence of higher CVD risk (HR 1.34; 95% CI: 0.99–1.81).
• Programmed frozen ART cycles were more strongly associated with increased CVD risk (HR 1.35; 95% CI: 1.18–1.55), possibly due to absence of corpus luteum and disrupted maternal circulation.

Clinical Implications

Clinicians should be aware of the modestly increased cardiovascular risk, particularly thromboembolism, in women undergoing multiple ART cycles, especially programmed frozen cycles. Monitoring cardiovascular health in these patients may help early identification and management of potential complications. Further research with larger cohorts and longer follow-up is needed to confirm these findings and guide clinical practice.

Conclusion

Women undergoing ART, particularly multiple and programmed frozen cycles, exhibit a modestly increased risk of cardiovascular disease driven by thromboembolism, without a clear increase in hypertension risk. These findings highlight the importance of cardiovascular monitoring in this population.

References

1. Norwegian Registry Study 2024 -- Association of Assisted Reproductive Technology Cycles with Hypertension and Cardiovascular Disease Risk in Women