Infertility liked to higher risk of atherosclerotic cardiovascular disease

Women with a history of infertility have a moderately higher risk of atherosclerotic cardiovascular disease (ASCVD) compared with those who have no such history, with the risk more pronounced among nulliparous infertile women who have or have not experienced a pregnancy loss, according to a study.

The analysis included 158,787 postmenopausal women who participated in the Women’s Health Initiative cohort. Researchers assessed infertility, parity, and pregnancy loss in relation to the primary outcome of the risk of ASCVD. They applied Cox proportional-hazards models adjusted for demographics and risk factors for ASCVD.

Of the women, 25,933 (16.3 percent) reported a history of infertility, 20,427 (80 percent) had at least one live birth, and 9,062 (35 percent) had at least one pregnancy loss.

There was evidence of a moderate overall association between infertility and ASCVD risk (adjusted hazard ratio, 1.02; 95 percent confidence interval [CI], 0.99–1.06) over 19 years of follow-up.

Among nulliparous women, infertility was associated with a 13-percent (95 percent CI, 1.04–1.23) greater risk of ASCVD. Among nulliparous women who also had a pregnancy loss, the risk increase associated with infertility was much higher at 36 percent (95 percent CI, 1.09–1.71).

The findings confirm the hypothesis that nulliparity and pregnancy loss may reveal more extreme phenotypes of infertility that may be linked to an increased ASCVD risk.