Fertility therapy may increase risk of stroke
The long-term cardiovascular (CV) safety of fertility therapy, particularly stroke, remains unclear due to the small number of studies and significant heterogeneity in this systematic review and meta-analysis.
The investigators searched published reports for studies addressing the question “does fertility therapy increase the risk of longer-term cardiovascular outcomes?” to summarize information linking fertility therapy with subsequent CV outcomes. They included 1) human studies; 2) case-control, cohort or randomized designs with 3) exposure to fertility therapy and 4) CV outcomes clearly reported; 5) presence of comparison group; 6) minimum 1-year follow-up; and 7) adjustment for age.
DerSimonian and Laird random-effects models were used to pool hazard ratios (HRs) with 95 percent confidence intervals (CIs) of outcomes such as acute cardiac event, stroke, venous thromboembolism, hypertension and diabetes mellitus, comparing women who received fertility therapy with those who did not.
A total of six observational studies were included in the meta-analysis, involving 41,910 women who received fertility therapy and 1,400,202 women who did not.
The meta-analysis showed no increased risk of a cardiac event (pooled HR, 0.91; 95 percent CI, 0.67 to 1.25; I2=36.6 percent) or diabetes mellitus (pooled HR, 0.93; 0.87 to 1.001; I2=0 percent). There were no pooled results for hypertension (I2=95.0 percent) and venous thromboembolism (I2=82.3 percent). On the other hand, a trend toward higher risk of stroke (pooled HR, 1.25; 0.96 to 1.63; I2=0 percent) was observed.
“Future studies are needed to address ongoing knowledge gaps in this area,” researchers said.