Assisted Reproductive Technology and Cardiovascular Risk in Women

Purpose of ReviewTo summarize what is currently known regarding the impact of assisted reproductive technology (ART) on the cardiovascular health of women, both during treatment and long-term, and to highlight specific at-risk subgroups and treatment considerations.Recent FindingsWomen utilizing ART are already at increased risk for cardiovascular pathology, and the association between ART and adverse pregnancy outcomes makes disentangling the individual contribution of ART to CVD risk challenging. Pregnancies conceived from ART are at increased risk for several complications including maternal venous thromboembolism and hypertensive disorders. The use of frozen embryo transfer and trophectoderm biopsy for preimplantation genetic testing appear to significantly increase the risk of hypertensive disorders of pregnancy. Though limited, current available evidence suggests ART does not appear to be associated with an increased risk for long-term cardiovascular morbidity and mortality. Women with pre-existing cardiac disease require specialized care from a multi-disciplinary team but can be considered candidates for ART with use of a gestational carrier even if pregnancy is not deemed safe due to their underlying conditions.SummaryMore high-quality evidence is needed to better assess the short and long-term effects of ART on the cardiovascular health of women. ART for special populations, including those with pre-existing cardiac conditions, requires special consideration to minimize complications.