Assisted Reproductive Technology, Comorbidities, and Cardiovascular Risk: The Experience of an Italian Center

Background: A growing number of infertile women undergo assisted reproductive technology (ART). Older maternal age and the presence of comorbidities may affect cardiovascular (CV) women health. Safety aspects are central in risk assessment; we report the experience of internal medicine clinical setting at the ART center. Materials and Methods: we investigated 243 infertile women (110 autologous and 133 oocyte donation [OD]); cardiometabolic parameters and CV risk factors were investigated during the clinical evaluation. Results: We observed high prevalence of dyslipidemia (62.9%), smoking habit (27.5%), and body mass index (26.7%). Waist 80cm was present in 65%, and waist to hip ratio (WHR) value >0.80 in 60.5% of women. The prevalence of migraine with aura, hypertension, and diabetes was 5.3%, 4.9%, and 4.5%, respectively. By evaluating variables according to autologous or OD ART, we observed that OD women were older than autologous, p<0.0001. Overweight and obesity prevalence was higher in OD group; waist and WHR were significantly higher in autologous than in OD group (75% vs. 57%, p=0.005, and 91.8% vs. 34.6%, p=0.01, respectively). We observed a statistically significant unfavorable risk profile in OD in comparison to autologous women (p=0.003); in particular, 60% of OD women carried 3-5 CV risk factors, and 8.3% carried at least six CV risk factors. Conclusions: The experience of an internal medicine clinic at the ART center strongly underlies the relevance of a careful medical evaluation before attempting ART, and suggests the opportuneness of a structured internal medicine clinic in every gynecology setting to better frame risk profile.