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Is Infertility Linked to Heart Failure?

ACCORDING to a new study, a history of infertility is associated with an increase in the risk of heart failure. The researchers from Massachusetts General Hospital (MGH), Boston, USA, found that females who had experienced infertility had 16% increase in the risk of developing heart failure compared with females who have no history of infertility.

One in five females in the USA have been affected with infertility, which also includes a range of conception issues. The study team partnered with Women’s Health Initiative (WHI), which was designed to query females’ reproductive history. The MGH team investigated women who were post-menopausal from WHI to confirm whether infertility was linked with the development of heart failure.

The two types of heart failure are heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). The ejection fraction is measured by determining how much volume percentage of blood, per heartbeat, is pumped into the left ventricle. An ejection fraction of less than 50% is considered abnormal.

HFpEF compared with HFrEF, over the past 10 years, has become the superior form of heart failure in both males and females; however, HFpEF is common in females. A group of 38,528 females who were post-menopausal were studied, and about 14% of the participants had a history of infertility. There was a 15-year follow-up period, which revealed that females with a history of infertility had a 16% increased risk of heart failure. Furthermore, the researchers compared the heart failure subtypes and found that infertility was associated with a 27% increased future risk of HFpEF compared with HFrEF.

“We, as scientists and doctors, are beginning to recognise how important a female’s reproductive history is for their future risk of heart disease. Infertility is one of many cardiovascular risk factors, such as hypertension and high blood pressure, but reproductive history is not routinely considered as part of the cardiovascular risk assessment,” says first author Emily Lau, Cardiologist and Director of the Menopause, Hormones & Cardiovascular Clinic at MGH. “We cannot change a female’s history of infertility, but if we know a female has had a history of infertility, we can be more aggressive about counselling her about other modifiable risk factors including high blood pressure, high cholesterol, smoking, and beyond.”