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Women Who Undergo Infertility Treatment May Face Higher Stroke Risk After Pregnancy - Cord Blood

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Women Who Undergo Infertility Treatment May Face Higher Stroke Risk After Pregnancy

A doctor looking at her notes

A large study has found that women who became pregnant after fertility treatments have a higher risk of having a stroke in the year following childbirth compared to women who conceive naturally. The study found that the risk of stroke was highest in the first 30 days after delivery and continued to rise throughout the year. However, it’s important to note that the overall number of stroke hospitalizations among women who underwent treatment remains very low.

Why It Matters: A contributor to maternal deaths

The United States has the highest maternal mortality rate among developed countries, and strokes account for about 7.5% of pregnancy-related deaths. The use of assisted reproductive technology has significantly increased in the past decade, with around 2% of births in the US involving some form of infertility treatment. The study included various infertility treatments such as intrauterine insemination, assisted reproductive technology, use of a surrogate, and fertility preservation procedures. While these treatments are generally safe, previous studies have linked them to increased risks during pregnancy, such as pre-eclampsia, placental abnormalities, and preterm birth.

Background: The largest study yet

Previous studies on stroke after infertility treatments have produced mixed results. However, this new study, published in JAMA Network, is believed to be the largest to examine the risk of stroke hospitalization among women who underwent fertility treatments. The study analyzed health outcomes of 31 million patients who had a hospital delivery in 28 states between 2010 and 2018, including 287,813 who had received infertility treatments. The findings revealed that the risk of hemorrhagic stroke, which involves bleeding in the brain, was twice as high among women who underwent fertility treatment compared to those who didn’t. The odds of ischemic stroke, caused by interrupted blood supply to the brain, were also significantly higher among women who received treatment.

However, it’s important to note that another recent study published in JAMA Cardiology, which focused on women in Scandinavian countries, found no evidence of an increased risk for cardiovascular disease among those who had received infertility treatments. The sample size of that study was much smaller though, including only 2.4 million women.

The current research did not consider certain important risk factors for stroke, such as smoking, body mass index, and hypertension. Despite this limitation, the researchers still found a heightened risk.

What’s Next: A warning for women

The study’s senior author, Dr. Cande V. Ananth, chief of epidemiology and biostatistics at the Robert Wood Johnson Medical School in New Jersey, highlighted three possible explanations for the link between stroke and infertility treatment. First, women who receive infertility treatment are more likely to experience vascular complications like pre-eclampsia and placental abruption. Second, these treatments can cause physiological changes, such as increased blood clotting due to high estrogen levels. Third, there may be different biological characteristics among women seeking infertility treatment.

Dr. Ananth emphasized that stroke is still very rare among women after childbirth, regardless of whether they received infertility treatments or not. However, it is important for patients to be aware of the potential risks and receive appropriate counseling.