Top Things to Know: Assessing and Addressing Cardiovascular and Obstetric Risks in Patients Undergoing Assisted Reproductive Technology
Prepared by Anne Leonard MPH, BSN, RN, FAHA; National Senior Director Science and Medicine
- Assisted reproductive technology (ART) is defined as the in vitro handling of oocytes and/or embryos. In 2020, greater than 326,000 ART cycles were performed at 449 clinics in the United States reporting data, which yielded 75,023 live births and 79,942 live born infants.
- The short-term risks from ART that can adversely impact patients with cardiovascular disease (CVD) are discussed in this statement.
- The risk for adverse pregnancy outcomes and risk of future CVD after ART is reviewed in this paper.
- This writing committee describes the evaluation and management in persons with CVD prior to undergoing ART.
- A suggested clinical pathway for evaluation, management and post retrieval for individuals with CVD undergoing ART is included in this statement.
- The paper outlines the risks associated with ART in individuals with cardiovascular disease or with risk factors for cardiovascular disease and discusses counseling for these risks; below are the areas covered:
Venous thromboembolism, atherosclerotic cardiovascular disease, stroke, spontaneous coronary artery dissection (SCAD), cardiomyopathy, heart transplantation recipients, valvular heart disease, congenital heart disease, history of arrhythmias, and risk factors for atherosclerotic CVD.
- The paper supports psychological health support during ART.
- The paper describes the steps for the process of ovarian stimulation with an overview of several potential modalities for ART.
- The paper outlines the safety of commonly prescribed cardiovascular medication during gamete retrieval, embryo transfer with and with immediate pregnancy.
- This paper offers critical information for the healthcare provider as they navigate counseling women undergoing ART who have CVD risks.
Citation
Mauricio R, Sharma G, Lewey J, Tompkins R, Plowden T, Rexrode K, Canob¬bio M, Skowronski J, Hameed A, Silversides C, Reynolds H, Vaught A; on behalf of the American Heart Association Cardiovascular Disease & Stroke in Women and Underrepresented Populations Committee of the Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; and Council on Lifelong Congenital Heart Disease and Heart Health in the Young. Assessing and addressing cardiovascular and obstetric risks in patients undergoing assisted reproductivetechnology: a scientific statement from the American Heart Association. Circulation. Published online January 15, 2025. doi: 10.1161/CIR.0000000000001292