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Fertility therapy not tied to later heart problems

By Andrew M. Seaman

NEW YORK (Reuters Health) - Women who give birth with the help of fertility treatments don't end up with more heart problems than those who give birth without the hormone injections, according to a new study.

Researchers found that Canadian women who used fertility therapy actually ended up with about half the risk of death and heart problems during the 10 years after giving birth, compared to women who didn't get the treatments.

"Overall, the single most important finding is that women who deliver following fertility therapy had fewer of these cardiovascular events than controls," said Dr. Donald Redelmeier, the study's senior author from the University of Toronto.

But Redelmeier, who is also a practicing physician at Sunnybrook Health Sciences Center in Toronto, said the findings don't mean women should seek out fertility treatments just to lower their risk of death or heart problems.

"We do not believe this is a direct effect of treatment," he said.

In reality, the researchers, who published their findings in the Journal of the American College of Cardiology, believe that women who get fertility treatments take better care of their health to increase the likelihood of a successful pregnancy.

The findings are contrary to concerns that complications tied to fertility treatments and seen late in pregnancy - such as high blood pressure, diabetes and blood clots - would increase women's risk for later problems, like heart attacks, heart failure and stroke.

Women receiving fertility therapy inject themselves with hormones to increase egg production.

For the new study, Redelmeier and his colleagues analyzed information on about 1.2 million women who gave birth in the province of Ontario between July 1993 and March 2010. About 7,000 of those women gave birth after fertility therapy.

The researchers found that despite women who received fertility treatments being older, having more risk factors for heart disease and having more complications at delivery, they were less likely to die or have heart problems over the next decade, compared to the women who didn't use the hormone injections.

There were about 103 heart problems or deaths per 100,000 women who gave birth with the help of fertility therapy. That compared to a rate of 117 deaths, strokes, heart failures and other problems for every 100,000 women who gave birth without hormone treatments.

Overall, there was a 45 percent decreased risk of death and heart problems among women who had fertility therapy once the researchers accounted for their ages, years of delivery, medical histories, delivery complications and demographics.

"The other reassuring thing is that there was no increase in breast cancer," Redelmeier said.

In an accompanying editorial, Dr. Jolien Roos-Hesselink from the Erasmus Medical Center in The Netherlands and Dr. Mark Johnson from Imperial College London agree with the researchers that the reduced risk of death and heart problems among those who received fertility therapy is most likely due to them adopting a healthy lifestyle.

Dr. Frederick Licciardi from the Fertility Center at NYU Langone Medical Center in New York told Reuters Health the new study can't prove that's why those women were less likely to die or have heart problems - but it makes sense.

"You may just have women who are more in tune with their bodies. They may seek medical attention when something does come up," said Licciardi, who was not involved in the new research.

"The results are not surprising but it is reassuring," he added.

The researchers can't say whether these results also apply to women who don't get pregnant and give birth after fertility treatment, because they weren't included in the study.

The study also can't say whether there might be an increased risk of death or heart problems after the first decade after birth.

"More research is always welcome because the intervention is becoming so popular and so widespread," Redelmeier said.

SOURCE: http://bit.ly/11AIhhY Journal of the American College of Cardiology, online July 31, 2013.

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