Ivf And Stroke: Is There A Link?

There is some evidence to suggest that IVF treatment may be linked to an increased risk of stroke. A 2017 study published in the Canadian Medical Association Journal found that women who underwent IVF and didn't get pregnant were 19% more likely to experience heart problems, including heart failure, later in life. However, it is unclear whether IVF treatment directly causes this increased risk or if it acts as a stress test, revealing underlying conditions that could lead to both infertility and future heart disease.

Additionally, a case report published in the Journal of Human Reproductive Sciences in 2018 discussed the mechanisms by which assisted reproductive techniques may increase the risk of thrombosis in patients with a history of venous thromboembolism (VTE). The report highlighted that the risk of VTE in patients undergoing IVF is ten times higher than in the general population, and certain factors such as aggressive stimulation, elevated estradiol levels, and multiple pregnancies can further increase this risk.

Furthermore, there have been individual accounts of women experiencing strokes during or after IVF treatment. In one case, a woman suffered a stroke and was left brain-damaged while undergoing IVF treatment, resulting in substantial agreed damages in court. In another instance, a woman taking birth control pills as part of her fertility treatment experienced a hemorrhagic stroke, which doctors believed was caused by the estrogen in the pills.

While these cases suggest a potential link between IVF and stroke, more research is needed to establish a definitive causal relationship and understand the underlying mechanisms.

IVF and the risk of blood clots

In vitro fertilisation (IVF) is associated with an increased risk of blood clots during pregnancy. Research has found that women who are pregnant through IVF are at a higher risk of blood clots and artery blockages than those who conceive spontaneously.

The Science Behind It

IVF has been considered a risk factor for venous thrombosis (VT) with thrombosis known to occur after ovulation induction. Ovarian stimulation during IVF induces supraphysiological endogenous levels of oestrogen, which might lead to hypercoagulability and cause thrombosis.

Studies and Statistics

A study by researchers from the Karolinska Institute in Sweden examined data on the risk of pulmonary embolism (a sudden blockage in the lung artery) and venous thromboembolism (a blood clot in a vein) for 23,498 women who got pregnant through IVF and 116,960 women who fell pregnant naturally. The average age of the women was 33, and they all gave birth between 1990 and 2008. The risk of venous thromboembolism for IVF-pregnant women was 4.2 in 1,000, but just 2.5 in 1,000 for women who fell pregnant naturally. The risk was higher during the first trimester of pregnancy.

Another study found that the risk of venous thromboembolism was significantly increased in IVF pregnancies compared with other pregnancies. Further research has shown that the risk of blood clots becomes greater during normal pregnancy, with a recent study demonstrating that women who are pregnant and women who have given birth within the past three months are four times as likely to have "serious blood clot problems".

Symptoms and Prevention

Women who fall pregnant through IVF should contact their doctor if they experience any symptoms of blood clots, such as pain in the legs, especially if there is a family history of clots. To prevent blood clots, exercises such as stretching and seated leg movements can be performed.

IVF and the risk of stroke

In vitro fertilisation (IVF) has gone from being front-page news to a standard choice for couples struggling with infertility. While the procedure has been refined over the years to boost success rates, there is still a lack of research into the long-term impact of the fertility drugs used in IVF.

One area of concern is the possible link between fertility treatments and the future risk of cardiovascular diseases. The higher levels of estrogen used to induce ovulation can lead to a slightly increased risk of blood clots immediately after fertility therapy. It is unclear whether this risk lasts beyond pregnancy. The exogenous hormones used to stimulate ovulation may also disrupt the linings of blood vessels, and it is unknown whether this continues in the long term.

A 2017 study published in the Canadian Medical Association Journal compared women who underwent IVF and didn't get pregnant after a year with those who had the same treatment and did conceive. It found that those who had unsuccessful fertility treatments were 19% more likely to have heart problems, including heart failure, later in life. However, this may not have been caused by IVF. The women who didn't get pregnant might have had an underlying condition that caused both infertility and heart disease later in life.

Another study, co-authored by Natalie Dayan, an assistant professor of medicine at McGill University, reviewed six studies involving nearly 42,000 women who had received fertility therapy. It found that while there wasn't a higher risk of a cardiac event or diabetes, there might be a link to an increased risk of stroke. However, the number of studies included in the review was small, and more data is needed to determine the level of risk.

The absolute numbers of thrombosis after ovarian stimulation are usually very low, and thrombosis is more likely to occur in women who achieve pregnancy. Nevertheless, the risk of thrombosis is dramatically increased in cases of ovarian hyperstimulation syndrome (OHSS), which can occur as a side effect of IVF treatment. OHSS can result in the leakage of hormones and fluid from the ovaries, leading to fluid accumulation in the abdominal cavity and chest. If left untreated, it can be fatal.

To reduce the risk of thrombosis during IVF treatment, various risk-reduction strategies must be adopted, such as the use of mild stimulation, antagonist protocol, avoiding ovarian hyperstimulation, and the use of gonadotropin-releasing hormone agonist trigger.

IVF and the risk of heart failure

In vitro fertilisation (IVF) is a standard choice for couples struggling with infertility. However, there is a dearth of research on the long-term impact of the fertility drugs that are almost always part of the IVF cycle. One area of concern is the possible link between fertility treatments and the future risk of cardiovascular diseases.

The Link Between IVF and Heart Problems

Higher levels of estrogen used to induce ovulation can lead to a slightly increased risk of blood clots immediately after fertility therapy. It is unclear whether this increased risk lasts beyond pregnancy. The exogenous hormones used to stimulate ovulation may also disrupt the linings of blood vessels, and it is unknown whether this continues in the long term.

IVF and Heart Failure Risk

A 2017 study published in the Canadian Medical Association Journal compared women who underwent IVF and didn't get pregnant after a year with those who had the same treatment and did conceive. It found that those who had unsuccessful fertility treatments were 19% more likely to have heart problems, including heart failure, later in life. That translates to four additional events per 1,000 women.

However, it is important to note that these cases may not have been caused by IVF. Instead, "fertility therapy might act as a stress test," according to Jacob Udell, a cardiologist and clinician-scientist. The women who didn't get pregnant might have had an underlying condition that caused both the infertility and the increased risk of heart disease later in life. For example, polycystic ovarian syndrome causes infertility while also putting women at a higher risk of diabetes and obesity, which are precursors to heart disease.

Preventing Heart Failure in IVF Patients

To reduce the risk of thrombosis during IVF treatment, several risk-reduction strategies must be adopted. These include assessing the risk before starting treatment, using mild stimulation, avoiding ovarian hyperstimulation, and using a gonadotropin-releasing hormone agonist trigger instead of human chorionic gonadotropin. Additionally, single embryo transfer is preferred to avoid the risk of multiple pregnancies, which is another risk factor for thrombosis.

While there is a possible link between IVF and heart failure, more research is needed to fully understand the long-term risks. In the meantime, it is important for clinicians to assess the risk of thrombosis in IVF patients and adopt appropriate risk-reduction strategies to make the treatment safer.

IVF and the risk of ovarian hyperstimulation syndrome

Ovarian Hyperstimulation Syndrome (OHSS) is a rare but severe complication that can occur during IVF treatments. OHSS is the body's response to excessive or imbalanced hormone levels, particularly the hormone human chorionic gonadotropin (HCG). During IVF, women are administered fertility drugs and injections that stimulate and boost certain fertility hormones in their bodies, promoting higher levels of hormones to help follicles develop in the ovaries.

When the ovaries are overstimulated, it can lead to ovarian pain and severe problems, including rapid weight gain, shortness of breath, and vomiting. OHSS, if left untreated, can prove fatal, which is why fertility specialists are always mindful and observant of this condition arising.

The symptoms of OHSS can range from mild to severe, with mild cases typically resolving within a week or two. Mild symptoms include mild to moderate abdominal pain, abdominal bloating or increased waist size, and tenderness in the area of the ovaries. In contrast, severe cases of OHSS can result in hospitalization and require aggressive treatment. Symptoms include severe abdominal pain, rapid weight gain of up to 40 pounds, and decreased urination.

OHSS is more common in people with Polycystic Ovary Syndrome (PCOS) who are undergoing fertility treatments. Other risk factors include a large number of follicles within the ovaries, high estrogen levels before receiving the HCG shot, and previous experience of OHSS.

To prevent OHSS, fertility doctors may alter or adjust medications and fertility drugs used during IVF, wait a few days before administering HCG when estrogen levels are high, and avoid using an HCG trigger shot if the risk of OHSS is significant. Freezing good- to high-quality eggs or embryos can also reduce the need for another IVF cycle.

While IVF is generally safe, OHSS is a severe complication that requires careful monitoring and prompt treatment to avoid fatal outcomes.

IVF and the risk of pre-eclampsia

In vitro fertilisation (IVF) is an effective way to help women get pregnant. However, recent studies have found that IVF pregnancies, especially those using frozen embryo transfers, carry an increased risk of preeclampsia, a serious blood pressure condition. This risk is thought to be linked to the absence of the corpus luteum, a collection of cells that forms in the ovary after ovulation and produces hormones that help maintain pregnancy and the body's adjustment to it.

The Link Between IVF and Pre-Eclampsia

The absence of the corpus luteum in IVF pregnancies is due to the use of programmed cycles, which involve medical suppression of reproductive hormones to prevent the corpus luteum from developing. This suppression ultimately leads to a lack of relaxin, a hormone that helps relax blood vessels. As a result, blood vessels may remain stiff, increasing the risk of preeclampsia.

Reducing the Risk of Pre-Eclampsia in IVF Pregnancies

To reduce the risk of preeclampsia in IVF pregnancies, researchers suggest using modified natural cycles that allow the corpus luteum to develop. This can be done through a modified natural cycle or ovulation induction for oligoovulatory women. Additionally, replacement of missing corpus luteum factors could be explored as a potential solution.

While IVF is a successful method for achieving pregnancy, it is important to be aware of the potential risks associated with it. The increased risk of preeclampsia in IVF pregnancies, particularly those using frozen embryo transfers, highlights the importance of careful monitoring and consideration of modified natural cycles to reduce this risk. Further research is needed to confirm these findings and explore potential interventions.

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