In vitro fertilization risks  (IVF) and the medical complications that can be associated with it has been treated by our Observatory. Now we refer to women with heart disease are known to have an increased risk of suffering medical complications compared to healthy women (Circulation 2001: 104; 515-21/Eur Heart J 2010; 31, 2124-32). But does this risk increase when women with heart problems undergo IVF?

A recently published article (JACC 2014; 64,1862-6) evaluated in vitro fertilization risks for the first time, confirming that it really exists. The study included 20 women, mean age 37 ± 4 years, with 22 pregnancies. Fifteen pregnancies (68%) occurred in women with congenital heart problems and 7 (32%) in women with acquired heart disease.

At least one complication was detected in 73% of the pregnancies. Eighteen percent of the heart patients suffered ovarian hyperstimulation syndrome, compared to 1% of the healthy women. Adverse cardiac maternal outcomes were detected in 27% of the cardiac patients, compared to 13% in pregnant women with heart disease not conceiving with assisted reproductive technologies (ART). Foetal or neonatal problems were detected 45% of the cardiac patients compared to 20% of pregnant women with heart disease not conceiving with ART. Foetal prematurity was also higher in the heart patients (32%) than in a reference ART population (13%). As the authors state, ovarian hormonal hyperstimulation is a “potentially serious complication of ART“, which is more dangerous in heart patients, in which moderate forms of ovarian hyperstimulation can be poorly tolerated.

Ethical approach

From an ethical point of view (said eh authors), it seems clear that the poor response to ART in women with heart disease must be considered.

Based on the above, the authors concluded that the potential risks of ART in women with heart problems undergoing these procedures should be counterbalanced with their “right” to be mothers.