Nation-wide mapping of the use of fertility drugs and their impact on cardiovascular events in Swedish women

Solid trends of delayed age at childbearing contribute to increasing fertility challenges and reliance on assisted reproduction.

Prior to in-vitro fertilization women must undergo controlled stimulation of the ovaries to maximize the number of oocytes retrieved. In much milder protocols, similar drugs are also given to induce ovulation for natural fertilization attempts.

Since it is more common than not for a treatment cycle to be unsuccessful, most women end up repeatedly exposed to these protocols.

Given the long-standing interest in the connections between sex hormones and women’s cardiovascular health it is somewhat surprising that current fertility practices have not gained more scrutiny. Long-term follow-up of hard endpoints like coronary heart disease or stroke is scarce.

In the short-term there are clear indications that the hormone modulation associated with IVF increases the risk of serious and potentially life-threatening complications like venous thromboembolism in pregnancy, but little is known of the risk to unsuccessful treatment cycles.

This proposal expands on earlier investigations regarding the safety of fertility treatments and takes a comprehensive approach toward understanding fertility drug use in Sweden, and its consequences for both short- and long-term serious cardiovascular events in women.

Given the increasing reliance on fertility treatments by an otherwise healthy population it is imperative that we understand the safety of current practices.All this can be done thanks to the unique resources in our national registers of health, in particular the Prescribed Drug Register and Quality Register for Assisted Reproductive Techniques.

By combining solid epidemiological experience with expert knowledge in VTE and clinical perspectives, we have a unique ability to further our understanding of the safety of different fertility treatment protocols to ideally identify particular women at risk and ultimately improve clinical approaches.