New research conducted at Rutgers University in New Jersey has found that women who conceive through fertility treatments are at a higher risk of suffering a stroke compared to those who conceive naturally. The study, which tracked 30 million pregnancies, revealed that women who underwent procedures such as in vitro fertilization (IVF) or intrauterine insemination (IUI) were 66 percent more likely to experience a stroke within one year of giving birth. Additionally, these women were twice as likely to suffer a hemorrhagic stroke, characterized by bleeding in the brain, and 55 percent more likely to experience an ischemic stroke, caused by a blood clot blocking blood flow to the brain.
According to the researchers, stroke is the leading cause of death among pregnant women, primarily due to the strain that pregnancy puts on the body. Approximately 30 out of every 100,000 women who give birth experience a stroke within a year of delivery. While it remains unclear why women who receive fertility treatments face a higher risk, the researchers speculate that hormone treatments required during these procedures, as well as a potential higher risk of improper placenta implantation, may contribute to the increased danger.
The study also highlighted the rising number of women turning to IVF and IUI to conceive, particularly as more Americans delay starting a family until their 40s. IVF involves the removal of an egg from the ovaries, fertilizing it with sperm in a lab, and then implanting the resulting embryo into the uterus. On the other hand, IUI involves injecting sperm directly into the uterus. Both treatments require estrogen injections to stimulate ovulation and support uterine lining development. The elevated levels of estrogen can potentially damage blood vessel linings and increase clotting factors, raising the risk of stroke.
In addition to stroke, IVF has been associated with a higher risk of ischemic placental disease, where the placenta fails to attach properly to the uterine lining or is too small. This condition can trigger high blood pressure, inflammation, and increased clotting factors, further contributing to the risk of stroke.
Other factors that may increase the likelihood of stroke among women undergoing fertility treatment include underlying health risks such as obesity, smoking, or alcohol use, all of which can hinder natural conception. Age may also play a role, as the average age of women using IVF in the study was 32 years old, slightly older than those who conceived spontaneously (27 years old). Notably, the strokes observed in the study occurred after pregnancy, possibly due to a drop in blood pressure as the body returned to its pre-pregnancy state.
The study, published in JAMA Network Open, analyzed data from the Nationwide Readmissions Database, which included records of more than 31 million women who delivered babies between 2010 and 2018. Of these women, less than one percent had received fertility treatments. The analysis accounted for various factors like maternal age, multiple births, hospital type, and income, revealing a 66 percent higher risk of stroke among women who had undergone fertility treatment.
It is important for both healthcare providers and women considering fertility treatments to be aware of these increased stroke risks. Further research is needed to better understand the mechanisms behind these associations and to develop strategies to mitigate the potential adverse effects.
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