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Cardiovascular autonomic nervous function in children conceived by assisted reproductive technology with frozen or
Ikram Mizrak1,2, Morten A V Lund3,4, Ann V Landgrebe4
1Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
Insights
Children conceived by assisted reproductive technology show reduced heart rate variability at rest, potentially indicating future cardiovascular risks. Further research in larger groups is recommended.
Area of Science:
- Cardiology
- Pediatrics
- Reproductive Medicine
Background:
- Epigenetic alterations in assisted reproduction may increase cardiovascular risks.
- Children conceived via assisted reproduction (ART) might experience premature cardiovascular aging.
- Cardiovascular autonomic nervous function in ART-conceived children is not well understood.
Purpose of the Study:
- To investigate cardiovascular autonomic nervous function in children conceived via ART.
- To compare heart rate variability (HRV) and baroreflex function between naturally conceived and ART-conceived children.
- To assess differences between fresh and frozen embryo transfer in ART-conceived children.
Main Methods:
- Evaluated HRV during rest and provocation maneuvers.
- Assessed baroreflex function in 8-12-year-old children.
- Compared naturally conceived (n=33) with ART-conceived children (fresh n=38, frozen n=34).
Main Results:
- ART-conceived children had lower mean RR-interval and high-frequency HRV.
- Children conceived by fresh embryo transfer showed significantly altered HRV indices.
- No significant differences in heart rate and blood pressure response to maneuvers or baroreflex function were observed between groups.
Conclusions:
- ART-conceived children exhibit reduced resting heart rate variability and vagal modulation.
- Findings suggest a potential sympathetic predominance in ART-conceived children.
- Lowered resting HRV may precede premature hypertension in ART-conceived children, warranting further investigation.
Abstract:
As a result of epigenetic changes, children conceived by assisted reproduction may be at risk of premature cardiovascular aging with notably increased blood pressures. Their cardiovascular autonomic nervous function is unknown. Therefore, this study investigated the cardiovascular autonomic nervous function in 8-12-yr-old children (51% girls) conceived naturally (n = 33) or by assisted reproduction with frozen (n = 34) or fresh (n = 38) embryo transfer by evaluating heart rate variability, during rest; from provocation maneuvers; and from baroreflex function. Heart rate and blood pressure response to provocation maneuvers and baroreflex function were comparable between children conceived naturally or by assisted reproduction. The mean RR-interval and high-frequency component of heart rate variability were lower in children conceived by assisted reproduction than in children conceived naturally. Children conceived by fresh embryo transfer had ∼17% lower heart rate-corrected standard deviation of normal-to-normal R-R intervals; ∼22% lower heart rate-corrected square root of the mean of the squared difference between successive R-R intervals; and ∼37% higher low-frequency/high-frequency ratio than naturally conceived children. Children conceived by assisted reproduction still had lower heart rate variability and vagal modulation than naturally conceived children after adjustment for confounders. Thus, these results raise the possibility of sympathetic predominance in children conceived by assisted reproduction. Therefore, it is important to reproduce these results in larger and older cohorts as sympathetic predominance relates with cardiovascular and metabolic diseases.NEW & NOTEWORTHY We observed that children conceived by assisted reproductive technology (both frozen and fresh embryo transfer) had lowered heart rate variability during rest as compared with children conceived naturally. During physiological stress maneuvers, however, the cardiovascular autonomic nervous regulation was comparable between children conceived by assisted reproductive technologies and naturally. Our findings highlight the potential that lowered heart rate variability during rest in children conceived by assisted reproductive technologies may precede premature hypertension.
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