Association Between Prepregnancy Blood Pressure and Reproductive Outcomes of In Vitro Fertilization.

Area of Science:

• Reproductive Medicine
• Cardiovascular Health
• Obstetrics

Background:

• Updated hypertension guidelines (2025, 2017 ACC/AHA) lowered the diagnostic threshold to 130/80 mm Hg.
• The impact of this new hypertension classification on reproductive outcomes remains unclear.

Purpose of the Study:

• To investigate the association between prepregnancy blood pressure (BP) levels and reproductive outcomes in women undergoing in vitro fertilization (IVF).

Main Methods:

• Retrospective cohort study at a Reproductive Medicine Center in China.
• Categorized 43,629 women into normal BP, elevated BP, stage 1 hypertension, and stage 2 hypertension groups based on pre-IVF BP measurements.
• Examined associations between BP categories and IVF cycle outcomes.

Main Results:

• Women with stage 1 and stage 2 hypertension had significantly lower live birth rates (46.1% and 41.4%) compared to normal BP (49.2%).
• Stage 1 and stage 2 hypertension were linked to increased risks of pregnancy loss, preeclampsia, and preterm delivery.
• Elevated BP was associated with a higher risk of gestational hypertension; optimal BP cutoffs aligned with stage 1 hypertension diagnosis.

Conclusions:

• Prepregnancy stage 1 and stage 2 hypertension are associated with reduced live birth rates following IVF.
• These hypertension stages also increase the risk of adverse pregnancy complications, including pregnancy loss and preeclampsia.