Assisted Reproductive Technology for Adults With Congenital and Acquired Heart Disease

Area of Science:

• Reproductive Medicine
• Cardiology
• Maternal-Fetal Medicine

Background:

• Assisted reproductive technology (ART) use is rising among individuals with cardiovascular disease (CVD) seeking pregnancy.
• Evaluating ART safety in this high-risk population is crucial.

Purpose of the Study:

• To compare adverse cardiovascular, obstetric, and neonatal events in individuals with CVD conceiving via ART versus spontaneous conception.
• To assess the safety and efficacy of ART in women with pre-existing cardiovascular conditions.

Main Methods:

• Retrospective analysis of the Standardized Outcomes in Reproductive Cardiovascular Care cohort (November 2011 - December 2024).
• Matching ART pregnancies (n=100) 2:1 with spontaneously conceived pregnancies (n=200) in individuals with CVD.
• Exploratory analysis of ART safety and efficacy in a subset (n=41) at the primary center.

Main Results:

• No significant differences in maternal cardiovascular events (congestive heart failure, arrhythmia) between ART and spontaneous conception groups.
• Comparable obstetric outcomes including hypertensive disorders and preterm birth.
• Similar neonatal outcomes such as birthweight and NICU admission rates.
• In a subset, ART yielded high implantation (56.2%) and live birth rates (57.7%).

Conclusions:

• Pregnancy outcomes following ART are comparable to spontaneous conception in individuals with CVD.
• ART is a safe reproductive option for women with cardiovascular disease.
• Supports the continued use of ART in this specific patient population.