Assisted Reproductive Technology for Adults With Congenital and Acquired Heart Disease

Assisted reproductive technology (ART) is increasingly used by individuals with cardiovascular disease (CVD) to achieve pregnancy.

The objective of the study was to compare adverse cardiovascular, obstetric, and neonatal events in individuals with CVD who conceived using ART vs age-matched controls who conceived spontaneously.

Retrospective analysis of the Standardized Outcomes in Reproductive Cardiovascular Care cohort from November 2011 to December 2024. Pregnancies conceived using ART were matched 2:1 with spontaneous conceptions in individuals with congenital or acquired CVD. An exploratory analysis for short-term safety and efficacy was performed in those who received ART at the primary center.

The cohort included 100 pregnancies conceived with ART and 200 spontaneous pregnancies, followed for 1-year postpartum. There were no significant differences in congestive heart failure (4% vs 4%, P = 1.0) and sustained arrhythmia (9% vs 6%, P = 0.34). With respect to obstetric and neonatal outcomes, there was no difference in hypertensive disorders of pregnancy (21% vs 15%, P = 0.20), preterm birth (11% vs 13%, P = 0.85), birthweight (3.2 kg vs 3.1 kg, P = 0.40), or need for neonatal intensive unit admission (32% vs 22%, P = 0.13). In a subset of the population receiving ART at our institution (n = 41 subjects undergoing 57 in vitro fertilization cycles), there were 15 median oocytes per retrieval. There were 85 embryo transfers with an implantation rate of 56.2% and live birth rate of 57.7%.

In individuals with CVD, pregnancy outcomes following ART were comparable to those with spontaneous conception, supporting the safety of ART in this population.