Cardiologist Ashley Simmons, MD, and infertility specialist Michael Lydic, MD, at The University of Kansas Health System in Kansas City explain the relationship between heart disease and infertility
Heart health may not be the first concern among couples dealing with infertility. However, recent studies indicate that unexplained infertility may be associated with health conditions that put both men and women at increased risk for heart disease.
Infertility, or the inability to conceive after 12 months of trying to get pregnant, affects approximately 11% of reproductive-age women and 15% of couples in the U.S. Even young, healthy-appearing men and women with unexplained infertility may have future tendencies toward insulin resistance, metabolic syndrome, high blood pressure and other conditions that may put them at higher risk of heart disease.
More studies are needed to clarify whether there is a definitive connection between infertility and poor heart health. However, there are some clues that may help explain the correlation between the conditions.
A common cause of infertility that can affect heart health
Polycystic ovary syndrome (PCOS), a disorder that affects 6-8% of women, is also a common cause of infertility, accounting for up to 15% of cases.
Women who have PCOS may experience irregular or absent periods, facial and chest hair, acne and obesity. They also tend to have higher levels of insulin in the body, which may lead to elevated triglycerides and cholesterol levels, and a narrowing of the arteries due to the buildup of plaque.
"Insulin resistance is a common pathway to many diseases, such as type 2 diabetes, stroke and heart disease," explains reproductive endocrinology and infertility specialist Michael Lydic, MD.
Other conditions that are risk factors for heart disease when left untreated, such as obesity and high blood pressure, also tend to be common in women with PCOS. Yet up to 70% of women who have PCOS go undiagnosed.
"Unfortunately, many young women may not know they have PCOS," Dr. Lydic says. "If a woman suspects she has PCOS, she should see her gynecologist and discuss her symptoms and concerns."
Reproductive health mirrors overall health
Experts agree that reproductive health may reflect overall health. Obesity, stress, excessive alcohol use and smoking can also affect reproductive health in both men and women.
"If you are having difficulty conceiving, it is important to learn how to manage stress, lose weight if you are overweight and keep your blood pressure under control. And it is probably not a bad idea to get your cholesterol, blood sugar and blood pressure checked, especially if you have a family history of heart disease," says cardiologist Ashley Simmons, MD.
Men diagnosed with infertility seem to be at greater risk of obesity, type 2 diabetes, alcohol and substance abuse and other health issues. In fact, a recent study looking at the risk of chronic conditions in infertile men indicated that even young men who were diagnosed with infertility had higher rates of heart disease when compared with those who were fertile or who had a vasectomy.
Some doctors believe that this is because hormonal imbalances in men with infertility could play a role in heart health. However, it's not clear if there is a causative effect between infertility and conditions that increase the risk for heart disease, and more research is needed.
Fertility therapy and effects on heart health
When it comes to heart health and infertility, there may be good news for women who successfully undergo fertility therapy. According to a large Canadian study, women who gave birth after receiving fertility therapy had about half the risk of heart disease later in life when compared with women who delivered without fertility treatments.
However, Dr. Simmons warns that it is too soon to tell whether or how fertility therapy may affect heart health.
"We need more studies to better understand if there is a true association," Dr. Simmons says. "Women who are undergoing fertility therapy may be more proactive about leading a healthy lifestyle because they are very motivated to get pregnant. So it is hard to tell if the positive impact on heart health is related to fertility therapy or lifestyle changes."
Dr. Lydic agrees. "Many women undergoing fertility therapy may be counseled on lifestyle choices that positively affect heart health."
Healthy choices for a healthy heart
A healthy lifestyle gives couples dealing with infertility the best chance of conceiving and living with a healthy heart.
"Exercising, not smoking, drinking plenty of water, and eating a proper diet of healthy fats, lean meats and vegetables can help you stay healthy," says Dr. Lydic.
Dr. Simmons agrees that making good lifestyle choices can go a long way to maintain overall health and prepare for pregnancy.
"If you are having trouble with fertility, it's a good idea to look at your lifestyle and see where you could make improvements. The bottom line is taking good care of yourself."
If you are having trouble with fertility, it's a good idea to look at your lifestyle and see where you could make improvements. The bottom line is taking good care of yourself. – Ashley Simmons, MD
Cardiologist