February has been designated as American Heart Month, an occasion for health care professionals to provide education and awareness about the risk of heart disease, the leading cause of death in this country for both men and women.
Why is an infertility physician writing about heart health awareness?
Female infertility patients, whose median age is around 36 or 37, might not think heart disease applies to them at this point in their life. They’re focused on getting pregnant rather than developing cardiovascular disease decades down the road. Their male partners too are probably not thinking about the dangers of heart disease unless they are significantly older. There are some important connections, however, between infertility and heart disease for both genders.
PCOS and Heart Disease
Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder causing infertility in three to ten percent of reproductive-aged women. Though the cause of PCOS is not known, what is known is that PCOS causes menstrual irregularities, the inability to get pregnant, increased hair growth on the face and chest, acne, and obesity. Additionally if not treated properly, it can have long-term consequence, including increasing your risk for heart disease. This is due to the higher levels of insulin caused by PCOS, which are known to elevate levels of triglyceride and cholesterol, lower high density lipoprotein (HDL), raise blood pressure and increase atherosclerosis in your blood vessels. In turn, these symptoms increase the risks for a heart attack and/or stroke.
Some women achieve positive results by going on the type of diet used for diabetes prevention or taking metformin, an insulin-sensitizing medication. The goals of treatment include improving insulin resistance and lowering insulin levels. An improvement in ovulatory function can also be obtained.
Male Infertility and Hypertension
According to a study conducted by lead author Dr. Michael Eisenberg, male fertility specialist and Stanford University professor, there is a correlation between normal sperm status and overall health. After studying the records of nearly 10,000 men, with a median age of 38 who regularly submitted semen samples over a 14-year span, the researchers found that about half the men had abnormal sperm. Taking it a step further, they also found that heart, vascular and blood pressure problems could have played a role in causing their infertility. The study authors recommend that men try to decrease stress and stick to a Mediterranean diet to improve their fertility while decreasing blood pressure.
Positive Results for Women from the GRAVID Study
There also is some positive news about fertility treatment actually lowering a woman’s risk for heart disease. The General Reproductive Assistance and Vascular Illness Study, abbreviated as GRAVID, revealed some pleasant, though unexpected findings about the health of women who had undergone fertility treatment. Those who gave birth after fertility therapy had about half the risk of CVD in the next 10 years compared to women who gave birth without. However in the short-term, treatment increased the odds of complications during pregnancy, such as gestational diabetes and hypertension.
Pre-existing Heart Disease and Fertility Treatment
Women who have been diagnosed with a heart condition should check with their physician to see if treatment and pregnancy are safe for them. Fortunately, there are options like egg donation and/or surrogacy to help build a family if your health would be at risk.
Decreasing Risk Factors
Conveniently trying to mitigate heart disease through diet, exercise, and quitting smoking can also help improve fertility health. Additionally talking to your primary care physician, especially if you have a family history, is important for periodically monitoring your blood pressure and cholesterol and understanding your overall risk.
So ‘Go Red’ and spread awareness about heart health to help yourself and others.
• HRCFertility website
• PCOS and Heart Disease, Nicole Galen, RN, PCOS Expert
• Fertility Therapy and Heart Risk, Go Red editors