Arterial stiffness during controlled ovarian hyperstimulation and early pregnancy in women exposed to assisted reproduction

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: Female sex hormones have vasorelaxing effects in non-pregnant and pregnant women. We aimed to investigate the effect of controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF), and early pregnancy, on arterial stiffness as assessed by digital pulse wave analysis (DPA), hypothesizing reduced arterial stiffness as an effect of increased estrogen levels.

MATERIAL AND METHODS: A total of 68 women undergoing IVF were examined with DPA before conception and during IVF treatment with COH and embryo transfer (ET), and in gestational week seven in 19 women who became pregnant. Heart rate (HR), mean arterial pressure (MAP) and the DPA variables cardiac ejection elasticity index (EEI), b/a, dicrotic index (DI), d/a and aging index (AI) were measured.

RESULTS: HR was significantly increased at all measuring points (p ≤ 0.003) but MAP only at ET (p 0.007). DPA variables representing large arteries (EEI, b/a) and peripheral arteries (DI, but not d/a), and the global variable AI, indicated increased arterial stiffness at ET compared with baseline (p ≤ 0.035). No DPA variable was significantly changed at pregnancy measurements compared to baseline.

CONCLUSION: During COH for IVF treatment, DPA showed no changes in arterial stiffness during the follicular phase or in early pregnancy, but increased arterial stiffness in central and peripheral arteries in the early luteal phase. The result suggests a hormonal hemodynamic activation counteracting the effects of estrogen.

Details

Authors
Organisations
External organisations
  • Skåne University Hospital
  • Nordic IVF Malmö
  • Cura Mödravård, Malmö
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Obstetrics, Gynecology and Reproductive Medicine
Original languageEnglish
Pages (from-to)182-191
JournalHypertension in Pregnancy
Volume37
Issue number4
Early online date2018 Sep 21
Publication statusPublished - 2018 Oct 2
Publication categoryResearch
Peer-reviewedYes