Infertility and Risk of Cardiovascular Disease: A Prospective Cohort Study

Leslie V. Farland, Yi Xin Wang, Audrey J. Gaskins, Janet W. Rich-Edwards, Siwen Wang, Maria Christine Magnus, Jorge E. Chavarro, Kathryn M. Rexrode, Stacey A. Missmer

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


BACKGROUND: Certain symptoms associated with infertility are associated with cardiovascular disease, including menstrual cycle irregularity, early menopause, and obesity; however, few studies have investigated the association between infertility and cardiovascular disease risk. METHODS AND RESULTS: Participants in the NHSII (Nurses’ Health Study II) who reported infertility (12 months of trying to con-ceive without success, including women who subsequently conceived) or who were gravid, with no infertility were followed from 1989 until 2017 for development of incident, physician-diagnosed coronary heart disease (CHD) (myocardial infarction, coronary artery bypass grafting, angioplasty, stent) and stroke. Time-varying Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% CIs and were adjusted a priori for potential confounding variables. Among 103 729 participants, 27.6% reported having ever experienced infertility. Compared with gravid women who had not reported infertility, women with a history of infertility had greater risk of CHD (HR, 1.13 [95% CI, 1.01–1.26]) but not stroke (HR, 0.91 [95% CI, 0.77– 1.07]). The association between history of infertility and CHD was strongest among women who reported infertility at an earlier age (HR for infertility first reported at ≤25 years, 1.26 [95% CI, 1.09–1.46]; HR at 26–30 years, 1.08 [95% CI, 0.93–1.25]; HR at >30 years, 0.91 [95% CI, 0.70–1.19]). When we investigated specific infertility diagnoses, elevated risk of CHD was observed among women whose infertility was attributed to an ovulatory disorder (HR, 1.28 [95% CI, 1.05–1.55]) or endometriosis (HR, 1.42 [95% CI, 1.09–1.85]). CONCLUSIONS: Women with infertility may be at an increased risk of CHD. Risk differed by age at first infertility diagnosis and was restricted to ovulatory-and endometriosis-related infertility.

Original languageEnglish (US)
Article numbere027755
JournalJournal of the American Heart Association
Issue number5
StatePublished - Mar 7 2023


  • cardiovascular disease
  • coronary heart disease
  • endometriosis
  • infertility
  • myocardial infarction
  • polycystic ovary syndrome
  • stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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