Infertility, fertility treatment, and risk of hypertension

Objective To evaluate the association between infertility and fertility treatments on subsequent risk of hypertension. Design Cohort study. Setting Not applicable. Patient(s) A total of 116,430 female nurses, followed from 1993 to June 2011, as part of the Nurses' Health Study II cohort. Intervention(s) None. Main Outcome Measure(s) Self-reported, physician-diagnosed hypertension. Result(s) Compared with women who have never reported infertility, infertile women were at no greater risk of hypertension (multivariable adjusted relative risk (RR) = 1.01, with 95% confidence interval [CI] [0.94-1.07]). Infertility due to tubal disease was associated with a higher risk of hypertension (RR = 1.15 [1.01-1.31]), but no other diagnoses were associated with hypertension risk, compared with women who did not report infertility (ovulatory disorder: RR = 1.03 [0.94-1.13]; cervical: RR = 0.88 [0.70-1.10]; male factor: RR = 1.05 [0.95-1.15]; other reason: RR = 1.02 [0.94-1.11]; reason not found: RR = 1.02 [0.95-1.10]). Infertile women collectively had 5,070 cases of hypertension. No clear pattern between use of fertility treatment and hypertension was found among infertile women (clomiphene citrate: RR = 0.97 [0.90-1.04]; gonadotropin alone: RR = 0.97 [0.87-1.08]; intrauterine insemination: RR = 0.86 [0.71-1.03]; in vitro fertilization: RR = 0.86 [0.73-1.01]). Conclusion(s) Among this relatively young cohort of women, no apparent increase occurred in hypertension risk among infertile women, or among women who had undergone fertility treatment previously.