Are you trying to have a child but having no luck? According to the latest statistics from the U.S. Centers for Disease Control and Prevention (CDC), 13.4% of women of childbearing age in the United States are having difficulty conceiving.1 As infertility rates increase, more and more women are using assisted reproductive technology (ART).
An example of ART is in vitro fertilization (IVF), which is the most popular option. Here, a fertility specialist retrieves eggs from the ovaries and mixes them with sperm. The fertilized egg then enters the woman’s uterus again. The actual number of babies born through IVF is still very small. Less than 2% of all births each year.2
ART can help initiate the first steps of pregnancy, but it is not without drawbacks. According to the Cleveland Clinic, it can increase the risk of having more than one baby, not to mention the financial costs. Moreover, ART is less likely to cause ovarian hyperstimulation syndrome. Because ART may require multiple attempts to be successful, stress levels are also expected to increase.3 Now, a new study has added another risk to the list: heart disease.
Can IVF increase your risk of heart disease?
A study published in the European Journal of Preventive Cardiology tested the hypothesis that most women have never heard of ART. Can these practices affect long-term heart and blood vessel health?4
To conduct the analysis, researchers followed women born between 1965 and 2000 for an average of 12 years after infertility treatment. They used national health registry data that allows for long-term follow-up without relying on memory or self-reporting. They then compared women who received ART with those who did not. We also analyzed how risk shifts with increasing number of ART cycles.
• Risk increases with each ART cycle — Each additional ART cycle was associated with a higher overall risk of cardiovascular disease. The increase per cycle was modest but consistent. This is important information because many women often have more than one cycle in a row. Small increases are added as you build up exposure.
• Blood clots pose cardiovascular risks. The increased risk was primarily due to pulmonary embolism and deep vein thrombosis. For those of you who are unfamiliar with these terms, a pulmonary embolism is a blood clot that travels to the lungs. Deep vein thrombosis refers to the formation of a blood clot in the deep veins, usually in the legs.
• Frozen embryo transfer carries greater risks — Programmed frozen embryo transfer cycles showed a stronger association with cardiovascular disease than other cycle types. In these cycles, the body’s natural hormone-producing structures do not function in the same way after ovulation.
• Clotting, not general heart disease, is the key concern. Excluding pulmonary embolism and deep vein thrombosis from the analysis significantly attenuated the association between ART cycles and cardiovascular events. These comparisons reinforce the key points. Coagulation is the main indicator. This clarity will help you focus on what to watch for and discuss with your clinician, rather than assuming a broad, non-specific cardiovascular threat.
• The risk remains even after age, health, and pregnancy are taken into account. The association was maintained after adjustment. This strengthens confidence that the observed risk does not arise solely from the pregnancy itself or a pre-existing condition. This supports the hypothesis that ART exposure adds its own layer of cardiovascular stress beyond pregnancy.
The authors explained that repetitive high-dose hormonal stimulation during ART alters fluid balance, blood thickness, and vascular lining behavior. The hormones used to stimulate egg production move the blood toward clot formation and weaken the natural anticoagulant properties of blood vessels. Over time, repeated exposure reinforces these changes.
• Repeated exposure to hormones changes blood flow and clotting. The endothelium is the inner lining of blood vessels. Under normal conditions, it keeps blood flowing smoothly. The hormonal surge associated with ART disrupts this balance, leading to increased adhesion and blood clot formation. As the lining loses its protective role, the risk of blood clots increases even after several years.
Please note that this study does not discourage women from choosing ART. This will only raise awareness so that full informed consent is clear to patients. In other words, knowing where risks appear allows for targeted prevention, early recognition of warning signs, and smarter follow-up.
The researchers emphasized that monitoring cardiovascular health is an essential strategy to prevent further problems in the future. Additionally, they noted that if a woman undergoes numerous ART cycles, healthcare practitioners are encouraged to match the patient’s cardiometabolic profile to minimize risk.
How to Assess Cardiovascular Risk Across ART Options
Long-term cardiovascular data regarding ART-specific drugs are still limited. That said, if you decide to use this approach to get pregnant, it’s important to familiarize yourself with each method used. The table below provides an overview of common ART strategies and the latest research surrounding them. It is best to consult a fertility specialist for more information.
| method | Current information | Recommendation |
|---|---|---|
| Gonadotropin and hyperestrogen stimulation | Transient thrombosis physiology; Overall cardiovascular disease signs are caused by blood clots, not heart attacks | Ask how your practice can help mitigate your risk of ovarian hyperstimulation syndrome. Identify personal venous thromboembolism risk factors |
| Programmed frozen embryo transfer (no corpus luteum) | Stronger association with cardiovascular disease risk following additional programmed freeze cycles in registry study | Discuss whether natural cycle frozen embryo transfer is right for you. |
| Clomiphene | Limited high-quality long-term cardiovascular disease data; Not selected in new registry analysis | Immediately report chest pain, visual changes, or severe headaches during your cycle. |
| letrozole | Limited long-term cardiovascular disease data; Often used to induce ovulation | Estrogen levels may be lower than with some stimulation protocols. Still Monitoring for Symptoms |
| Progesterone/estrogen for luteal support | short-term hormonal exposure; No clear, independent signs of long-term cardiovascular disease | Use exactly as prescribed. Watch out for swelling in your legs or sudden shortness of breath. |
Who should have a cardiology evaluation before receiving ART?
Whichever form of ART a woman chooses, it is wise to first assess her cardiovascular health. As a result, it turns out that there may be underlying conditions that may worsen the outcome. This was found in a study published in Expert Review of Cardiovasive Therapy.5
• Cardiovascular disease may already have been present to begin with. The study population included women undergoing infertility treatment, many of whom had cardiometabolic risk factors even before pregnancy began. The researchers emphasized that infertility itself often overlaps with diseases such as polycystic ovary syndrome, obesity, insulin resistance, and high blood pressure.
• Infertility treatment places extra stress on the cardiovascular system. One notable finding in this study was the comparison of cardiovascular burden across different reproductive states. Pregnancy alone dramatically increases cardiac output. This means your heart pumps much more blood per minute than usual.
Infertility treatment further increases the burden by increasing the possibility of multiple pregnancies. Pregnancy with twins or a higher-order pregnancy requires significantly more cardiovascular activity than a singleton pregnancy.
• Many cardiovascular risk factors remain underrecognized and undermonitored. Blood pressure, lipid levels, glycemic control, and weight trajectory often receive less attention during infertility treatment due to the focus on pregnancy.
• Kidney health may also be at risk. According to the featured study, the risk of kidney damage, as well as arrhythmias and ischemic stroke, was highest in women who became pregnant using ART and had existing cardiovascular risk factors.
How to Lower Your Cardiovascular Risk When You Decide to Pursue ART
ART or not, optimizing cardiovascular health is of utmost importance. One basic step women (and everyone else for that matter) can take is to minimize their linoleic acid (LA) intake. As noted in my research published in the World Journal of Cardiology, LA disrupts mitochondrial function, producing reactive oxygen species (ROS) that damage the inner lining of arteries.
• Beware of the numerous LA sources — Avoid ultra-processed foods as they commonly contain corn, soybeans, safflower, and cotton oil. Less obvious sources of LA include conventionally raised pork and poultry, which are typically high in feed in LA.
Reduce your daily intake to less than 5g. If you can keep it under 2g, even better. The Mercola Health Coach app (coming soon) will include Seed Oil Sleuth, a tool designed to help you track down to the tenth of a gram of LA in your food.
• Additional Notice — Going back to the ART-specific recommendations, here are some tips to keep in mind:
◦ Ask about protocols that reduce the risk of ovarian hyperstimulation syndrome, including staged stimulation and, where appropriate, considering natural cycle frozen embryo transfer instead of programmed embryo transfer.
◦ If you have a history or risk factors for high blood pressure, track your blood pressure at home. Bring your reading with you when you visit.
◦ Review your medications and supplements with your health care provider, especially any that affect clotting.
◦ If you feel unwell, do not hesitate to contact your doctor. Remember, you and your team are partners managing a time-limited and slightly higher-risk period.
When do I need urgent care and when should I call the clinic?
Lastly, don’t hesitate to contact emergency services. Use this triage guide during and after your ART cycle to help you decide:
• Call emergency services immediately — Sudden severe chest pain and shortness of breath, swelling and pain in one leg, coughing up blood, or severe headaches with neurological symptoms all require immediate medical attention.
• Call your doctor within a day — Make an appointment with your health care provider if you experience persistent chest discomfort, new heart palpitations, repeated high blood pressure measurements, worsening abdominal bloating due to rapid weight gain, or calf tenderness or swelling.
Frequently Asked Questions (FAQs) About Assisted Reproductive Technology (ART) and Heart Disease
cue: Does IVF increase a woman’s risk of heart disease?
no way: yes. IVF and other ARTs are associated with a higher long-term risk of cardiovascular disease, especially as the number of treatment cycles increases. The risk is cumulative rather than one-off and is primarily caused by blood clot-related events.
cue: Are strokes more common after IVF or fertility drugs?
no way: Studies do not show that strokes are generally more common in all women after IVF. The risk of ischemic stroke was higher in women using ART and who already had underlying cardiovascular risk factors, but this does not suggest stroke risk as a dominant or widespread consequence of IVF itself.
cue: Which fertility drugs have the highest risk of blood clots?
no way: The highest risk of blood clots is associated with birth protocols that include gonadotropin and high estrogen stimulation. These drugs increase the tendency of blood to clot, especially when they cause ovarian hyperstimulation syndrome. Programmed frozen embryo transfer protocols also stand out for their higher risk due to their hormonal design.
cue: Is IVF safe if I have high blood pressure or risk of preeclampsia?
no way: If you already have risk factors for high blood pressure or preeclampsia, IVF requires special caution. Rather than automatically treating IVF as safe or unsafe, it would be wise to undergo cardiovascular screening prior to treatment, close monitoring during the cycle and pregnancy, and receive an individualized risk assessment.
cue: Do IVF hormones raise blood pressure?
no way: Although IVF hormones have been associated with an increased incidence of pregnancy-related hypertensive disorders, studies have shown no significant increase in chronic hypertension after IVF.
