Int J Gynaecol Obstet. 2026 Jul 21. doi: 10.1002/ijgo.71234. Online ahead of print.
ABSTRACT
OBJECTIVE: Infertility is increasingly recognized as a marker for heightened cardiovascular risk in women due to shared pathophysiological pathways such as chronic inflammation, endothelial dysfunction, and adverse metabolic profiles. The aim of the present study was to examine the association between infertility and the long-term risk of major cardiovascular outcomes, including cerebrovascular disease (CeVD), heart failure (HF), and ischemic heart disease (IHD), in a large, nationwide population-based cohort.
METHODS: This study used Taiwan's National Health Insurance Research Database (2000-2021) to identify women aged 18-50 years with infertility and compare them with non-infertility controls using 1:4 age matching and 1:1 propensity score matching (PSM) to balance baseline characteristics. The primary outcome was a composite of CeVD, HF, and IHD. Risks were assessed using Cox proportional hazards models and reported as hazard ratios (HRs) with 95% confidence intervals (CIs), with subgroup analyses stratified by age (18-34 and 35-50 years).
RESULTS: A total of 39 337 women with infertility and 157 348 controls were included after 1:4 age matching; 20 974 matched pairs remained after 1:1 PSM. The infertility group had a significantly higher risk of the composite outcome, which persisted after adjustment and PSM (adjusted HR = 1.15, 95% CI: 1.08-1.21; PS-matched HR = 1.18, 95% CI: 1.10-1.26). Similar patterns were observed for CeVD and IHD, with consistent trends across age subgroups, particularly among those aged 35-50 years.
CONCLUSION: In this nationwide cohort study, infertility was associated with modestly increased long-term risks of CeVD and IHD, with age-specific patterns observed for CeVD. These findings highlight the importance of cerebrovascular and heart disease awareness in the long-term follow-up of women with infertility, pending confirmation in prospective studies.
PMID:42479931 | DOI:10.1002/ijgo.71234