Cardiovascular risk factors among women with self-reported infertility

Shruthi Mahalingaiah, Fangui Sun, J. Jojo Cheng, Erika T. Chow, Kathryn L. Lunetta, Joanne M. Murabito

Amongst women with certain types of ovulatory disorder infertility, the studies are conflicting whether there is an increased risk of long-term cardiovascular disease risk. This paper evaluates the associations of several CVD risk factors among Framingham women with self-reported infertility. Women who completed the Framingham Heart Study Third Generation and Omni Cohort 2 Exam 2 (2008-2011), and reported on past history of infertility and current cardiovascular disease status were included in this cross-sectional study. Directly measured CVD risk factors were: resting blood pressure, fasting lipid levels, fasting blood glucose, waist circumference, and body mass index (BMI). Multivariable models adjusted for age, smoking, physical activity, and cohort. Generalized estimating equations adjusted for family correlations. We performed sensitivity analyses to determine whether the association between infertility and CVD risk factors is modified by menopausal status and menstrual cycle length. Comparing women who self-reported infertility to those who did not, there was an average increase in BMI (β = 1.03 kg/m(2), 95% CI: 0.18, 1.89), waist circumference (β = 3.08 in., 95% CI: 1.06, 5.09), triglycerides (β = 4.47 mg/dl, 95% CI:-1.54, 10.49), and a decrease in HDL cholesterol (β = -1.60 mg/dl, 95% CI: -3.76, 0.56). We estimated that infertile premenopausal women have an increased odds of obesity (BMI ≥ 30 kg/m(2)) (OR = 1.56, 95% CI: 1.11, 4.49) and diabetes (OR = 1.96, 95% CI: 0.86, 4.49). BMI and waist circumference were the most strongly correlated CVD risk factors amongst women reporting a history of infertility.