MON-201 Female Subfertility and Long-Term Cardiovascular Risk

Abstract Disclosure: E. Armeni: None. C. Polymeropoulou: None. N. Mili: None. E. Siliogka: None. A. Augoulea: None. I. Lambrinoudaki: None. Objective: Infertility and cardiovascular disease (CVD) are widespread health concerns that share common risk factors, such as oxidative stress, endothelial dysfunction, and chronic inflammation. Although research has suggested a potential link between female infertility and an increased risk of CVD, findings remain inconclusive. This systematic review (SR) and meta-analysis (MA) aim to investigate whether women with infertility have a greater likelihood of developing cardiovascular conditions later in life. Methods: This SR and MA of 21 studies followed PRISMA guidelines and was registered in PROSPERO (CRD42023420300). The Newcastle-Ottawa Scale assessed study quality. Statistical analyses included odds ratios (OR) and hazard ratios (HR) using Mantel-Haenszel and inverse variance methods. Heterogeneity was evaluated via I². We performed sensitivity analyses to assess the impact of the participant's age at recruitment, the duration of follow-up (FU, cut-off 10 years for short vs extended), and exposure to assisted reproduction techniques (ART) on the observed associations. Results: We compared 178,828 women with a history of infertility with 3,398,781 controls and found a higher prevalent and incident risk of future CVD (HR = 1.14, 95% CI: 1.12–1.16; I² = 89%), CHD (HR = 1.17, 95% CI: 1.12–1.23; I² = 0%) and cerebrovascular events (HR=1.16; 95% CI: 1.11–1.21; I² = 73%). Compared to controls, studies evaluating infertile women aged < 40 years showed a higher risk of CVD (HR=1.20; 95% CI: 1.17-1.23; I2=81%; I² = 81%), whereas those studies evaluating infertile women aged 40 years or more showed a comparable risk for CVD (HR=1.04; 95% CI: 1.00-1.07; I² = 29%). Studies with shorter observation periods (FU < 10 years) reported higher incident risk for all cardiovascular events compared to the pooled risk retrieved from studies with extended FU (> 10 years). We found that women exposed to ART vs controls (392,266 and 33,630,919, respectively) had a higher incident risk for CVD (HR = 1.18; 95% CI: 1.11–1.25; I² = 97%), although ART exposure did not significantly increase the risk of CHD, cerebrovascular events, or heart failure.Discussion: This study reveals an elevated risk of CVD, encompassing CHD and cerebrovascular events, among women with a history of infertility. The risk is higher for women experiencing infertility early on during their reproductive life. ART exposure was linked to a higher risk of CVD; however, the true impact of ART remains unclear due to substantial variability across studies, likely influenced by differing methodologies and ART protocols. Presentation: Monday, July 14, 2025