Cardiovascular Risk and Unexplained Infertility

Updated: Apr 26

By Dr. Shreya Batra, ND

Why assess cardiovascular risk for patients with unexplained infertility?

Infertility is a multifactorial concern which impacts 1 in 6 couples in Canada. When couples are given the diagnosis of “unexplained” infertility, it is very disheartening as it provides no explanation for next steps.

Along with assessing reproductive hormonal concerns such as estrogen and progesterone balance, assessment for endometriosis, PCOS, luteal phase defect/progesterone deficiency…etc., it is important to assess the following as well:

  1. Thyroid hormones

  2. Cortisol

  3. HbA1c

  4. Cardiovascular risk markers (the topic of this blog post!)

Cardiovascular risk markers are often not given any importance when discussing infertility. However, for couples experiencing unexplained infertility or recurrent miscarriages, it should be evaluated and corrected.

Cardiovascular risk assessment includes the following:

  1. Weight to hip ratio

  2. Blood pressure

  3. Cholesterol – LDL and HDL

  4. Triglycerides

  5. Insulin and Glucose Fasting

A study done in 2017 showed that women self-reporting infertility had increased cardiovascular risk markers. The risk markers were different based on the infertility subtype:

  1. Polycystic Ovarian Syndrome: increased total cholesterol, triglycerides, LDL, insulin and lowered HDL.

  2. Endometriosis: Lipoprotein A and triglycerides were elevated

  3. Uterine Fibroids: increased blood pressure

  4. Pre-mature ovarian failure (early menopause): increased triglycerides, LDL and decreased HDL. 

Another study clearly showed the relationship between increased bad cholesterol (LDL) and lowered good cholesterol (HDL) and infertility. It was found that individuals who had high cholesterol levels had an increased risk of cardiovascular disease, but also reduced ability to get pregnant.

It is also important to note that the correlation between cardiovascular disease and fertility is not only exclusive to female patients. This is certainly something that needs to be evaluated and discussed with male patients as well.

For Male Patients:

high cholesterol may also impair fertility and lower sperm quality. Studies have found that a diet that increased cholesterol circulating in the blood, impacted sperm count, motility and morphology negatively. Furthermore, increased insulin levels (with or without a diagnosis of diabetes) also impacted fertility parameters in males

Overall, it is important to consider cardiovascular and metabolic risk factors for individuals trying to get pregnant, especially if they have been given a diagnosis of “unexplained infertility”.

What’s Next?

After a full intake, if I think necessary, testing cardiovascular risk factors along with other reproductive hormones, is a common practice for my patients. I want to make sure we get to the root cause of the problem and make sure your body is optimized for a pregnancy. If you are trying to get pregnant and have not had a full workup done – please book a 15 minute meet and greet with me to see how we can get your treatment plan started and what your next steps are!

References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5424365/

  2. https://www.nih.gov/news-events/news-releases/nih-study-links-high-cholesterol-levels-lower-fertility

  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5395549/

  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060264/

  5. https://www.hindawi.com/journals/omcl/2019/4521786/

  6. https://www-sciencedirect-com.ccnm.idm.oclc.org/science/article/pii/S1472648317303826

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