Infertility, fertility treatment, and risk of hypertension

ObjectiveTo evaluate the association between infertility and fertility treatments on subsequent risk of hypertension.DesignCohort study.SettingNot applicable.Patient(s)A total of 116,430 female nurses, followed from 1993 to June 2011, as part of the Nurses' Health Study II cohort.Intervention(s)None.Main Outcome Measure(s)Self-reported, physician-diagnosed hypertension.Result(s)Compared with women who have never reported infertility, infertile women were at no greater risk of hypertension (multivariable adjusted relative risk (RR) = 1.01, with 95% confidence interval [CI] [0.94–1.07]). Infertility due to tubal disease was associated with a higher risk of hypertension (RR = 1.15 [1.01–1.31]), but no other diagnoses were associated with hypertension risk, compared with women who did not report infertility (ovulatory disorder: RR = 1.03 [0.94–1.13]; cervical: RR = 0.88 [0.70–1.10]; male factor: RR = 1.05 [0.95–1.15]; other reason: RR = 1.02 [0.94–1.11]; reason not found: RR = 1.02 [0.95–1.10]). Infertile women collectively had 5,070 cases of hypertension. No clear pattern between use of fertility treatment and hypertension was found among infertile women (clomiphene citrate: RR = 0.97 [0.90–1.04]; gonadotropin alone: RR = 0.97 [0.87–1.08]; intrauterine insemination: RR = 0.86 [0.71–1.03]; in vitro fertilization: RR = 0.86 [0.73–1.01]).Conclusion(s)Among this relatively young cohort of women, no apparent increase occurred in hypertension risk among infertile women, or among women who had undergone fertility treatment previously.