1 Department of Experimental and Clinical Medicine, University of Florence , Florence, Italy .
2 Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital , Florence, Italy .
J Womens Health (Larchmt). 2018 Oct;27(10):1285-1292. doi: 10.1089/jwh.2018.6981. Epub 2018 Jun 15.
A growing number of infertile women undergo assisted reproductive technology (ART). Older maternal age and the presence of comorbidities may affect cardiovascular (CV) women health. Safety aspects are central in risk assessment; we report the experience of internal medicine clinical setting at the ART center.
we investigated 243 infertile women (110 autologous and 133 oocyte donation [OD]); cardiometabolic parameters and CV risk factors were investigated during the clinical evaluation.
We observed high prevalence of dyslipidemia (62.9%), smoking habit (27.5%), and body mass index (26.7%). Waist ≥80 cm was present in 65%, and waist to hip ratio (WHR) value >0.80 in 60.5% of women. The prevalence of migraine with aura, hypertension, and diabetes was 5.3%, 4.9%, and 4.5%, respectively. By evaluating variables according to autologous or OD ART, we observed that OD women were older than autologous, p < 0.0001. Overweight and obesity prevalence was higher in OD group; waist and WHR were significantly higher in autologous than in OD group (75% vs. 57%, p = 0.005, and 91.8% vs. 34.6%, p = 0.01, respectively). We observed a statistically significant unfavorable risk profile in OD in comparison to autologous women (p = 0.003); in particular, 60% of OD women carried 3-5 CV risk factors, and 8.3% carried at least six CV risk factors.
The experience of an internal medicine clinic at the ART center strongly underlies the relevance of a careful medical evaluation before attempting ART, and suggests the opportuneness of a structured internal medicine clinic in every gynecology setting to better frame risk profile.
越来越多的不孕女性接受辅助生殖技术（ART）。高龄产妇和合并症可能会影响女性心血管（CV）健康。安全性是风险评估的核心；我们报告了 ART 中心内科临床环境的经验。
我们调查了 243 名不孕女性（110 名自体和 133 名卵母细胞捐赠 [OD]）；在临床评估期间调查了心血管代谢参数和 CV 危险因素。
我们观察到血脂异常（62.9%）、吸烟习惯（27.5%）和体重指数（26.7%）的高患病率。65%的女性腰围≥80cm，60.5%的女性腰围与臀围比值（WHR）>0.80。有先兆偏头痛、高血压和糖尿病的患病率分别为 5.3%、4.9%和 4.5%。根据自体或 OD-ART 评估变量，我们观察到 OD 女性比自体女性年龄更大，p<0.0001。超重和肥胖的患病率在 OD 组更高；与 OD 组相比，自体组的腰围和 WHR 显著更高（75%比 57%，p=0.005，91.8%比 34.6%，p=0.01）。与自体女性相比，OD 女性的风险状况明显不利（p=0.003）；特别是，60%的 OD 女性有 3-5 个 CV 危险因素，8.3%的女性有至少 6 个 CV 危险因素。
ART 中心内科临床的经验强烈强调了在尝试 ART 之前进行仔细医学评估的重要性，并建议在每个妇科环境中设置结构化的内科诊所，以更好地确定风险状况。
