Cardio-metabolic risk factors among young infertile women: a systematic review and meta-analysis

Abstract

BACKGROUND:There is currently no concise systematic review or meta-analysis addressing cardio-metabolic risk factors in women experiencing infertility. OBJECTIVES:To determine whether infertile women have higher levels of cardiovascular risk factors compared to fertile women. SEARCH STRATEGY:We performed a systematic literature search using Pubmed, EMBASE and CINAHL, Scopus and additional manual and bibliographic searches for relevant articles (end search date of 6th November 2019). SELECTION CRITERIA:We selected studies that compared cardio-metabolic risk factors between fertile and infertile women of reproductive age. DATA COLLECTION AND ANALYSIS:At least two authors independently screened potentially eligible studies. MAIN RESULTS:There was an increased presence of several cardio-metabolic risk factors in infertile women compared to fertile women. Infertile women had statistically significant higher BMI, increased TC, LDL-C, and TG compared to fertile women. Fasting glucose, fasting insulin, HOMA-IR and MAP were not found to be different between fertile and infertile women. A subgroup analysis revealed that TC, HDL-C, fasting glucose and fasting insulin were increased only in women with polycystic ovarian syndrome compared to fertile women, while BMI, TG and LDL-C were statistically significantly increased in women with any indication of infertility compared to fertile women. CONCLUSIONS:Infertile women have a higher level of cardio-metabolic risk factors compared to fertile women. This finding has clinical implications for infertile women in general, and those attempting to conceive through medically assisted reproduction.