Large Artery Stiffness is Elevated in Women with a Prior Pregnancy Conceived via In Vitro Fertilization

In vitro fertilization (IVF) is an effective treatment for infertility; however, IVF may increase future maternal cardiovascular disease (CVD) risk. Vascular dysfunction, characterized by increased large elastic artery stiffness and endothelial dysfunction, predicts future CVD risk. However, if IVF use influences maternal vascular dysfunction is unknown. We studied premenopausal women with a live birth within the past 1–5 years conceived either without medical assistance (n=24) or via IVF (n=15), matched for age, body fat percentage, and seated blood pressure. Large artery stiffness (carotid β-stiffness index) and endothelial function (brachial artery flow-mediated dilation) were assessed after 10 minutes of supine rest following an overnight fast. Large artery stiffness was greater in the IVF group compared with the reference group (6.5±1.9 vs. 5.08±1.2 U, p=0.022); endothelial function did not differ (p=0.619). To explore potential mechanisms, mouse aortas were incubated with serum from a subset of participants (n=11/group) to assess the influence of circulating factors on arterial stiffness (via elastic modulus). The elastic modulus was 28% higher in the group treated with serum from IVF patients relative to the reference group (p=0.078), suggesting circulating factors may contribute to observed differences in large artery stiffness. Follicle-stimulating hormone (FSH) concentrations were greater in the IVF compared with reference group (p=0.026), and FSH concentrations were positively associated with in vivo large artery stiffness (r=0.57, p<0.001). Large artery stiffness is elevated in individuals with a history of IVF-conceived live birth, potentially related to circulating factors, including FSH.