Assisted Reproductive Technology, comorbidities, and cardiovascular risk: the experience of an Italian Center.

A growing number of infertile women undergo assisted reproductive technology (ART). Older maternal age and the presence of comorbidities may affect cardiovascular 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 cardiovascular risk factors were investigated during the clinical evaluation. We observed high prevalence of dyslipidemia (62.9%), smoking habit (27.5%), and BMI (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 unfavourable 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 to ART, and suggests the opportuneness of a structured internal medicine clinic in every gynecology setting in order to better frame risk profile.