Use of assisted reproductive technologies (ART) is increasing among women with cardiovascular disease (CVD), although safety data remain limited. A retrospective case-control study published in the Canadian Journal of Cardiology evaluated maternal cardiac, obstetric, fetal and neonatal outcomes in pregnancies conceived using ART in women with CVD.

Consecutive ART pregnancies referred to a Canadian quaternary cardio-obstetrics program between 2021 and 2024 were included. The ART group comprised 66 pregnancies and was matched 1:1 by primary cardiac diagnosis to spontaneously conceived pregnancies evaluated during the same period.

Within the ART group, 51.5% had acquired heart disease, 36.4% had congenital heart disease, 7.6% had both, and 4.5% had genetic syndromes with cardiac involvement. Women in the ART group were older than controls. Mean age was 38.5 ± 5.6 vs 35.6 ± 4.7 years (p<0.001).

No cases of ovarian hyperstimulation syndrome (OHSS) or ART-related complications were reported. Cesarean delivery occurred more frequently in the ART group (68.2% vs 48.5%; p=0.031), as did postpartum hemorrhage (13.6% vs 1.5%; p=0.021). Other maternal cardiac, obstetric, fetal and neonatal outcomes were comparable between groups.

These findings indicate that ART outcomes were comparable between groups, with higher rates of cesarean delivery and postpartum hemorrhage observed in the ART group. ART may be pursued in women with low-to-moderate risk or clinically stable CVD when managed in specialized cardio-obstetric settings.