Self-reported infertility, metabolic dysfunction, and cardiovascular events: a cross-sectional analysis among U.S. women

After adjusting for demographic, lifestyle, and behavioral factors, women who reported ever experiencing infertility had higher odds of reporting symptoms consistent with metabolic syndrome and cardiovascular events.

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Volume 111, Issue 1, Pages 138–146


Jessica L. Gleason, M.P.H., C.P.H., Edmond D. Shenassa, Sc.D., Marie E. Thoma, Ph.D.



To explore associations between infertility and metabolic syndrome, and cardiovascular events. Infertility is increasingly a public health issue, with emerging links to chronic disease. Existing literature on infertility focuses primarily on known causes, which likely excludes a substantial number of women for whom there is no known cause or formal diagnosis.


We conducted a cross-sectional analysis examining the association between self-reported infertility (i.e., ever experiencing inability to conceive after 12 months of trying to become pregnant) and metabolic syndrome and cardiovascular events (i.e., congestive heart failure, coronary heart disease, heart attack, or stroke). Data were analyzed using multivariate logistic regression.


A total of 744 U.S. women, 20–59 years of age, from the National Health and Nutrition Examination Survey (2013–2014), participated in the study. Among them, 15.7% reported ever experiencing infertility, 27.6% met the definition of metabolic syndrome, and 2.84% reported ever having a cardiovascular event.



Main Outcome Measure(s)

Metabolic syndrome and cardiovascular events.


Compared to women who had never experienced infertility, women who reported infertility had a 1.79 (95% confidence interval [CI] 1.04, 3.08) higher odds of reporting symptoms of metabolic syndrome and 1.83 (95% CI 1.15, 2.89) times higher odds of having experienced a cardiovascular event. Furthermore, women with self-reported infertility had a 71% higher odds of reporting a cardiovascular event after controlling for metabolic syndrome (95% CI 1.01, 3.00).


Our results suggest that among U.S. women, the experience of infertility at any point in a woman's reproductive window may be associated with later-life cardiovascular health.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.