Predictors of increased blood pressure in women after induction of superovulation for extracorporeal fertilization

Objective is to study the relationship of hemodynamic, hormonal and metabolic changes with increased blood pressure (BP) in women after the induction of superovulation for extracorporeal fertilization (ECF).

Design and methods. We examined 80 women aged from 25 to 38 years (mean age 32,3 ± 3,6 years). All patients underwent ECF at the Center for Reproductive Technologies of the St Petersburg Mariinsky Hospital. Daily monitoring of BP was carried out twice: before the induction of superovulation for ECF and on the first day after this manipulation.

Results. After induction of superovulation, an increase in average daily BP ≥ 135/85 mm Hg occurred in 52,5 % of women and an increase in average night BP ≥ 120/70 mm Hg was registered in 13,8 %. In women with initially increased average daily BP, the relative risk of its further increase on the first day after induction of superovulation was 1,46 (95 % confidence interval (CI) 0,79–2,68) compared with women who had normal average daily BP. In women with initially elevated average nightly BP, the relative risk of its further increase after induction of superovulation was 1,16 (95 % CI 1,06–1,27). An increase of BP after induction of superovulation may be associated with age, female factor infertility, the presence of chronic diseases of the genitourinary system in past, changes in the metabolic profile (increase in total cholesterol, urea, creatinine, glucose, estradiol; decreased thyroid-stimulating hormone level), heart rhythm disturbances, episodes of apnea/hypopnea during sleep, increase in heart rate, increased sympathetic activity.

Conclusions. Induction of superovulation during in vitro fertilization has an adverse effect on the circadian BP profile. While planning in vitro fertilization, the risk factors for BP increase should be identified and modified. This will help to avoid adverse cardiovascular reactions associated with the procedure. Women with the hypertensive reaction after the induction of superovulation require dynamic BP monitoring.

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