Congenital Heart Disease and Fertility Among Pregnant Patients

Patients with congenital heart disease (CHD) who became pregnant do not have impaired fertility compared with other pregnant patients, according to results of a study published in the International Journal of Cardiology.

To better investigate fertility in CHD, data for this study were sourced from the Danish National Birth Cohort (DNBC). Pregnant women (N=93,832) between 1996 and 2002 were evaluated for fertility by asking if their pregnancy was planned and if so, how long they tried to conceive. Answers to fertility questions were compared between women with (n=360) and without (n=93,472) CHD.

The CHD and control cohorts comprised women with median ages of 29 (IQR, 27-32) and 30 (IQR, 27-33) years, 52.5% and 45.6% had no children, 79.4% and 83.2% had a regular menstrual cycle, 26.1% and 22.5% used oral contraceptives in the 4 months prior to pregnancy, and 41.1% and 50.6% had self-reported very good health, respectively.

Among the CHD and control cohorts, 18.1% and 17.6% of pregnancies were unplanned, 57.8% and 56.2% tried to conceive for 5 or fewer months, 13.1% and 12.6% tried to conceive for 6 to 12 months, 6.9% and 7.5% tried to conceive for more than 12 months, and 4.2% and 6.2% used medical assistance to conceive, respectively.

Compared with control patients, women with CHD were not more likely to spend 6 to 12 months attempting to conceive (adjusted relative risk ratio [aRRR], 1.02; 95% CI, 0.75-1.39) or to attempt for more than 12 months or use medical assistance (aRRR, 0.86; 95% CI, 0.61-1.20).

Among the subset of women with simple CHD (n=291), no significant differences in fertility were observed compared with control patients.

The major limitation of this study is that only women who were able to achieve pregnancy were included. These results may not be generalizable to all women with CHD.

This study found that CHD likely did not affect fertility among women who were able to conceive. The study authors concluded, “We found no indication of impaired fertility in women with CHD, assessed by TTP [time to pregnancy], as compared to unaffected women. Results were unchanged when comparing women with simple CHD and unaffected women. These findings add to our limited knowledge regarding fertility in women with CHD, which, hopefully, provides comfort for patients with simple heart defects in particular.”