Women with hypertension face decreased fecundability

Hypertension, regardless of blood pressure (BP) control, appears to exert a negative influence on fecundability in women, as reported in a study.

Researchers used data from the National Free Preconception Checkup Projects in Guangdong Province, China. They identified 1,422 couples whose female partners had been diagnosed with hypertension and 997,703 reference couples whose female partners had no hypertension.

The primary outcome of fecundability was assessed by time to pregnancy (TTP) and infertility (TTP >12 months).

Analysis showed that relative to women without hypertension, those with controlled hypertension (time ratio, 1.47, 95 percent confidence interval [CI], 1.24–1.73) or uncontrolled hypertension (time ratio, 1.59, 95 percent CI, 1.34–1.90) had prolonged TTP (relative risk, 1.19, 95 percent CI, 1.09–1.31) and elevated risk of infertility (relative risk, 1.24, 95 percent CI, 1.14–1.34).

However, instrumental variable analyses indicated that BP control had no significant association with both fecundability measures, namely TTP (time ratio, 0.68, 95 percent CI, 0.34–1.36; p=0.270) and infertility (relative risk, 0.97, 95 percent CI, 0.70–1.34; p=0.849), among women with hypertension.

Propensity score matching and inverse probability of treatment weighting analyses yielded consistent results.

The present data highlight the potential value of preconception hypertension screening and may inform the design of future trials, according to the researchers.