No association found between congenital heart defects and infertility

Men and women with simple to moderate congenital heart defects have no greater risk of infertility than the general population.

A recent nationwide study in Denmark is the first to evaluate the risk of infertility in people with congenital heart defects compared to people without them. The findings, published in the Journal of the American Heart Association, showed while the number of people with congenital heart defects who became parents was lower than the general population, those who did have children had the same number of children as those in the Danish population on average.

Previous research into the effect of these heart defects on fertility had been inconclusive, and the issue had become more pressing as an increasing number of patients with congenital heart defects were reaching childbearing age, said authors. 'Published literature on fertility is truly limited, despite the fact that some – in particular female patients – express concerns about their fertility' said Dr Louise Udholm of Copenhagen University Hospital, the lead author of the study.

Researchers used the Danish health registry to access data from almost 1.4 million people born between 1977 and 2000. They identified 8679 (0.6 percent) men and women diagnosed with congenital heart defects. Half had a simple defect; 34 percent had a moderate defect and seven percent had a complex defect. The study estimated the risk of being diagnosed with infertility and compared it with the unaffected population. They also compared birth rates, proportions of individuals becoming parents or remaining childless, and the number of children per parent.

For people with simple to moderate congenital heart defects, no greater risk of infertility was observed compared with the unaffected population. The researchers were unable to evaluate the risk for people with complex defects because the group was too small. Researchers also observed that while birth rates were lower in people with congenital heart defects, those who were parents had the same number of children as the unaffected population.

Suggesting the results implied there could be a psychosomatic effect on people with congenital heart defects that could affect their approach to having children, Dr Udholm said: 'These results suggest that even more focus should be given to educational programs for adolescents with heart defects, or perhaps the parents in particular, in order to make sure that these young patients live their lives like their peers as much as possible with regards to relationships and sex and these more sensitive aspects of life.'

Dr Yonatan Buber is the associate programme director for the Adult Congenital Heart Disease Service at the University of Washington Medical Centre, Seattle, was not involved in the study, and said 'Many of our patients come into a clinic stating in fact that they know that they cannot become pregnant, when it's absolutely not the case'.