The functional state of the heart in women prior to extracorporeal fertilization and its dynamics after stimulation of superovulation

The purpose of the work – to study echocardiographic parameters before and after the induction of superovulation to determine the nature of the effect of extracorporeal fertilization on the functional state of the cardiovascular system in healthy women of reproductive age.

Materials and methods. The article presents the results of clinical and instrumental examination of 80 practically healthy women (mean age 32.3 ± 3.5 years). All women were examined twice – before and after induction of superovulation during extracorporeal fertilization.

Results. It was established that a decrease in the stroke volume of blood (p < 0.001) was accompanied by a compensatory increase in heart rate (p < 0.001). These changes ensured the stability of the minute blood volume after induction of superovulation (before – 51.1 ± 1.1 ml; after – 52.1 ± 1.2 ml; p > 0.05). After induction of superovulation in women, an increase in the integral systolic index of cardiac remodeling was noted (before – 108.7 ± 2.5 units; after – 118.5 ± 4.7 units; p < 0.001), an indicator of myocardial stress in systole (before – 111.5 ± 6.7 dyne/cm²; after – 127.3 ± 7.4 dyne/cm²; p < 0.001) and the indicator of myocardial stress in diastole (before — 139.4 ± 6.8 dyne/cm²; after — 165.7 ± 7.9 dyne/cm²; p < 0.001). In practically healthy women, after induction of superovulation, the left ventricular ejection fraction increased (before – 71.3 ± 4.2%; after – 74.8 ± 4.1%; p < 0.001). The revealed dynamics is regarded as a response of the myocardium to a change in the hormonal background during superovulation induction. This is evidenced by the correlation between the estradiol level and the left ventricular ejection fraction (r = 0.36; p < 0.05).

Conclusion. Induction of superovulation does not adversely affect systolic and diastolic function of the left ventricle. However, after these manipulations there is an increase in systolic and diastolic myocardial stress, which reflects myocardial stress in response to hemodynamic changes. Remodeling indices are more informative for evaluating maladaptive and adaptive variants of myocardial changes in healthy women than traditional echocardiographic indicators. In this regard, remodeling indices should be used as additional indicators of the functional state of the heart in women before and after the induction of superovulation in vitro fertilization.