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We also considered the potential influence of exposure to assisted reproductive technology (ART) on the risk of future CVD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis of 22 studies, registered in PROSPERO (CRD42023420300), followed PRISMA guidelines. Pooled odds ratios (OR) and hazard ratios (HR) were calculated using Mantel-Haenszel and inverse variance methods, while heterogeneity was evaluated using I\u00b2. Sensitivity analyses were performed to explore the impact of study design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We observed that women with infertility compared to controls had a higher risk of incident CVD (infertile vs controls: 178,828 vs 3,398,781; HR\u2009=\u20091.14, 95% CI 1.12-1.16; I\u00b2\u2009=\u200989%), CHD (HR=1.17, 95% CI 1.12-1.23; I\u00b2\u2009=\u20090%), and cerebrovascular events (HR=1.16, 95% CI 1.11-1.21; I\u00b2=73%). Exposure to ART was associated with a higher risk of overall CVD across five studies (HR = 1.17, 95% CI 1.11\u20131.24; I\u00b2 = 96%) and with increased incident stroke across four studies (HR = 1.12, 95% CI 1.03\u20131.23; I\u00b2 = 60%), whereas no significant association was observed with CHD. However, some of the estimates were heterogenous, which limits certainty and causal inference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Women with infertility compared with controls had higher pooled estimates for incident CVD, CHD and cerebrovascular events. However, these estimates were heterogeneous (I\u00b2 up to 99%), which limits certainty and precludes causal inference.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12020-025-04543-x","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T06:26:07Z","timestamp":1770791167000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Female infertility and long-term cardiovascular risk: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"91","author":[{"given":"Christina","family":"Polymeropoulou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikoletta","family":"Mili","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Armeni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elina","family":"Siliogka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areti","family":"Augoulea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1488-2668","authenticated-orcid":false,"given":"Irene","family":"Lambrinoudaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"issue":"10","key":"4543_CR1","doi-asserted-by":"publisher","first-page":"e56","DOI":"10.1161\/CIR.0000000000000659","volume":"139","author":"EJ Benjamin","year":"2019","unstructured":"E.J. 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