14 Since ART use is increasing among women with chronic conditions, there is also an expected trend that more women with a history of stroke may desire to conceive via ART. 14 Importantly, use of exogenous oestrogen, in the form of combined oral contraceptives or hormonal replacement therapy, has been shown to increase the risk of stroke. 15 16 This risk has been attributed to procoagulant and proinflammatory effects of oestrogen as well as acquired resistance to activated protein C. 17 In parallel, after a stroke, the American Heart Association guidelines recommend against the use of oestrogen-containing oral contraceptives due to increased risk of subsequent stroke.
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