This study investigates the association between a history of infertility and midlife cardiovascular health (CVH) in female individuals. The research is based on data from Project Viva, a prospective cohort study of pregnant participants enrolled between 1999 and 2002. Infertility history was collected at a midlife visit between 2017 and 2021, approximately 18 years after enrollment. The American Heart Association’s Life’s Essential 8 (LE8) was used to assess CVH, which includes scores in behavioral and biomedical domains. The study found that among 468 parous individuals, 160 (34.2%) experienced any infertility. The mean LE8 scores were 76.3 (SD 12.2) overall, 76.5 (13.4) for the behavioral domain, 76.0 (17.5) for the biomedical domain, and 78.9 (19.2) for the blood biomarkers subdomain. In adjusted models, those with a history of infertility had significantly lower LE8 scores compared to those without infertility, with an estimated overall LE8 score of 2.94 points lower, a biomedical domain score of 4.07 points lower, and a blood subdomain score of 5.98 points lower. The behavioral domain score was also lower, although not statistically significant. The findings suggest that a history of infertility may be a marker for future CVH in female individuals, highlighting the importance of early identification and ongoing cardiovascular preventive strategies. The study also notes that associations were more pronounced for infertility experienced before age 35 years.This study investigates the association between a history of infertility and midlife cardiovascular health (CVH) in female individuals. The research is based on data from Project Viva, a prospective cohort study of pregnant participants enrolled between 1999 and 2002. Infertility history was collected at a midlife visit between 2017 and 2021, approximately 18 years after enrollment. The American Heart Association’s Life’s Essential 8 (LE8) was used to assess CVH, which includes scores in behavioral and biomedical domains. The study found that among 468 parous individuals, 160 (34.2%) experienced any infertility. The mean LE8 scores were 76.3 (SD 12.2) overall, 76.5 (13.4) for the behavioral domain, 76.0 (17.5) for the biomedical domain, and 78.9 (19.2) for the blood biomarkers subdomain. In adjusted models, those with a history of infertility had significantly lower LE8 scores compared to those without infertility, with an estimated overall LE8 score of 2.94 points lower, a biomedical domain score of 4.07 points lower, and a blood subdomain score of 5.98 points lower. The behavioral domain score was also lower, although not statistically significant. The findings suggest that a history of infertility may be a marker for future CVH in female individuals, highlighting the importance of early identification and ongoing cardiovascular preventive strategies. The study also notes that associations were more pronounced for infertility experienced before age 35 years.