Gestational diabetes in IVF and spontaneous pregnancies

Increasing number of pregnancies resulting from In vitro Fertilisation (IVF) combined with increased awareness of Gestational Diabetes Mellitus (GDM) - related morbidity calls for research on possible differences in pregnancy outcomes between IVF and non-IVF GDM complicated pregnancies. The aim of this study was to compare GDM - affected pregnancies, both resulting from IVF and conceived without medical intervention with regards to maternal data, fetal biometry and neoanatal outcomes.

We used our Clinic's databases to retrospectively identify 36 women who had successful IVF and developed GDM during the course of their singleton pregnancy (IVF group) and 137 non-IVF women with GDM (non-IVF group). They were matched according to age, pre-pregnancy BMI and none had the history of diabetes mellitus before their pregnancies. We compared the maternal characteristics, course of pregnancy and neonatal outcome.

The weight gain until the diagnosis of GDM in both non-IVF and IVF groups of women was not significantly different (9.81±4.37 vs 10.0±4.8 kg, p=0.8 respectively) with similar time at which they came under the specialist GDM care (29±4.0 vs 28±4.5 wks, p=0.42,). When analyzing first trimester fasting glucose levels we found it to be significantly higher in IVF group (89±16.2 vs 83±11.3 mg/dl, p=0.04). Second trimester oral glucose tolerance test (OGTT) results and glucose levels during GDM treatment did not differ between the groups. No changes were noted in investigated fetal and neonatal variances: 3rd trimester AC, it's percentile and neonatal birth weight (3 460±641 vs 3 200±440 g, p=0.22).

GDM among women after in vitro fertilisation is characterised by higher first trimester fasting glucose levels. Early diagnostic intervention in IVF pregnancies is specially needed.