JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):155
Poster Presentation
29^th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263934

P-143. In Vitro Fertilization and Obstetric Outcomes: Impact on the Route of Delivery and Gestational Complications

Camila Haas¹, Joana Carmona¹, Elisa Weirich Braido¹, Carolina Comissoli Fernandes¹, Laura Randon Chapochnicoff¹, Isadora de Carvalho Schamm¹, Marta Ribeiro Hentschke¹

¹ Pontifícia Universidade Católica do Rio Grande do Sul - Porto Alegre - RS - Brasil

Objective: To investigate the most common obstetric outcomes in patients undergoing In Vitro Fertilization (IVF).
Methods: A literature review was performed in the PubMed database using the following search strategy: ("In Vitro Fertilization" OR "IVF" OR "Assisted Reproductive Techniques" OR "ART") AND ("Cesarean Section" OR "Elective Cesarean Section") AND ("Pregnancy Outcome" OR "Obstetric Complications"). The search was limited to studies published in the last ten years. Filters were applied to include only original articles, systematic reviews, meta-analyses and case reports. Fourteen out of 22 articles were included.
Results: The current studies have shown that IVF pregnancies have higher cesarean section rates, particularly in cases involving oocyte donation and a history of previous cesarean section. In pregnancies with oocyte donation (OD), in addition to being associated with higher cesarean rates, is recently being linked to increased risks of hypertensive disorders, preterm birth, and fetal growth restriction. A meta-analysis indicates that hypertensive disorders and pre-eclampsia were more frequent in IVF with OD (13-39.3%) and autologous IVF (1.9-23.3%) pregnancies than spontaneous pregnancies (2.1-3.8%). Furthermore, in patients with endometriosis, when artificial cycle endometrial preparation was used, this pathology was associated with a higher occurrence of placenta previa, possibly due to the physiology of deep infiltrating endometriosis lesions impacting placental implantation. Moreover, programmed frozen embryo transfer cycles seem to be associated with greater rates of hypertensive complications, preeclampsia, postpartum hemorrhage, labor induction, and cesarean delivery compared to natural cycle transfers. Another meta-analysis compared women undergoing Artificial Reproduction Techniques (ART) with previous caesarean section vs. previous vaginal delivery. The study showed that the previous Caesarean section, when compared with women who had previous vaginal delivery, leads to significantly decreased clinical pregnancy rate (p<0.001), live birth rate (p<0.001). increased the miscarriage rate (p<0.0001), and difficult transfer (p<0.001).
Conclusion: The review shows that pregnancies resulting from IVF have a higher incidence of obstetric complications, particularly increased rates of cesarean section, hypertensive disorders, and preterm birth, when compared to spontaneous pregnancies. Factors such as oocyte donation, endometriosis, and programmed embryo transfer cycles appear to further increase these risks, possibly due to physiological and placental implantation alterations. Understanding these outcomes is essential for preconception counseling, prenatal care planning, and the adoption of strategies aimed at reducing risks and improving maternal–fetal prognosis. Individualized management and counseling are essential to optimize outcomes in this population.