Gestational diabetes in IVF and spontaneous pregnancies

OBJECTIVE: 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. METHODS: 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. RESULTS: 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 (3460 +/- 641 vs 3 200 +/- 440 g, p=0.22). CONCLUSIONS: 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.