Gestational diabetes mellitus in women after in vitro fertilization: prevalence, pathogenetic features, and risk factors

Abstract

Background: The increasing number of infertile couples has led to the growing popularity of assisted reproductive technologies as a means of achieving desired pregnancy. It is known that assisted reproductive technologies are an independent risk factor for a serious pregnancy complication—gestational diabetes mellitus. The multifactorial and polygenic nature of gestational diabetes mellitus, as well as its high prevalence following in vitro fertilization, make this issue of particular interest for research.

Aim: To investigate the prevalence of gestational diabetes mellitus in pregnancies achieved through in vitro fertilization, its pathogenetic features, and possible risk factors.

Methods: Scientific publications from eLibrary and PubMed databases were analyzed, focusing on the prevalence, risk factors, and pathogenetic features of gestational diabetes mellitus after assisted reproductive technologies. Outpatient and inpatient medical records of 116 women with singleton pregnancies from 2018 to 2022 were analyzed retrospectively and prospectively. The main group included 77 (66%) patients with in vitro fertilization pregnancies and confirmed gestational diabetes mellitus; the reference group included 39 (34%) in vitro fertilization patients without gestational diabetes mellitus.

Results: The prevalence of gestational diabetes mellitus among pregnant women after in vitro fertilization is significantly higher than in the general pregnant population and, according to various sources, reaches up to 12.6%. Gestational diabetes mellitus is a polygenic multifactorial disease, with epigenetic influences acting as triggers in the presence of specific gene polymorphism associations. A high pregestational body mass index was identified as a risk factor for gestational diabetes mellitus after in vitro fertilization, whereas the number of in vitro fertilization attempts and the follicle-stimulating hormone to luteinizing hormone ratio did not significantly affect its development in this cohort. The etiology of infertility may be a risk factor for gestational diabetes mellitus according to some data, but in our study, no statistically significant differences were found between groups based on infertility cause (p > 0.05).

Conclusion: Understanding the pathogenetic features, identifying, and timely modifying potential risk factors for gestational diabetes mellitus among pregnant women following in vitro fertilization will allow for timely correction of carbohydrate metabolism disorders, as women with gestational diabetes mellitus are at high risk for pregnancy complications and the subsequent development of type 2 diabetes mellitus.

Keywords

gestational diabetes mellitus / assisted reproductive technologies / in vitro fertilization

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