Clinical course of pregnancy in women undergoing assisted reproductive technologies

Authors

DOI:

https://doi.org/10.18370/2309-4117.2026.83.12-17

Keywords:

assisted reproductive technologies, controlled ovarian stimulation, pregnancy-related vomiting, retrochorionic hematoma, cervical insufficiency, preterm birth

Abstract

Objective of the study: to investigate the course of pregnancy achieved after controlled ovarian stimulation (COS) cycles.
Materials and methods. The course of pregnancy and delivery was analyzed in 156 patients. A total of 126 patients who conceived using assisted reproductive technologies (ART) were divided into three groups: Group I included 41 women whose pregnancy was achieved by in vitro fertilization in a natural cycle; Group II included 43 patients after 1–2 COS cycles; Group III included 42 women after 3 or more COS cycles. The control group consisted of 30 patients with spontaneous pregnancies.
Depending on the pharmacological support of COS, the patients were additionally divided into subgroups: 22 patients in subgroup IIA and 21 women in subgroup IIIA did not receive additional antioxidant therapy during COS, whereas 21 women in subgroup IIB and 21 participants in subgroup IIIB received melatonin for antioxidant support.
The frequency of first-trimester complications (hemorrhagic discharge, retrochorionic hematoma, lower abdominal pain, vomiting), second-trimester complications (cervical insufficiency, threatened miscarriage), and third-trimester complications (preterm birth, preeclampsia, fetal growth restriction) was assessed in all participants.
Results. The first trimester of pregnancy after ART was characterized by a lower frequency of threatened miscarriage and retrochorionic hematoma compared with spontaneous pregnancy, which may be explained by standardized progesterone support. However, pregnancy following COS was associated with an increased frequency of hemorrhagic discharge during the first trimester, particularly after three or more COS cycles. In contrast, women after ART more frequently reported first-trimester vomiting; its incidence was higher in women after COS and increased further with multiple stimulation cycles.
Cervical insufficiency was the most common second-trimester complication, and its frequency increased with the number of COS cycles.
During the third trimester, women after ART more frequently experienced preterm delivery, with incidence increasing alongside the number of stimulation cycles. A tendency toward a higher frequency of fetal growth restriction was also observed in patients who underwent more than three COS cycles. Importantly, the administration of antioxidant therapy during COS significantly reduced the frequency of these complications.
Conclusions. Pregnancy after ART is more frequently associated with gestational complications, including early pregnancy vomiting and hemorrhagic discharge in the first trimester, cervical insufficiency in the second trimester, and preterm birth in the third trimester. The severity of these disorders increases with the number of COS cycles. The addition of antioxidant therapy to stimulation protocols was associated with a reduction in the frequency of observed obstetric complications.

Author Biographies

L. Gasanova, P.L. Shupyk National Healthcare University of Ukraine, Kyiv

postgraduate student, Obstetrics, Gynecology and Reproductology Department

M.N. Shalko, P.L. Shupyk National University of Health Care of Ukraine; Kyiv City Center for Reproductive and Perinatal Medicine, Kyiv

PhD, associate professor, Department of Reproductive and Perinatal Medicine;
DSc in public administration, deputy director for organizational and methodological work

Y.B. Motsiuk, Ivano-Frankivsk National Medical University, Ivano-Frankivsk

PhD, associate professor, I.D. Lanovyi Department of Obstetrics and Gynecology

M.I. Antoniuk, Bogomolets National Medical University, Kyiv

PhD, assistant, Obstetrics and Gynecology Department No. 1

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Published

2026-05-14

How to Cite

Gasanova, L., Shalko, M., Motsiuk, Y., & Antoniuk, M. (2026). Clinical course of pregnancy in women undergoing assisted reproductive technologies. REPRODUCTIVE ENDOCRINOLOGY, (83), 12–17. https://doi.org/10.18370/2309-4117.2026.83.12-17

Issue

No. 83 (2026)

Section

Assisted reproductive technologies

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