Association between In Vitro fertilization and gestational diabetes mellitus: a multicenter cohort study

Introduction This multicenter retrospective cohort study investigates the association between in vitro fertilization (IVF) and gestational diabetes mellitus (GDM) risk across demographic subgroups. Methods Using clinical data from 61,329 pregnant women (3,902 IVF-conceived; 57,427 naturally conceived) across three tertiary hospitals in China, we compared GDM incidence diagnosed through standardized oral glucose tolerance tests (24-28 gestational weeks). Results The IVF group exhibited significantly higher GDM incidence (17.32% vs. 12.91%, p<0.001). The analysis adjusted for age, parity, pre-pregnancy body mass index (BMI), family history of DM, alanine aminotransferase (ALT), and creatinine revealed IVF-conceived pregnancies had 15% elevated GDM risk. Subgroup analyses demonstrated heightened IVF-associated GDM risk in women aged <35 years, those with pre-pregnancy BMI <24 kg/m 2 , and primiparous women. No significant associations were observed in older women (≥35 years), individuals with BMI ≥24 kg/m 2 , or multiparous women. Discussion These findings identify IVF as an independent GDM risk factor, particularly in younger, leaner, and first-time mothers. The results underscore the importance of stratified prenatal monitoring and mechanistic investigations into fertility treatments’ metabolic impacts.