Is IVF pregnancy considered high-risk and is monitoring by maternal fetal medicine provider warranted?

Conceiving by in vitro fertilization (IVF) alone does not automatically put your pregnancy at high-risk. However, the reason(s) for you to seek out IVF in order to conceive may categorize your pregnancy as high risk. Therefore, knowing what high-risk pregnancies are will help you determine if you would need a maternal fetal medicine (MFM) provider as part of your care team through your pregnancy journey with the goal of holding a healthy and crying baby in your arms.

High-risk pregnancy definition:

According to the society of maternal fetal medicine, “a high-risk pregnancy is one that requires special care because of a problem with the pregnancy itself, a preexisting health condition of the pregnant person, or a fetal birth defect or complication.”

Pregnancy problems that would warrant monitoring from MFM provider include:

• History of recurrent pregnancy loss

• History of preterm birth

• Blood pressure concerns:

  • Gestational hypertension

  • Preeclampsia

  • Eclampsia

  • HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome

• Bleeding concerns include:

  • Placenta previa - placenta may block birth canal and cause bleeding during labor.

  • Placenta accreta/increta/percreta - all of these conditions lead to placenta attaching to the uterus wall too tightly and cannot separate after baby is born.

  • Placental abruption - can range from partial detachment (mild bleeding) to complete detachment (significant bleeding) of the placenta from the uterus wall.

Health problems of the pregnant person that would warrant monitoring from MFM provider include:

• Heart disorders (e.g., congenital heart disease, heart transplant, cardiomyopathy)

• Lung problems (e.g., asthma, restrictive lung disease, cystic fibrosis, tuberculosis)

• Obesity

• Endocrine disorders (e.g., Addison’s disease, thyroid disease, type 1 diabetes mellitus)

• Digestive disorder (e.g., gall bladder disease, history of liver transplantation, Wilson’s disease, eating disorder)

• Blood disorders (e.g., sickle cell disease, Von Willebrand disease, inherited thrombophilia)

• Kidney disorders (e.g., history of kidney transplant, nephropathy, chronic renal insufficiency)

• Neurologic conditions (e.g., seizure disorders, multiple sclerosis, myasthenia gravis)

• Psychiatric conditions (e.g., substance use disorder, depression)

• Infectious disorders (e.g., HIV, hepatitis A/B/C, syphilis)

• Autoimmune disorders (e.g., antiphospholipid syndrome, systemic lupus erythematosus)

• Cancer

Fetal problems that would warrant monitoring from MFM provider:

• Fetal birth defects*

  • Central nervous system

  • Spinal cord

  • Chest

  • Heart

  • Gastrointestinal

• Fetal complications*

  • Twins, triplets, and more

  • Growth restrictions

  • Infections

*This is not a comprehensive list, please reference the source below for more details.

Source: “What makes a pregnancy high risk?” Society for Maternal Fetal Medicine. Accessed on 8/2/2022. https://www.highriskpregnancyinfo.org/whats-a-high-risk-pregnancy