# Clinical Characteristics and Maternal-Perinatal Outcomes of In Vitro Fertilization Patients Referred to a Hospital in Lima, Peru

## TL;DR

This study examines the maternal and perinatal outcomes of IVF pregnancies at a hospital in Lima, Peru, finding high rates of complications and emphasizing the need for better guidelines.

## Contribution

The study provides insights into IVF outcomes in a Peruvian setting, highlighting the need for national guidelines for high-risk IVF patients.

## Key findings

- IVF pregnancies were associated with high rates of maternal complications like hypertension and preeclampsia.
- Over 40% of neonates were born prematurely, and 31% required NICU admission.
- Multiple gestations occurred in 33.3% of pregnancies, and one maternal death was reported.

## Abstract

Introduction: Infertility represents a major reproductive health challenge worldwide, and in vitro fertilization (IVF) has become an effective option for many couples seeking pregnancy. However, IVF has been associated with increased maternal and perinatal morbidity, with higher rates of hypertensive disorders, multiple gestations, and preterm birth. In Peru, despite the growing use of assisted reproductive technologies, national guidelines for patient selection and risk stratification remain limited.

Objective: To describe the clinical characteristics and maternal-perinatal outcomes of females with IVF-conceived pregnancies referred to the Guillermo Almenara Irigoyen National Hospital (HNGAI), a tertiary referral center in Lima, Peru.

Methods: A descriptive, observational, retrospective study was conducted between January 2024 and March 2025. A total of 42 females with IVF-conceived pregnancies managed at the High-Risk Obstetrics Unit of HNGAI were included. Maternal demographic variables, obstetric history, comorbidities, and perinatal outcomes were analyzed using Microsoft Excel 2020 (Microsoft Corporation, Redmond, WA).

Results: The mean maternal age was 41 years. Chronic hypertension, thrombophilia, and preeclampsia were among the most frequent comorbidities. Prematurity occurred in 20 neonates (46.8%). Cesarean delivery was performed in 41 patients (97.5%), and 14 pregnancies (33.3%) were multiple gestations. Fetal and neonatal anomalies were identified in six cases (14.3%), predominantly of cardiovascular origin. Thirteen neonates (31.0%) required admission to the neonatal intensive care unit (NICU). One maternal death (2.4%) occurred due to hepatic rupture secondary to severe preeclampsia.

Conclusions: IVF-conceived pregnancies managed at this national referral center were associated with a high rate of maternal and perinatal complications. These findings underscore the importance of individualized evaluation and ethical selection of IVF candidates, as well as the need for national guidelines to ensure safe reproductive care in high-risk populations.