OBJECTIVE To determine if singleton in vitro fertilization (IVF) pregnancies carry a higher risk for ante- and perinatal complications compared with naturally conceived pregnancies. METHODS One hundred forty singleton pregnancies conceived by IVF and 140 matched control pregnancies conceived naturally were analyzed with respect to the incidence of antepartum complications and perinatal outcome. The study was conducted in a university hospital, and pregnancy and labor were managed according to a standardized protocol. RESULTS Sixteen IVF pregnancies and two control pregnancies ended preterm (P < .01), resulting in the birth of infants with lower birth weight in the former group (P = .01). Except for placenta previa, which occurred four times in IVF pregnancies and not in the control group, no differences in antenatal events were found. Labor was more often induced in IVF pregnancies than in control pregnancies. Elective cesarean delivery for obstetric reasons was performed ten times in the IVF group and never in the controls (P < .01). However, once in labor, no differences in the rate of instrumental or cesarean delivery were found. There were eight minor congenital malformations in the IVF group and none in the control group (P < .01). CONCLUSIONS Even when managed in a single center, IVF pregnancies carry a greater antenatal risk than matched controls. Once in labor, and managed in a similar fashion, the outcome does not differ from that of controls.