Objective. To study the course of multiple pregnancy after the use of different methods of assisted reproductive technologies. Patients and methods. A total of 234 patients with multiple pregnancy developed through in vitro fertilization (IVF) were examined: 99 patients under the surrogate motherhood program (IVF-SM), 68 women after IVF with donor oocytes (IVF-DO), and 67 patients after IVF with own oocytes (IVF-OO). Patient subgroups were formed based on the presence or absence of obstetric complications. Results. Univariate analysis of pregnancy course showed that the incidence of gestational hypertension was significantly higher in the IVF-DO group than in the IVF-SM and IVF-OO groups. Pre-eclampsia (PE) in patients in the IVF-DO group was significantly more common than in the IVF-SM group (OR: 5.87; 95% CI: 1.94–17.74, p < 0.0005). Intrahepatic choles-tasis (11.7%) and gestational diabetes (7.3%) were also more common in the IVF-DO group, but these data were not statistically significant. In multivariate analysis adjusted for maternal age, the incidence of PE remained significantly higher in the IVF-DO group compared with the IVF-SM group (OR: 7.68; 95% CI: 1.64–35.84, p < 0.0055). There were no significant differences between the IVF-DO and IVF-OO groups (OR: 2.8; 95% CI 0.77–10.22, p < 0.1487) and the IVF-OO and IVF-SM groups (OR: 0.36; 95% CI 0.11–1.24, p < 0.1305). Conclusion. Multiple pregnancy following IVF-DO is significantly associated with a higher risk of pre-eclampsia and fetal growth restriction compared with the IVF-OO and IVF-SM groups. © 2023, Dynasty Publishing House. All rights reserved.