We present a clinical case detailing the course and management of avascular necrosis of the femoral heads occurring during a twin pregnancy following in vitro fertilization. Avascular necrosis is a multifactorial condition predominantly affecting young individuals, often leading to severe secondary osteoarthritis of the hip joints and subsequent disability. Timely diagnosis of this condition in both outpatient and inpatient settings is critically important. A differentiated approach to progesterone administration, specifically in terms of dosage and duration, can effectively prevent and manage gestational complications, while significantly reducing the risk of irreversible trophic disturbances in bone tissue. The present report provides an in-depth clinical description of the case, highlighting diagnostic considerations and management strategies.