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Nearly half of women suffering from endometriosis report pelvic pain deterioration after IVF, with immediate post-cycle pain flare emerging as the strongest predictor of symptom exacerbation.
A large international survey indicates that in vitro fertilization (IVF) may be associated with worsening pelvic pain symptoms in a substantial proportion of women with endometriosis, challenging the assumption that fertility treatment is pain-neutral in this population.
This cross-sectional study, led by Jonas Vibert, included 546 females aged ≥18 years with surgically or imaging-verified endometriosis who had experienced at least one IVF cycle. Data were collected through a 25-item online questionnaire assessing demographics, reproductive history, comorbidities, and self-reported pain trajectories prior to, during, and following IVF. The key endpoint was perceived deterioration of pelvic pain after IVF, with secondary endpoints including deterioration of dysmenorrhoea and dyspareunia. As per the findings:
Women reporting pain worsening had markedly higher current pain scores when compared to those who did not report worsening. A key finding was that an immediate post-IVF cycle pain flare was the most powerful predictor of later symptom deterioration:
Perceiving oocyte retrieval as the most painful part of IVF was tied to lower chances of exacerbated pelvic pain (aOR 0.53). Achieving a live birth after IVF reduced the likelihood of pelvic pain worsening (aOR 0.63) and dysmenorrhoea worsening. Presence of bladder pain syndrome/interstitial cystitis independently anticipated dyspareunia aggravation. The findings suggest IVF may not be universally pain-neutral in endometriosis and highlight the requisition for:
Human Reproduction Open
IVF in endometriosis: emerging evidence of exacerbation of pelvic pain and potential predictors
Jonas Vibert et al.
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