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The following is a summary of “Pain assessment in women with or without endometriosis during the IVF process: a prospective study,” published in the November 2023 issue of Obstetrics and Gynecology by Cathelain, et al.

During the different steps of IVF, how does the type and impact of pain change for infertile women with and without endometriosis? Between November 2019 and June 2021, a prospective, single-center, observational cohort study was done at Lille University Hospital. All patients starting an IVF cycle were asked to participate in the study. 

Patients filled out approved pain assessment surveys at three important times during IVF: before treatment began, at the end of stimulation, and on the day of egg removal. The questionnaires asked about the type of pain, not where it hurt. A total of 278 people were looked at, with 205 not having endometriosis and 73 having it. At the start of the IVF process, women with endometriosis reported more pain than women without the disease (mean number scale score 3.47 vs. 1.12 [P < 0.0001]), and 17.81% of women with endometriosis had nerve pain. Before starting treatment, 22% of people with endometriosis had depression or thought they had depression, and 33% had anxiety. 

This was compared to 8% and 20% of people without endometriosis, respectively. For IVF women who did not have endometriosis, the pain got a lot worse between the start of the cycle, the end of stimulation, and the day of removal (P ≤ 0.05). But for people with endometriosis, the pain did not change much at these times. People with endometriosis report more pain, but the pain levels did not rise during IVF for these patients. To improve pain management, screening and describing all patients’ pain traits before they started treatment and while they were being stimulated seemed important.

Source: sciencedirect.com/science/article/abs/pii/S1472648323003498