Similar evolution of pain symptoms and quality of life in women with and without endometriosis undergoing assisted reproductive technology (ART)

Abstract

| INTRODUC TI ONEndometriosis is a common benign gynecological disorder that affects approximately 10% of all reproductive women. 1 It is characterized by the ectopic presence of endometrial glands and stroma. 2 AbstractIntroduction: Altogether 10% of all women of fertile age suffer from endometriosis, and up to 25% of these women require assisted reproductive technology (ART) to conceive. During ART the process of controlled ovarian stimulation causes high levels of estrogen, which in theory increases the risk of the progression of symptoms related to this estrogen-dependent disorder. Because several case reports have described the worsening of endometriosis during ART we carried out this study to investigate whether controlled ovarian stimulation during ART aggravates symptoms in women with endometriosis in terms of pain and quality of life. Material and methods:This prospective cohort study was based on questionnaires containing the Endometriosis Health Profile (EHP-30) and pain evaluated on the numerical rating scale (NRS). Women aged below 40 years were recruited and divided into three groups according to their endometriosis and ART status. Questionnaires were administered before and after controlled ovarian stimulation in one ART cycle.Change in EHP-30 and NRS scores from the 1st to 2nd questionnaire was analyzed. Results:In total 52 women with endometriosis undergoing ART, 50 not undergoing ART, and 52 without endometriosis undergoing ART completed two questionnaires each. Both groups with endometriosis experienced a small increase in their quality of life, while women without endometriosis experienced a decrease. Pelvic pain worsened among women undergoing ART, but no greater worsening was detected among women with endometriosis compared with women without. Conclusions:This study showed no worsening in quality of life and a slight worsening in pelvic pain during ART regardless of endometriosis status. K E Y W O R D SART, assisted reproductive technology, endometriosis, pain, patient-reported outcome measures, quality of life

Angiogenesis signaling in endometriosis: Molecules, diagnosis and treatment (Review)

“…The current medical treatment for EM focuses on either hormonal modulation to induce a low estrogen state or surgical treatment to remove the ectopic lesions. However, even if the ectopic lesions are removed by surgery, certain patients will still have recurrence and even face the possibility of reoperation ( 106 ). Nevertheless, targeted therapeutic strategies based on anti-angiogenic therapy have been demonstrated in oncology and ophthalmology and have been widely used in clinical practice ( 8 , 43 ).…”