{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T18:40:28Z","timestamp":1776537628869,"version":"3.51.2"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:00:00Z","timestamp":1774656000000},"content-version":"vor","delay-in-days":86,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>STUDY QUESTION<\/jats:title>\n                    <jats:p>Does IVF worsen pelvic pain in women with endometriosis?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SUMMARY ANSWER<\/jats:title>\n                    <jats:p>Nearly half of women with endometriosis reported perceived worsening of pelvic pain after IVF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WHAT IS KNOWN ALREADY<\/jats:title>\n                    <jats:p>Prior studies generally suggested no IVF-related pain worsening, but few assessed delayed flares or longer-term trajectories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY DESIGN, SIZE, DURATION<\/jats:title>\n                    <jats:p>International cross-sectional study based on an online survey conducted between September 2024 and April 2025 including 546 respondents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS\/MATERIALS, SETTING, METHODS<\/jats:title>\n                    <jats:p>Women aged \u226518\u2009years with surgically or imaging-confirmed endometriosis and at least one completed IVF cycle. A 25-item questionnaire captured demographics, reproductive history, comorbidities, and patient-reported pain trajectories before, during, and after IVF. The primary outcome was perceived worsening of pelvic pain after IVF (patient-reported outcome measure; PROM). Secondary outcomes were worsening of dysmenorrhoea and dyspareunia. Group comparisons and exploratory multivariable logistic regressions were performed. Predictor analyses were exploratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MAIN RESULTS AND THE ROLE OF CHANCE<\/jats:title>\n                    <jats:p>Among 546 respondents, 48.9% reported worsening pelvic pain after IVF, 49.1% reported worsening dysmenorrhoea, and 35.5% worsening dyspareunia. Current pain scores were significantly higher in women reporting worsening versus no worsening (all P\u2009&amp;lt;\u20090.001). In multivariable analyses, immediate post-cycle pain flare emerged as the strongest and most consistent predictor across all pain outcomes, independently associated with worsening of pelvic pain (adjusted odds ratio [aOR] 5.91, 95% CI 3.88\u20139.14), dysmenorrhoea (aOR 4.03, 95% CI 2.08\u20138.05), and dyspareunia (aOR 3.17, 95% CI 2.07\u20134.90) (all P\u2009&amp;lt;\u20090.001). For the primary outcome, reporting oocyte retrieval as the most painful IVF step (aOR 0.53, 95% CI 0.31\u20130.88; P\u2009=\u20090.016) and achieving a live birth after IVF (aOR 0.63, 95% CI 0.42\u20130.92; P\u2009=\u20090.020) were independently associated with lower odds of pelvic pain worsening. In secondary outcome models, live birth was associated with lower odds of dysmenorrhoea worsening, while bladder pain syndrome\/interstitial cystitis independently predicted worsening of dyspareunia. A formal response rate could not be calculated due to open online dissemination without a known denominator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LIMITATIONS, REASONS FOR CAUTION<\/jats:title>\n                    <jats:p>Self-reported, retrospective data are prone to recall and selection bias, and the cross-sectional design precludes causal inference. Recruitment via associations and social media without a denominator limits generalizability, absence of baseline pain scores impedes assessment of change, and incomplete capture of peri-IVF hormonal regimens may confound results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WIDER IMPLICATIONS OF THE FINDINGS<\/jats:title>\n                    <jats:p>IVF may not be pain-neutral in endometriosis. Monitoring pain trajectories at key IVF milestones may help identify women at risk of long-term exacerbation. Prospective studies should test whether early monitoring combined with tailored interventions\u2014optimized analgesia, psychological support, or adapted stimulation protocols\u2014can mitigate chronic pain trajectories throughout the IVF journey and ultimately improve quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY FUNDING\/COMPETING INTEREST(S)<\/jats:title>\n                    <jats:p>No specific funding; authors declare no conflicts of interest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>TRIAL REGISTRATION NUMBER<\/jats:title>\n                    <jats:p>N\/A.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/hropen\/hoag027","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T12:46:08Z","timestamp":1774442768000},"source":"Crossref","is-referenced-by-count":0,"title":["IVF in endometriosis: emerging evidence of exacerbation of pelvic pain and potential predictors"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2449-7734","authenticated-orcid":false,"given":"Jonas","family":"Vibert","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Lausanne University Hospital , Lausanne,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1549-7948","authenticated-orcid":false,"given":"Eliane","family":"Maalouf","sequence":"additional","affiliation":[{"name":"Information Management Institute, University of Neuch\u00e2tel , Neuch\u00e2tel,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7730-5677","authenticated-orcid":false,"given":"Jean-Marie","family":"Wenger","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Geneva , Geneva,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2113-7706","authenticated-orcid":false,"given":"Antonio","family":"Mercorio","sequence":"additional","affiliation":[{"name":"Assisted Reproductive Technology Unit, Department of Gynecology, H\u00f4pital Foch , Suresnes,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3168-4594","authenticated-orcid":false,"given":"Giuseppe","family":"Benagiano","sequence":"additional","affiliation":[{"name":"Geneva Foundation for Medical Education and Research , Geneva,","place":["Switzerland"]},{"name":"Faculty of Medicine and Dentistry, Sapienza University of Rome , Rome,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7475-9082","authenticated-orcid":false,"given":"Nicola","family":"Pluchino","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Lausanne University Hospital , Lausanne,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"2026041813564590600_hoag027-B1","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.1093\/humrep\/der208","article-title":"IVF and endometriosis-related symptom progression: insights from a prospective study","volume":"26","author":"Benaglia","year":"2011","journal-title":"Hum Reprod"},{"key":"2026041813564590600_hoag027-B2","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1093\/oxfordjournals.humrep.a019276","article-title":"Impact of the in-vitro fertilization process on emotional, 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