title: Vocal symptoms in women undergoing in vitro fertilization.
abstract: OBJECTIVE
  The aim of this study was to investigate changes in vocal symptoms in relation to estrogen level in women undergoing in vitro fertilization.
  
  
  METHODS
  A total of 31 women were enrolled in this study. The following vocal symptoms were investigated: vocal tiring or fatigue, vocal straining, throat clearing, lump sensation, hoarseness, and aphonia (or loss of voice). The severity of these symptoms was graded from 0 to 4, where 0 means absence of the symptom and 3 means severe symptom presence. The frequency of these symptoms was evaluated in the first visit at presentation; second visit, 4 to 5 days after ovarian stimulation; and third visit, 8 to 10 days after stimulation. In the second and third visits, the estradiol levels were measured.
  
  
  RESULTS
  The mean age was 32.33 ± 4.80 years. Ten of the 31 patients had at least 1 vocal symptom. The most common vocal symptom in all 3 visits was throat clearing, with an incidence of 22.6% in the first and second visits and 19.4% in the third visit. This was followed by vocal fatigue or tiring and lump sensation, with an incidence of 9.68% for both. The incidence of all the vocal symptoms as well as their severity did not change throughout the visits, except for throat clearing, which has decreased in the third visit but not significantly (22.6% vs 19.4%, P = 1). Subjects with vocal symptoms had lower estradiol level compared with those with no vocal symptoms; however, the difference was not statistically significant (P = .108 and .267, respectively).
  
  
  CONCLUSIONS
  Subjects undergoing in vitro fertilization do not experience changes in their vocal symptoms when present, except for throat clearing. However, those with vocal symptoms have lower levels of estradiol compared with those with no vocal symptoms.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon. ah77@aub.edu.lb
authors.forename: Abdul-latif
authors.initials: AL
authors.lastname: Hamdan
authors.forename: Randa
authors.initials: R
authors.lastname: Al Barazi
authors.forename: Alyssa
authors.initials: A
authors.lastname: Kanaan
authors.forename: Solara
authors.initials: S
authors.lastname: Sinno
authors.forename: Anwar
authors.initials: A
authors.lastname: Soubra
mesh_terms: D004958:Estradiol / Q000097:blood*; D004967:Estrogens / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005500:Follow-Up Studies; D006801:Humans; D012720:Severity of Illness Index; D013068:Speech Production Measurement; D014832:Voice Disorders / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D014833:Voice Quality
chemical_list: D004967:Estrogens; D004958:Estradiol