title: Endometriosis-related infertility: assisted reproductive technology has no adverse impact on pain or quality-of-life scores.
abstract: OBJECTIVE
  To evaluate the impact of assisted reproduction technology (ART) on painful symptoms and quality of life (QoL) in women who have endometriosis as compared with disease-free women.
  
  
  METHODS
  Prospective controlled, observational cohort study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Two hundred and sixty-four matched-pairs of endometriosis and disease-free women undergoing ART.
  
  
  METHODS
  Assessment of pain evolution using visual analogue scale (VAS) during ART; QoL assessment with the Fertility Quality of Life (FertiQoL) tool.
  
  
  METHODS
  VAS pain intensities relative to dysmenorrhea, dyspareunia, noncyclic chronic pelvic pain (NCCPP), gastrointestinal pain, lower urinary tract pain; trends for VAS change between postretrieval and baseline evaluation; FertiQoL score; and statistical analyses conducted using univariate and adjusted multiple linear regression models.
  
  
  RESULTS
  After excluding canceled cycles and patients lost to follow-up observation, 102 women with endometriosis and 104 disease-free women were retained for the study. The trends for VAS change between the postretrieval and baseline evaluations in the women with endometriosis compared with the disease-free women revealed a statistically significant pain decrease for dysmenorrhea (-1.35 ± 3.23 and 0.61 ± 4.00) and dyspareunia (-1.19 ± 2.58 and 0.14 ± 2.06). For NCCPP, gastrointestinal symptoms, and lower urinary tract symptoms, there were no statistically significant differences between the groups. After multiple linear regression, no worsening of pain was observed in the endometriosis group as compared with disease-free group. In addition subgroup analysis according to endometriosis phenotype failed to show any increase of pain. The quality of life in the endometriosis group was comparable to that of the disease-free group.
  
  
  CONCLUSIONS
  Assisted reproduction technology did not exacerbate the symptoms of endometriosis or negatively impact QoL in women with endometriosis as compared with disease-free women.
authors.affiliation: Department of Gynaecology Obstetrics II and Reproductive Medicine, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Laboratoire d'Immunologie, Institut Cochin, Inserm, U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France. Electronic address: pietro.santulli@cch.aphp.fr.
authors.forename: Pietro
authors.initials: P
authors.lastname: Santulli
authors.affiliation: Department of Gynaecology Obstetrics II and Reproductive Medicine, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Bourdon
authors.affiliation: Department of Gynaecology Obstetrics II and Reproductive Medicine, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Presse
authors.affiliation: Department of Gynaecology Obstetrics II and Reproductive Medicine, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Gayet
authors.affiliation: Department of Gynaecology Obstetrics II and Reproductive Medicine, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Laboratoire d'Immunologie, Institut Cochin, Inserm, U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Département de Génetique, Développement et Cancer, Institut Cochin, Inserm, U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Marcellin
authors.affiliation: Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics, Institut Cochin, Inserm U1153, Paris, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Prunet
authors.affiliation: Department of Gynaecology Obstetrics II and Reproductive Medicine, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: de Ziegler
authors.affiliation: Department of Gynaecology Obstetrics II and Reproductive Medicine, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Département de Génetique, Développement et Cancer, Institut Cochin, Inserm, U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Chapron
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004715:Endometriosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D010147:Pain Measurement / Q000523:psychology / Q000639:trends*; D017699:Pelvic Pain / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D027724:Reproductive Techniques, Assisted / Q000523:psychology / Q000639:trends*
keywords: Endometriosis; IVF; pain; quality of life