Predictors of pain during oocyte retrieval

Abstract

Introduction: Pain during oocyte retrieval remains prevalent despite detailed and specific pain management protocols. Exploring the role of psychosocial risk factors of pain during the oocyte retrieval could identify possible targets for prevention. The present study assessed pain prevalence and possible risk factors for experiencing extreme pain levels in a large cohort of women receiving assisted reproductive technologies (ART) treatment.

Methods: Participants were 810 first attendees about to begin treatment with ART. The participants completed questionnaires at three time points: at their 21st day of the cycle, during the waiting time before the oocyte retrieval surgery and after the oocyte retrieval.

Results: Fifty-one (6.9%) of the women reported the oocyte retrieval to be very or extremely painful. The results of a multiple logistic regression indicated that the significant predictors of high pain intensity, measured before the oocyte retrieval, were negative gynecological experiences and side effects of hormonal treatment. Variables measured after the oocyte retrieval associated with pain intensity were higher levels of anxiety during the oocyte retrieval, lower levels of perceived control and longer duration of the procedure.

Discussion: The findings of the present study may help to identify those women who are at increased risk of experiencing unacceptable pain levels during oocyte retrieval procedures and the medical staff is advised to take psychological factors into account.

Keywords:

• Anxiety
• depression
• fertility treatment
• oocyte retrieval
• pain
• psychosocial

Acknowledgements

The authors would like to thank the clinical staff at [collaborating clinics] for their cooperation and valuable feedback during the data collection. Moreover, we wish to express our gratitude to all the couples who took part in this study and spent time responding to the questionnaires.

Disclosure statement

None to declare. No conflicts of interests are associated with this study or its publication.

Funding

The research was partly supported by an unrestricted grant from MSD and partly by a PhD scholarship from The Danish Agency for Science Technology and Innovation granted to Y.F. (AUID/144944/2009).

Current knowledge on this subject

• Alleviating pain is still a relevant challenge, when undergoing the oocyte retrieval procedure.

• Research in this area has mostly focused on improving pain protocols in relation to medical intervention and the exploration of psychosocial factors is sparse.

• A subgroup of women seems to experience almost unbearable pain.

What this study adds

• A subgroup of women is at risk of experiencing high pain levels and their gynecological history, experience of hormonal side-effects, anxiety levels during the oocyte retrieval procedure, as well as perceived lack of control are important predictive factors.

• This knowledge, could aid, women at risk of an intolerable pain experience, to be identified with relatively little effort in clinical practice.

• A patient centered approach could be beneficial in the planning and decision-making process in alleviating pain.