Hormonal Changes During In Vitro Fertilization Exacerbate Dry Eye Symptoms

Hormonal changes that occur during in vitro fertilization may lead to increased dry eye symptoms and ocular pain, according to research published in The Ocular Surface. Women who experience larger changes in sex hormone serum levels may experience worse symptoms compared with women with smaller changes, according to the report. 

Researchers included 40 women (mean age, 36.2 years) undergoing in vitro fertilization treatment in the investigation and examined dry eye signs and symptoms and ocular pain during 2 visits. The baseline visit was performed while estrogen levels were lowest (first day of menstruation) and the follow-up visit was conducted while estrogen levels were at their highest (9-11 days later). 

Study participants subjectively reported dry eye symptoms using validated instruments, which included the Ocular Surface Disease Index (OSDI), Symptom Assessment in Dry Eye (SANDE), Ocular Pain Assessment Survey (OPAS), and Meibomian Gland Dysfunction questionnaire (MGD14). The team performed noninvasive breakup time (NIBUT) measurement, meibomian gland evaluation, and corneal and conjunctival staining, and assessed hormonal changes using mass spectrometry and immunoassay.

Oestradiol levels increased nearly 50-fold from baseline to 9 to 11 day follow up (28.9 vs 1360 pg/mL), the report shows.  Both dry eye symptoms and ocular pain worsened while hormone levels were at their highest (P <.01 and P =.02, respectively). Higher oestradiol and lower luteinizing hormone levels were associated with worsening dry eye symptoms (P =.03 and P =.001, respectively) and reduced luteinizing hormone and increased progesterone were associated with increased ocular pain (P =.004 and P =.01, respectively).

“Some women may experience increased symptoms and signs of dry eye during [in vitro fertilization] treatment and women with greater changes in serum levels of sex hormones during [in vitro fertilization] treatment may expect to experience greater changes in symptoms of dry eye and ocular pain,” according to the researchers. “This information should help guide the counseling process and ophthalmic management of women undergoing [in vitro fertilization] treatment.”

Limitations include a short study duration.