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Migraine in women undergoing fertility treatment: A prospective study.

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Title: Migraine in women undergoing fertility treatment: A prospective study.
Authors: Jean, Jasmin (AUTHOR), Klein, Julia Isabella (AUTHOR), Karashchuk, Nataliya (AUTHOR), Thomas, Charlene (AUTHOR), Stubbs, Rodrique (AUTHOR), Broner, Susan (AUTHOR), Reichman, David (AUTHOR), Robbins, Matthew S. (AUTHOR), Safdieh, Joseph E. (AUTHOR)
Source: Headache: The Journal of Head & Face Pain. Jul2026, Vol. 66 Issue 7, p1499-1513. 15p.
Subjects: Infertility treatment, Risk assessment, Progesterone, Pearson correlation (Statistics), Questionnaires, Enzyme-linked immunosorbent assay, Fisher exact test, Multiple regression analysis, Psychology of women, Descriptive statistics, Anxiety, Mann Whitney U Test, Chi-squared test, Multivariate analysis, Human reproductive technology, Longitudinal method, Estradiol, Fertilization in vitro, Follicle-stimulating hormone, Confidence intervals, Menstruation disorders, Data analysis software, Migraine, Mental depression, Disease risk factors
Abstract: Objective: To determine if there is increased headache burden and disability among women with and without migraine during an in vitro fertilization (IVF) cycle. Background: Migraine and infertility commonly impact women of childbearing age. Estradiol fluctuations influence migraine, yet the impact of exogenous estrogen on migraine during fertility treatments such as IVF is not well characterized. We assessed migraine burden and disability among women with and without a history of migraine during an IVF cycle. Secondary outcomes included psychological symptoms and estradiol levels. We hypothesized that although all women may be at risk of migraine symptoms during an IVF cycle, women with migraine would be more likely to experience greater headache‐related disability and associated psychological symptoms during an IVF cycle. Furthermore, we hypothesized that women with migraine would experience an increase in headache‐related disability between time point 2 (when estrogen peaks after ovulation trigger) and time point 3 (when estradiol levels reach a nadir). Women without a history of migraine were included to assess the development of de novo migraine during IVF due to shifts in estradiol. Methods: A prospective cohort study of adult women undergoing an IVF cycle at the Weill Cornell Medicine Center for Reproductive Medicine (New York, NY) from 2020 to 2023 completed an initial health questionnaire and follow‐up throughout an IVF cycle at three time points. Data collected included a measure of headache disability (Headache‐Attributed Lost Time over the past 30 days [HALT‐30]); psychological scales (Depression Anxiety and Stress Scale‐21 item); and serum estradiol, follicle‐stimulating hormone, luteinizing hormone, and progesterone levels. Results: Seventy‐six participants completed all study time points, including 52 with migraine (18 with aura) and 24 controls. At each time point, the migraine group had higher total HALT‐30 scores compared to controls. HALT‐30 scores were 5.6 (confidence interval: 2.1 to 9.1) higher, on average, in the migraine group compared to the control group after controlling for time and the interaction between the two (p = 0.002). There were no statistically significant differences in HALT‐30 scores over time when analyzing the migraine with aura and migraine without aura groups separately. However, in the combined model, with each week that passed, the HALT score increased, on average, by 0.09 in the migraine without aura group (p = 0.011). Despite the migraine group having greater headache‐related disability scores at each time point, the level of disability as measured by the HALT‐30 did not change over time throughout the IVF cycle. Serum estradiol levels peaked at the second time point in both groups without significant differences between groups. Participants with migraine consistently reported greater psychological distress (stress, anxiety, and depression) than controls across multiple time points. Depression Anxiety and Stress Scale‐21 item stress scores decreased, on average, by 4 [interquartile range: −5, 0] points in the control group compared to 0 [interquartile range: −4, 4] points in the migraine group (p = 0.019) between the second and final time points. Conclusion: This prospective cohort study demonstrated that women without migraine history maintained a low level of headache‐related disability during IVF. It did demonstrate that women with history of migraine experienced elevated migraine disability during an IVF cycle; however, headache‐related disability did not change over time, specifically between time point 2 and time point 3 when there is the largest change (peak‐to‐nadir) in estradiol levels post‐ovulation trigger. This study highlights that the shifts in estradiol during an IVF cycle may not exacerbate headache‐related disability beyond baseline in women with migraine. However, participants with migraine reported higher levels of psychological distress at different time points in three domains throughout the study—stress, anxiety, and depression—highlighting the importance of mental health support for women with migraine during an IVF cycle. Overall, this study found that participants maintained a low level of headache‐related disability throughout the IVF cycle; however, this study cannot rule out the possibility of transient exacerbations in disability that were not captured by the HALT‐30. Plain Language Summary: Many women undergoing in vitro fertilization (IVF) experience migraine; however, it is unclear how IVF treatment will affect their headaches. In this study, we followed women with and without a history of migraine through an IVF cycle and found that those with migraine had greater headache‐related disability scores at each time point, but the degree of headache‐related disability did not change over time. These findings suggest that migraine disability may not increase throughout IVF treatment in women with migraine and may not be related to IVF‐related hormonal changes, but participants with migraine reported higher levels of stress, anxiety, and depression at different time points throughout the study, highlighting the importance of mental health support for women with migraine during an IVF cycle. [ABSTRACT FROM AUTHOR]
Copyright of Headache: The Journal of Head & Face Pain is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Migraine in women undergoing fertility treatment: A prospective study.
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  Data: <searchLink fieldCode="AR" term="%22Jean%2C+Jasmin%22">Jean, Jasmin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Klein%2C+Julia+Isabella%22">Klein, Julia Isabella</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Karashchuk%2C+Nataliya%22">Karashchuk, Nataliya</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Thomas%2C+Charlene%22">Thomas, Charlene</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Stubbs%2C+Rodrique%22">Stubbs, Rodrique</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Broner%2C+Susan%22">Broner, Susan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Reichman%2C+David%22">Reichman, David</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Robbins%2C+Matthew+S%2E%22">Robbins, Matthew S.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Safdieh%2C+Joseph+E%2E%22">Safdieh, Joseph E.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Headache%3A+The+Journal+of+Head+%26+Face+Pain%22">Headache: The Journal of Head & Face Pain</searchLink>. Jul2026, Vol. 66 Issue 7, p1499-1513. 15p.
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  Data: <searchLink fieldCode="DE" term="%22Infertility+treatment%22">Infertility treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Risk+assessment%22">Risk assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Progesterone%22">Progesterone</searchLink><br /><searchLink fieldCode="DE" term="%22Pearson+correlation+%28Statistics%29%22">Pearson correlation (Statistics)</searchLink><br /><searchLink fieldCode="DE" term="%22Questionnaires%22">Questionnaires</searchLink><br /><searchLink fieldCode="DE" term="%22Enzyme-linked+immunosorbent+assay%22">Enzyme-linked immunosorbent assay</searchLink><br /><searchLink fieldCode="DE" term="%22Fisher+exact+test%22">Fisher exact test</searchLink><br /><searchLink fieldCode="DE" term="%22Multiple+regression+analysis%22">Multiple regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Psychology+of+women%22">Psychology of women</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Anxiety%22">Anxiety</searchLink><br /><searchLink fieldCode="DE" term="%22Mann+Whitney+U+Test%22">Mann Whitney U Test</searchLink><br /><searchLink fieldCode="DE" term="%22Chi-squared+test%22">Chi-squared test</searchLink><br /><searchLink fieldCode="DE" term="%22Multivariate+analysis%22">Multivariate analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Human+reproductive+technology%22">Human reproductive technology</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink><br /><searchLink fieldCode="DE" term="%22Estradiol%22">Estradiol</searchLink><br /><searchLink fieldCode="DE" term="%22Fertilization+in+vitro%22">Fertilization in vitro</searchLink><br /><searchLink fieldCode="DE" term="%22Follicle-stimulating+hormone%22">Follicle-stimulating hormone</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Menstruation+disorders%22">Menstruation disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Migraine%22">Migraine</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+risk+factors%22">Disease risk factors</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: To determine if there is increased headache burden and disability among women with and without migraine during an in vitro fertilization (IVF) cycle. Background: Migraine and infertility commonly impact women of childbearing age. Estradiol fluctuations influence migraine, yet the impact of exogenous estrogen on migraine during fertility treatments such as IVF is not well characterized. We assessed migraine burden and disability among women with and without a history of migraine during an IVF cycle. Secondary outcomes included psychological symptoms and estradiol levels. We hypothesized that although all women may be at risk of migraine symptoms during an IVF cycle, women with migraine would be more likely to experience greater headache‐related disability and associated psychological symptoms during an IVF cycle. Furthermore, we hypothesized that women with migraine would experience an increase in headache‐related disability between time point 2 (when estrogen peaks after ovulation trigger) and time point 3 (when estradiol levels reach a nadir). Women without a history of migraine were included to assess the development of de novo migraine during IVF due to shifts in estradiol. Methods: A prospective cohort study of adult women undergoing an IVF cycle at the Weill Cornell Medicine Center for Reproductive Medicine (New York, NY) from 2020 to 2023 completed an initial health questionnaire and follow‐up throughout an IVF cycle at three time points. Data collected included a measure of headache disability (Headache‐Attributed Lost Time over the past 30 days [HALT‐30]); psychological scales (Depression Anxiety and Stress Scale‐21 item); and serum estradiol, follicle‐stimulating hormone, luteinizing hormone, and progesterone levels. Results: Seventy‐six participants completed all study time points, including 52 with migraine (18 with aura) and 24 controls. At each time point, the migraine group had higher total HALT‐30 scores compared to controls. HALT‐30 scores were 5.6 (confidence interval: 2.1 to 9.1) higher, on average, in the migraine group compared to the control group after controlling for time and the interaction between the two (p = 0.002). There were no statistically significant differences in HALT‐30 scores over time when analyzing the migraine with aura and migraine without aura groups separately. However, in the combined model, with each week that passed, the HALT score increased, on average, by 0.09 in the migraine without aura group (p = 0.011). Despite the migraine group having greater headache‐related disability scores at each time point, the level of disability as measured by the HALT‐30 did not change over time throughout the IVF cycle. Serum estradiol levels peaked at the second time point in both groups without significant differences between groups. Participants with migraine consistently reported greater psychological distress (stress, anxiety, and depression) than controls across multiple time points. Depression Anxiety and Stress Scale‐21 item stress scores decreased, on average, by 4 [interquartile range: −5, 0] points in the control group compared to 0 [interquartile range: −4, 4] points in the migraine group (p = 0.019) between the second and final time points. Conclusion: This prospective cohort study demonstrated that women without migraine history maintained a low level of headache‐related disability during IVF. It did demonstrate that women with history of migraine experienced elevated migraine disability during an IVF cycle; however, headache‐related disability did not change over time, specifically between time point 2 and time point 3 when there is the largest change (peak‐to‐nadir) in estradiol levels post‐ovulation trigger. This study highlights that the shifts in estradiol during an IVF cycle may not exacerbate headache‐related disability beyond baseline in women with migraine. However, participants with migraine reported higher levels of psychological distress at different time points in three domains throughout the study—stress, anxiety, and depression—highlighting the importance of mental health support for women with migraine during an IVF cycle. Overall, this study found that participants maintained a low level of headache‐related disability throughout the IVF cycle; however, this study cannot rule out the possibility of transient exacerbations in disability that were not captured by the HALT‐30. Plain Language Summary: Many women undergoing in vitro fertilization (IVF) experience migraine; however, it is unclear how IVF treatment will affect their headaches. In this study, we followed women with and without a history of migraine through an IVF cycle and found that those with migraine had greater headache‐related disability scores at each time point, but the degree of headache‐related disability did not change over time. These findings suggest that migraine disability may not increase throughout IVF treatment in women with migraine and may not be related to IVF‐related hormonal changes, but participants with migraine reported higher levels of stress, anxiety, and depression at different time points throughout the study, highlighting the importance of mental health support for women with migraine during an IVF cycle. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Headache: The Journal of Head & Face Pain is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=195037801
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/head.70111
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 15
        StartPage: 1499
    Subjects:
      – SubjectFull: Infertility treatment
        Type: general
      – SubjectFull: Risk assessment
        Type: general
      – SubjectFull: Progesterone
        Type: general
      – SubjectFull: Pearson correlation (Statistics)
        Type: general
      – SubjectFull: Questionnaires
        Type: general
      – SubjectFull: Enzyme-linked immunosorbent assay
        Type: general
      – SubjectFull: Fisher exact test
        Type: general
      – SubjectFull: Multiple regression analysis
        Type: general
      – SubjectFull: Psychology of women
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Anxiety
        Type: general
      – SubjectFull: Mann Whitney U Test
        Type: general
      – SubjectFull: Chi-squared test
        Type: general
      – SubjectFull: Multivariate analysis
        Type: general
      – SubjectFull: Human reproductive technology
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: Estradiol
        Type: general
      – SubjectFull: Fertilization in vitro
        Type: general
      – SubjectFull: Follicle-stimulating hormone
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Menstruation disorders
        Type: general
      – SubjectFull: Data analysis software
        Type: general
      – SubjectFull: Migraine
        Type: general
      – SubjectFull: Mental depression
        Type: general
      – SubjectFull: Disease risk factors
        Type: general
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      – TitleFull: Migraine in women undergoing fertility treatment: A prospective study.
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              Text: Jul2026
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              Y: 2026
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