Isabella Zappi, Arianna Falletta, Derek Maas, Archie Spindler, Elizabeth Weber, Zasca-Aisha Ristianto, Mackenzie R Martin, Andrew Rubenstein, Shannon DeVore, Amy K Bieber, Miriam K Pomeranz, Jerry Shapiro, Daniel R Mazori, Kristen I Lo Sicco
Women are increasingly utilizing assisted reproductive technologies when pursuing pregnancy, particularly in vitro fertilization (IVF), which requires supraphysiologic hormonal exposures and intensive pharmacotherapy. As IVF use continues to rise, recognition of associated cutaneous adverse events has become increasingly important, with dermatologic manifestations reported in up to one-quarter of patients. These manifestations encompass a broad clinical spectrum, including progestogen hypersensitivity, alopecia, acneiform eruptions, injection-related cutaneous complications, urticaria and other hypersensitivity reactions, and, in rare cases, severe cutaneous adverse reactions. The pathogenesis of these reactions is multifactorial and may reflect underlying infertility-related conditions, hormonally mediated effects on skin physiology, drug-specific immune responses, or complications related to the route of medication delivery. Although most cutaneous manifestations are mild and self-limited, they may significantly impact quality of life, treatment adherence, and patient anxiety during an already physically and emotionally demanding process. In this review, we summarize the existing literature to characterize the array, mechanisms, and clinical implications of cutaneous manifestations associated with IVF, highlighting the importance of multidisciplinary collaboration to ensure high-quality patient care.