title: Fifteen-year trend in the use of reproductive surgery in women in the United States.
abstract: OBJECTIVE
  To determine trends in female reproductive surgery volume.
  
  
  METHODS
  Database analysis using the Healthcare Cost and Utilization Project databases from 1988, 1992, 1998, and 2002.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  All patients who underwent reproductive surgeries using United States community hospital discharge data and inpatient and outpatient data for New Jersey (NJ) and Maryland (MD).
  
  
  METHODS
  SAS statistical software was used to estimate the number of reproductive surgeries per year; weighted least squares analysis was performed to estimate trends in surgeries.
  
  
  METHODS
  Number of reproductive surgeries.
  
  
  RESULTS
  Nationally, approximately 250,000 inpatient female reproductive surgeries are performed yearly. There was a modest decreasing trend (-17%) in total reproductive surgeries, and the number of procedures with an associated diagnosis of infertility declined 79%; neither change reached statistical significance. Alternatively, a significant decline occurred in surgeries of the fallopian tubes and ovaries. Likewise, inpatient surgeries were unchanged in NJ and actually increased in MD (+13%), although outpatient surgeries declined in both states (-12% and -37%, respectively).
  
  
  CONCLUSIONS
  The increased use of assisted reproductive technology (ART) has coincided with a decrease in surgeries on the fallopian tubes and ovaries. With the exception of surgery for tubal infertility, reproductive surgery has largely been complementary to, rather than replaced by, ART.
authors.affiliation: Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
authors.forename: Aline
authors.initials: A
authors.lastname: Ketefian
authors.forename: Jianfang
authors.initials: J
authors.lastname: Hu
authors.forename: Alfred A
authors.initials: AA
authors.lastname: Bartolucci
authors.forename: Ricardo
authors.initials: R
authors.lastname: Azziz
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data* / Q000639:trends*; D006801:Humans; D015994:Incidence; D007246:Infertility / Q000453:epidemiology / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends*; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data* / Q000639:trends*; D014481:United States / Q000453:epidemiology