Fifteen-year trend in the use of reproductive surgery in women in the United States.
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.
Ketefian
Aline
A
Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
Hu
Jianfang
J
Bartolucci
Alfred A
AA
Azziz
Ricardo
R
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