OBJECTIVE:

To determine trends in female reproductive surgery volume.

DESIGN:

Database analysis using the Healthcare Cost and Utilization Project databases from 1988, 1992, 1998, and 2002.

SETTING:

Academic medical center.

PATIENT(S):

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).

INTERVENTION(S):

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.

MAIN OUTCOME MEASURE(S):

Number of reproductive surgeries.

RESULT(S):

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).

CONCLUSION(S):

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.