Design: Retrospective analysis
Setting: Closed claims database
Patients or Participants: Women from eight US states with mandated assisted reproductive technology coverage.
Interventions: Cost analysis
Measurements and Main Results: Those with >6 months of continuous enrolment were divided into three cohorts: history of (1) hysteroscopic adhesiolysis (HA), (2) a different transcervical intrauterine procedure (“Procedure Experienced” or PE), or (3) no prior transcervical intrauterine procedure (“Procedure Free” or PF). PE included hysteroscopic myomectomy, uterine septum removal, and D&C for persisting products of conception. Propensity score matching was applied to generate similar cohorts all “followed” for 41 months. Direct healthcare resource use and costs in US dollars were captured (Table 1). Total costs for infertility evaluation and care were more than $1.5M in the HA cohort, and < $50K in the PF group; for the PE cohort (not in Table 1) the total costs were $259,360.Conclusion: Hysteroscopic adhesiolysis is associated with a dramatically increased use of infertility-related healthcare services largely due to IVF. Prevention of intrauterine trauma, and, particularly, IUAs should be a goal for intrauterine surgeons.
Munro, MG*1, Martin, C2, Kshirsagar, O3, Sobti, D3, Bharadwaz, MP3, Kumar, J4, Miller, J3, Wang, R3, Feldberg, IB5, Bortoletto, P6. 1Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Santa Monica, CA; 2Axtria Health, Berkeley Heights, NJ; 3Axtria Inc, Berkeley Heights, NJ; 4Axtria, Inc, Delhi, India; 5Rejoni Inc, Bedford MA; 6Boston IVF, Stoneham, MA
