Along with the Rise in Assisted Reproduction, Surgery Declines

The increased use of assisted reproductive technology (ART) has coincided with a decrease in surgeries on the fallopian tubes and ovaries, according to a new study.

Researchers from Cedars-Sinai Medical Center (Los Angeles, CA, USA) used the U.S. healthcare cost and utilization project databases to determine trends in female reproductive surgery volume for the United States overall, and in New Jersey and Maryland specifically, between 1988 and 2002. Researchers found that in the United States, the number of reproductive surgeries per 1,000 females aged 15 to 45 fell from 4.55 in 1988 to 3.79 in 2002, representing a modest decreasing trend (-17%) in total reproductive surgeries; the number of total reproductive surgeries declined by 7% in the state New Jersey and by 13% in the state of Maryland. There was a significant decline in numbers of tubal surgeries and ovarian surgeries during this period. With the exception of surgery for tubal infertility, the researchers concluded, reproductive surgery has largely been complementary to, rather than replaced by, ART. The study was published in the August 2009 issue of Fertility and Sterility.

"The implementation of IVF mandates, insurance limitations, or restricted payments on reproductive surgery, and the availability of experienced surgeons could all have a varying effect on the utilization of reproductive surgery,” concluded lead author Ricardo Azziz, M.D., M.P.H., and colleagues. "We are currently examining the trend in male reproductive surgery.”

ART is a general term referring to methods used to achieve pregnancy by artificial or partially artificial means, such as in vitro fertilization (IVF), used primarily in infertility treatments. Some forms of ART are also used in fertile couples for genetic reasons. ART is also used in couples who are discordant for certain communicable diseases such as HIV, to reduce the risk of infection when a pregnancy is desired. The term also includes any reproductive technique involving a third party, such a sperm donor. However, there is yet no strict definition of the term.

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