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McGough AM, Doody KA, Foy OB, Harris CA, Mandelbaum RS, Matsuo K, Paulson RJ. Seasonal fluctuation of in vitro fertilization encounters in the United States. J Assist Reprod Genet 2023; 40:1099-1107. [PMID: 36943573 PMCID: PMC10239406 DOI: 10.1007/s10815-023-02777-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/14/2023] [Indexed: 03/23/2023] Open
Abstract
PURPOSE To examine patient and hospital characteristics related to seasonal fluctuation in in vitro fertilization (IVF). METHODS This retrospective cohort study examined 33,077 oocyte retrievals identified in the National Ambulatory Surgery Sample. Exposure assignment was monthly IVF encounters: low-volume months (<25%ile), mid-volume months (≥25/<75%ile), and high-volume months (>75%ile). Main outcomes were patient and hospital characteristics related to the exposure groups, assessed with a multinomial regression model. RESULTS The median IVF encounters were 977 per month, ranging from 657 to 1074 (absolute-difference 417). January, July, and December were the lowest-quartile volume months, ranging from 657 to 710 encounters per month (low-volume months). May, August, and November were the top-quartile volume months, ranging from 1049 to 1074 encounters per month (high-volume months). In a multivariable analysis, patients undergoing IVF in the low-volume months were younger and less likely to have infertility or comorbidities. Patients undergoing IVF in the high-volume months were more likely to have lower household income and receive IVF at urban teaching facilities. Northeastern residents were less likely to have IVF in the low-volume months but more likely to have IVF in the high-volume months. Sensitivity analyses showed that the lowest-to-highest variability in monthly IVF encounters was higher in Northeast region compared to other regions (320 vs 50-128); infertility patients compared to those without (317 vs 190); privately insured patients compared to self-pay (227 vs 156); and older patients compared to younger (234 vs 192). CONCLUSION This study suggests substantial seasonal fluctuation in IVF oocyte retrieval in the USA based on patient and hospital factors.
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Affiliation(s)
- Alexandra M McGough
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, IRD520, Los Angeles, CA, 90033, USA
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kaitlin A Doody
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Olivia B Foy
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, IRD520, Los Angeles, CA, 90033, USA
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Chelsey A Harris
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, IRD520, Los Angeles, CA, 90033, USA
| | - Rachel S Mandelbaum
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, IRD520, Los Angeles, CA, 90033, USA
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, IRD520, Los Angeles, CA, 90033, USA.
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
| | - Richard J Paulson
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
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Dukhovny D, Hwang SS, Gopal D, Cabral H, Missmer S, Diop H, Declercq E, Stern JE. Length of stay and cost of birth hospitalization: effects of subfertility and ART. J Perinatol 2018; 38:1457-1465. [PMID: 30166621 PMCID: PMC6217794 DOI: 10.1038/s41372-018-0205-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 08/01/2018] [Accepted: 08/06/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The objective of this study is to measure delivery length of stay (LOS) and cost as proxies for infant morbidity in assisted reproductive technology (ART) and subfertile deliveries. STUDY DESIGN Massachusetts singleton births, ≥ 23 weeks gestational age (GA) between 2004 and 2010, were linked with ART data, vital records, and hospital discharges. LOS and costs (2010 US dollars) of infants born to fertile (no ART or indicators of infertility), subfertile (indicators of infertility but no ART), and ART-treated (linked to ART data) deliveries were compared. Least-square means and SE were calculated. RESULTS Of 345,756 singletons (fertile n = 332,481, subfertile n = 4987, and ART-treated n = 8288), overall LOS was 3.79 ± 0.01, 4.32 ± 0.15, and 4.90 ± 0.04 days, and costs were $2980 ± 6, $3217 ± 58, and $4483 ± 62, respectively. GA and birthweight predicted much of the intergroup difference. CONCLUSION Maternal fertility group was not an independent predictor of infant LOS and costs. Prematurity and birthweight were driving factors in resource utilization.
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Affiliation(s)
- Dmitry Dukhovny
- Department of Pediatrics, Oregon Health and Science University, Portland, USA.
| | - Sunah S. Hwang
- Section of Neonatology, Department of Pediatrics,
University of Colorado School of Medicine
| | - Daksha Gopal
- Department of Biostatistics, Boston University School of
Public Health
| | - Howard Cabral
- Department of Biostatistics, Boston University School of
Public Health
| | - Stacey Missmer
- Department of Obstetrics, Gynecology, and Reproductive
Biology, Michigan State University
| | | | - Eugene Declercq
- Department of Community Health Sciences, Boston University
School of Public Health
| | - Judy E. Stern
- Department of Obstetrics and Gynecology and Pathology,
Dartmouth-Hitchcock
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