B.J. Stegmann

The Estimated Annual Cost of Uterine Leiomyomata in the United States

OBJECTIVEnThe purpose of this study was to estimate the total annual societal cost of uterine fibroid tumors in the United States, based on direct and indirect costs that include associated obstetric complications.nnnSTUDY DESIGNnA systematic review of the literature was conducted to estimate the number of women who seek treatment for symptomatic fibroid tumors annually, the costs of medical and surgical treatment, the amount of work time lost, and obstetric complications that are attributable to fibroid tumors. Total annual costs were converted to 2010 US dollars. A sensitivity analysis was performed.nnnRESULTSnThe estimated annual direct costs (surgery, hospital admissions, outpatient visits, and medications) were

Achievement test performance in children conceived by IVF

4.1-9.4 billion. Estimated lost work-hour costs ranged from

Proficiency in oocyte retrieval: how many procedures are necessary for training?

1.55-17.2 billion annually. Obstetric outcomes that were attributed to fibroid tumors resulted in a cost of

Achievement Test Performance in Children Conceived by In Vitro Fertilization

238 million to

Characteristics predictive of response to ovarian diathermy in women with polycystic ovarian syndrome

7.76 billion annually. Uterine fibroid tumors were estimated to cost the United States

ASSESMENT OF CHANGES IN UTERINE AND SUBENDOME- TRIAL BLOOD FLOWS: THE USE OF PREDICTION OUTCOME

5.9-34.4 billion annually.nnnCONCLUSIONnObstetric complications that are associated with fibroid tumors contributed significantly to their economic burden. Lost work-hour costs may account for the largest proportion of societal costs because of fibroid tumors.

Variations in gestational age at delivery and birth weight in infants born after assisted reproductive technologies based on maternal infertility diagnoses

BACKGROUNDnLong-term follow-up studies of children conceived by IVF are limited. We examine academic performance on standardized tests [Iowa Tests of Basic Skills/Educational Development (ITBS/ITED)] of children conceived by IVF.nnnMETHODSnParents of children 8-17 years of age at the onset of the study (March 2008) who were conceived by IVF at the University of Iowa Hospitals and Clinics and living in the state of Iowa were contacted by mail. Parents completed questionnaires on their childs health and education and parental education. ITBS/ITED scores from school grades 3-12 were obtained on IVF children and a group of anonymous children matched by grade, year, gender and school district. Scores were analyzed using linear mixed models.nnnRESULTSnFour hundred and ninety-seven couples were contacted. Two hundred and ninety-five couples (463 children) agreed to participate (59.4% of parents), with ITBS/ITED scores available on 423 children (91.4% of participants). IVF children scored higher than the national mean (P < 0.0001) across all grades and subtests and higher than their matched peers for grades 3-11. A trend toward lower test scores in multiple gestations was present (but not significant). Factors found to affect test scores included parental level of education, maternal age, divorce and childs BMI. Cryopreservation, length of embryo culture and method of insemination did not affect scores.nnnCONCLUSIONSnIVF children scored higher on standardized tests than their matched peers, suggesting that IVF does not have a negative effect on cognitive development. However, long-term follow-up of IVF children is still limited. Further research should be performed on the effect of multiple gestation on academic performance.

Are there provider-dependent differences in the learning curve for proficiency with oocyte retrievals?

OBJECTIVEnTo determine a minimum number of procedures required for proficiency in oocyte retrieval and to characterize skill acquisition.nnnDESIGNnRetrospective analysis.nnnSETTINGnReproductive endocrinology and infertility fellowship training program.nnnSUBJECT(S)nFellows in training from 2005 to 2007 and 2008 to 2010.nnnINTERVENTION(S)nNone.nnnMAIN OUTCOME MEASURE(S)nProficiency scores were calculated by dividing the number of oocytes retrieved by oocytes expected. The 2005 to 2007 trainees were grouped and proficiency scores calculated as an average during specific points in their training. The 2008 to 2010 trainees were compared individually to determine differences in individual skill acquisition.nnnRESULT(S)nA greater number of oocytes were retrieved than expected, 8.6 versus 7.6. A relatively lower proficiency score was noted during the first 10 trainee aspirations (proficiency score=1.1) compared with subsequent aspirations (proficiency score=1.25 for retrievals 11-20, proficiency score=1.21 for retrievals 21-30 and >31). When individual fellows scores were calculated, the majority achieved proficiency by 20 aspirations, and all but one trainee achieved the mean staff proficiency score by 50 retrievals.nnnCONCLUSION(S)nRegardless of a trainees initial proficiency in oocyte retrieval, there were no statistically significant differences in the learning curve between trainees. The majority of individual fellows in training demonstrate proficiency in follicular aspirations within 20 procedures; however, a minority may require 50 procedures to achieve the proficiency of an attending physician.