Emergency department utilization for ovarian hyperstimulation syndrome

Area of Science:

• Reproductive Endocrinology
• Emergency Medicine
• Health Services Research

Background:

• Ovarian hyperstimulation syndrome (OHSS) is a serious risk associated with assisted reproductive technologies (ART).
• Severe OHSS cases may necessitate emergency department (ED) visits for treatment and potential hospitalization.
• The impact of strategies aimed at reducing OHSS incidence and complications on ED utilization remains unclear.

Purpose of the Study:

• To analyze trends in ED utilization for OHSS over a decade (2006-2016).
• To examine changes in OHSS-related admission rates, patient demographics, and healthcare charges.
• To compare ED visit charges for OHSS with age-matched controls.

Main Methods:

• A retrospective longitudinal study using the Nationwide Emergency Department Sample Database and National ART Surveillance System (2006-2016).
• Included ED visits with ICD-9 or ICD-10 OHSS diagnoses.
• Analyzed demographics, alternative diagnoses, admission rates, charges, and annual stimulation cycles.

Main Results:

• Ovarian stimulation cycles increased from 110,183 to 157,721 (2006-2016), while OHSS ED visits remained stable.
• OHSS admission rates significantly decreased from 52.7% to 33.1% (p < 0.01).
• Average ED charges for OHSS nearly doubled (p < 0.01) and were higher than controls (p < 0.01).

Conclusions:

• No significant increase in ED visits for OHSS occurred despite more stimulation cycles.
• A significant decline in OHSS admission rates suggests improved management or reduced severity.
• Increased ED charges indicate a potential rise in the cost of OHSS care or resource utilization.