Opioid dispensing patterns after oocyte retrieval

A minority of women undergoing oocyte retrieval fill an opioid prescription.

Like Comment

Volume 110, Issue 5, Pages 905–909

Authors:

Pietro Bortoletto, M.D., Malavika Prabhu, M.D., Elizabeth M. Garry, M.P.H., Krista F. Huybrechts, M.S., Ph.D., Raymond M. Anchan, M.D., Ph.D., Brian T. Bateman, M.D., M.Sc.

Abstract:

Objective

To study opioid dispensing patterns following oocyte retrieval.

Design

Retrospective cohort.

Setting

Not applicable.

Patient(s)

Women undergoing oocyte retrieval with a maximum of 1 opioid prescription in the 12 weeks prior to the procedure, without an opioid use or other substance use disorder.

Intervention(s)

None.

Main Outcome Measure(s)

We measured the frequency of opioids dispensed within 3 days of oocyte retrieval, most common opioids dispensed; and quantity dispensed, in median (interquartile range [IQR] and 10th–90th percentile ranges) oral morphine milligram equivalents (MME). Multivariate regression analyses were used to calculate odds ratios and 95% confidence intervals (CI) to examine the association between patient characteristics and the occurrence of an opioid dispensing.

Result(s)

In total, 61,463 women with an oocyte retrieval met the criteria for analysis. After oocyte retrieval, 11.9% were dispensed an opioid, most commonly hydrocodone (48.5%), codeine (23.0%), and oxycodone (17.7%). The median (IQR; 10th–90th percentile) oral MME dose dispensed after retrieval was 90 (50–125; 50–207). Women with mood disorders (adjusted odds ratio [aOR] 1.17, 95% CI 1.00–1.36), tobacco use (aOR 1.67, 95% CI 1.18–2.37), or anti-depressant use (aOR 1.62, 95% CI 1.47–1.80) were more likely to fill an opioid prescription, compared to those without these diagnoses.

Conclusion(s)

Although only a small proportion of women fill a prescription for opioids after oocyte retrieval, there is substantial variation in the amount dispensed. Patients with a concurrent mood disorder or those taking anti-depressants were more likely to fill an opioid prescription.


Read the full text here.


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

1 Comments

Go to the profile of Emily Barnard
Emily Barnard almost 2 years ago

Thank you for this interesting and timely study. Opioid use and misuse is certainly an epidemic in this country. I'm curious if other readers' practices give a small supply of opioids to all patients post-retrieval (as it can be difficult to get these medications to patients who require them later), or if they dispense only to selected patients based on discussions prior to retrieval, reports of pain post-procedure  discussions, or other factors? Is there any data on international practice of opioid prescribing post-retrieval?