Opioid dispensing patterns after oocyte retrieval

Fertil Steril. 2018 Oct;110(5):905-909. doi: 10.1016/j.fertnstert.2018.06.023.

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.

Keywords: Oocyte retrieval; opioids; pain.

MeSH terms

  • Adolescent
  • Adult
  • Analgesics, Opioid / administration & dosage*
  • Cohort Studies
  • Drug Prescriptions* / standards
  • Female
  • Humans
  • Infertility, Female / epidemiology
  • Infertility, Female / psychology
  • Infertility, Female / therapy
  • Middle Aged
  • Oocyte Retrieval / adverse effects
  • Oocyte Retrieval / psychology
  • Oocyte Retrieval / trends*
  • Pain, Postoperative / drug therapy*
  • Pain, Postoperative / epidemiology
  • Pain, Postoperative / psychology
  • Retrospective Studies
  • Young Adult

Substances

  • Analgesics, Opioid