Burden of Illness of Intrauterine Adhesions Following Intrauterine Procedures: A Retrospective Analysis of Real-World Data

Speaker(s)

Schmerold L1, Martin C2, Bharadwaz M3, Sobti D4, Ranjan N4, Mittal A5, Kumar J4, Miller J1, Wang R6, Feldberg I7, Munro MG8
1Axtria, Berkeley Heights, NJ, USA, 2Axtria, Hamilton, ON, Canada, 3Axtria, Mumbai, MH, India, 4Axtria, Gurugram, Haryana, India, 5Axtria, Gurugram, HR, India, 6Axtria, Boston, MA, USA, 7Rejoni Inc., Bedford, MA, USA, 8University of California, Los Angeles, Los Angeles, CA, USA

Presentation Documents

OBJECTIVES: Intrauterine adhesions (IUAs) are a disorder that can cause infertility, irregular menstruation, and pregnancy-related concerns, among other difficulties. We sought to assess the burden of illness of IUA in the United States (US) following intrauterine procedures through a retrospective analysis of closed claims data.

METHODS: Closed claims data were acquired for a total of 656,374 patients that underwent intrauterine procedures of interest or had IUA diagnosis within the period of 2017-2022. Among these patients, we selected those aged 18-55 with continuous enrolment for 6 months prior to and 24 months following their index procedures. We analyzed rates of IUA incidence and recurrence, as well as pregnancy and birth-related outcomes.

RESULTS: Application of exclusion criteria formed an analysis group of 130,998 patients. Among patients that underwent diagnostic tests following their primary procedure, IUA incidence had an average and maximum rate of 17.35% and 23.3% for patients who underwent any procedure or postpartum dilation & curettage, respectively. The rate of recurrence of IUAs following hysteroscopic adhesiolysis (the standard treatment for IUAs) was much higher, at approximately 50% for the first recurrence and 37% for the third. Comparisons of patients with and without IUAs revealed that IUAs are associated with menstrual abnormality, infertility, miscarriage, preterm delivery, and placental abnormalities such as placenta accreta and post-partum hemorrhage.

CONCLUSIONS: These results demonstrate the great burden of illness imposed by IUAs on the US healthcare system. Patients undergoing intrauterine procedures may develop IUAs, and although many do not undergo diagnostic checks, IUAs are common among those that undergo diagnostics. Patients who experience IUAs have poorer pregnancy-related outcomes than those who do not. This is true even after accounting for confounders in the data. Novel treatments are necessary to prevent the formation of IUAs and mitigate these highly burdensome outcomes.

Code

RWD165

Topic

Economic Evaluation, Epidemiology & Public Health, Study Approaches

Disease

Reproductive & Sexual Health, Surgery