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Hysterosalpingography (HSG) is one of the recommended diagnostic tests to assess tubal patency in women experiencing infertility. Although HSG is a diagnostic test, studies have shown that there could be an increase in pregnancy rates in the months after HSG. Iodinated contrast media are routinely utilized, to undertake HSG, which are classified as either water soluble contrast media (WSCM) or oil soluble contrast media (OSCM). [1,2]
A possible increase in the pregnancy rate following a HSG with OSCM was initially reported by Weir and Weir (1951) and later by Watson (1994) who also suggested that OSCM have fertility-enhancing effect especially in couples with unexplained infertility. [3,4] Subsequently, the hypothesis of the fertility-enhancing effect of OSCM was proposed through a number of nonrandomized studies, [5-10] and few randomized controlled trials (RCTs). [11-13] More Recently, Dreyer (2017) published the largest (Dutch) multi-centre RCT involving over 1100 infertile women and reported that almost 40% of the infertile women undergoing HSG with the OSCM had an ongoing pregnancy with approximately 39% of women resulting in live births. Rates of adverse events were also very low. [14] These new clinical data from a RCT clearly demonstrated a promising outcome of OSCM for infertile women.
Learning Outcomes:
- Overview of clinical data showing potential pregnancy enhancing effect of OSCM.
- Overview of the HSG technique & clinical experience of OSCM in the UK.
References:
[1]. Thoma ME, Fertil Steril 2013; 99(5): 1324-1331.
[2]. Cundiff G, et al. J Reprod Med 1995; 40: 19-24.
[3] Weir and Weir. 1951; 2: 514-22.
[4] Watson A et al. 1994, 470–477.
[5] Gillespie H., 1965. Br J Radiol 38,301–302.
[6] Barwin N., 1971. Ulster Med J 41, 61–65.
[7] Mackey RA. et al. 1971. Fertil Steril 22, 504–507.
[8] Acton C et al. 1988. Aust NZ J Obstet Gynaecol 28,127–133.
[9] DeCherney et al. 1980 Fertil Steril 33, 407–410.
[10] Yaegashi N et al. 1987. Acta Obstet Gynaecol Japon 39,1812–1814.
[11]. Johnson NP, et al. The FLUSH trial —2004; 19:2043-51.
[12] Nugent D, Watson AJ, et al. Fertil Steril 2002; 77: 173-5.
[13]. Ogata R, et al. Jap J Fertil Steril 1993; 38: 91-4.
[14] Dreyer et al. 2017. New England Journal of Medicine 376, 21, 2043
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Duration:72 mins
Speaker info
Professor Anne Hemingway
Professor Anne Hemingway qualified in 1975 from Guys Hospital Medical School, London University and following various key positions in medicine and academia Anne was appointed as the first female professor of radiology in the UK at Sheffield University in 1987. She has extensive experience in infertility imaging and has undertaken more than 10,000 hysterosalpingograms (HSGs). Anne has published over 80 peer reviewed articles, 30 book chapters and delivered numerous lectures locally, nationally and internationally.
Dr Imran Shahid
Dr Imran Shahid holds a doctorate in cancer treatment and has been working with Guerbet for over 10 years in the areas of Medical Affairs and Medical Information and currently holds the position of the Head of Global Medical Information. Imran has been extensively engaged in delivering lectures related to diagnostic and interventional radiology both at national and international levels, involving topics related to MRI, CT, oncology and infertility.