Does HSG contrast medium affect fertility?
Results of a new study in the New England Journal of Medicine suggest that using an oil-based solution for hysterosalpingography (HSG) rather than water may have benefits for women with infertility.
Researchers performed a multicenter, randomized trial that spanned 27 hospitals in the Netherlands and on more than 1000 infertile women who were undergoing HSG. The participants were randomized to having the procedure performed with oil- or water-based contrast. The couples then either received expectant management or the women had intrauterine insemination. Primary outcome for the trial was ongoing pregnancy within 6 months following randomization.
During the trial, 1119 women were randomly assigned to HSG with oil contrast (557 women) or water contrast (562 women). Ongoing pregnancies were reported in 220 of 554 women in the oil group and 161 of 554 women in the water group (rate ratio, 1.37; 95% confidence interval [CI], 1.16 to 1.61; P < 0.001). Live births occurred in 214 of the 552 women in the oil group and 155 of the 552 women in the water group (rate ratio, 1.38; 95% CI, 1.17 to 1.64; P < 0.001). In the 2 groups, the rates of adverse events were low and similar.
Researchers concluded that women who undergo HSG with oil-based contrast have higher rates of pregnancy and live birth than those who undergo HSG with water-based contrast.