Tubal flushing with oil-based or water-based contrast at hysterosalpingography for infertility: long-term reproductive outcomes of a randomized trial.
OBJECTIVE
To determine the impact of oil-based versus water-based contrast on pregnancy and live birth rates ≤5 years after hysterosalpingography (HSG) in infertile women.


DESIGN
A 5-year follow-up study of a multicenter randomized trial.


SETTING
Hospitals.


PATIENT(S)
Infertile women with an ovulatory cycle, 18-39 years of age, and having a low risk of tubal pathology.


INTERVENTION(S)
Use of oil-based versus water-based contrast during HSG.


MAIN OUTCOME MEASURE(S)
Ongoing pregnancy, live births, time to ongoing pregnancy, second ongoing pregnancy.


RESULT(S)
A total of 1,119 women were randomly assigned to HSG with oil-based contrast (n = 557) or water-based contrast (n = 562). After 5 years, 444 of 555 women in the oil group (80.0%) and 419 of 559 women in the water group (75.0%) had an ongoing pregnancy (relative risk [RR] 1.07; 95% confidence interval [CI] 1.00-1.14), and 415 of 555 women in the oil group (74.8%) and 376 of 559 women in the water group (67.3%) had live births (RR 1.11; 95% CI 1.03-1.20). In the oil group, 228 pregnancies (41.1%) were conceived naturally versus 194 (34.7%) pregnancies in the water group (RR 1.18; 95% CI 1.02-1.38). The time to ongoing pregnancy was significantly shorter in the oil group versus the water group (10.0 vs. 13.7 months; hazard ratio, 1.25; 95% CI 1.09-1.43). No difference was found in the occurrence of a second ongoing pregnancy.


CONCLUSION(S)
During a 5-year time frame, ongoing pregnancy and live birth rates are higher after tubal flushing with oil-based contrast during HSG compared with water-based contrast. More pregnancies are naturally conceived and time to ongoing pregnancy is shorter after HSG with oil-based contrast.


CLINICAL TRIAL REGISTRATION NUMBER
Netherlands Trial Register (NTR) 3270 and NTR6577(www.trialregister.nl).
['van Rijswijk|Joukje|J|', 'van Welie|Nienke|N|', 'Dreyer|Kim|K|', 'Pham|Clarabelle T|CT|', 'Verhoeve|Harold R|HR|', 'Hoek|Annemieke|A|', 'de Bruin|Jan Peter|JP|', 'Nap|Annemiek W|AW|', 'van Hooff|Machiel H A|MHA|', 'Goddijn|Mariëtte|M|', 'Hooker|Angelo B|AB|', 'Bourdrez|Petra|P|', 'van Dongen|Angelique J C M|AJCM|', 'van Rooij|Ilse A J|IAJ|', 'van Rijnsaardt-Lukassen|Henrike G M|HGM|', 'van Golde|Ron J T|RJT|', 'van Heteren|Cathelijne F|CF|', 'Pelinck|Marie J|MJ|', 'Duijn|Annette E J|AEJ|', 'Kaplan|Mesrure|M|', 'Lambalk|Cornelis B|CB|', 'Mijatovic|Velja|V|', 'Mol|Ben W J|BWJ|']
D000293:Adolescent D000328:Adult D003287:Contrast Media D005260:Female D005298:Fertility D006801:Humans D007047:Hysterosalpingography D007247:Infertility, Female D050498:Live Birth D009426:Netherlands D011237:Predictive Value of Tests D011247:Pregnancy D018873:Pregnancy Rate D027724:Reproductive Techniques, Assisted D007507:Therapeutic Irrigation D013997:Time Factors D061685:Time-to-Pregnancy D016896:Treatment Outcome D055815:Young Adult
hysterosalpingography ongoing pregnancy Female infertility oil-based contrast medium water-based contrast medium