Diagnosing the reason for infertility is a key step in managing infertility. As part of the fertility work-up, an HSG is a theranostic procedure that may offer your patients two benefits: diagnosing tubal & uterine abnormalities as well as an increased chance of conceiving. 2-9
Infertility is defined as primary when a woman is unable to ever bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth. 10,11
Infertility is defined as secondary when a woman is unable to bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth following either a previous pregnancy or a previous ability to carry a pregnancy to a live birth. 10,11
Hysterosalpingography is a radiological examination to investigate the uterine cavity, fallopian tubes & peritoneal cavity. It entails the injection of a contrast medium and visualization under fluoroscopy. Two types of contrast media can be used: oil-based or water-based. 12
According to recent studies and meta-analysis, pregnancy and live births rates are significantly higher after an HSG with oil-based contrast medium (Lipiodol® Ultra Fluid) as compared to water-based contrast medium. 2-8
Learn more about how Lipiodol® Ultra Fluid may help your patients get pregnant and read the latest meta-analysis & studies
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1. A policy audit on fertility. Analysis of 9 EU countries. March 2017. Fertility Europe.
2. Wang R et al. Effectiveness on fertility outcome of tubal flushing with different contrast media: systematic review and network meta-analysis. Ultrasound Obstet Gynecol. 2019 Aug;54(2):172-181.
3. Fang F et al. Oil-based versus water-based contrast for hysterosalpingography in infertile women: a systematic review and meta-analysis of randomized controlled trials. Fertil Steril. 2018 Jul 1;110(1):153-160.e3.
4. Dreyer K et al. Oil-based or water-based contrast for hysterosalpingography in infertile women. N Engl J Med. 2017 May 25;376(21):2043-52.
5. Johnson NP et al. The FLUSH trial--flushing with lipiodol for unexplained (and endometriosis-related) subfertility by hysterosalpingography: a randomized trial. Hum Reprod. 2004 Sep;19(9):2043-51.
6. Johnson NP et al. Lipiodol fertility enhancement: two-year follow-up of a randomized trial suggests a transient benefit in endometriosis, but a sustained benefit in unexplained infertility. Hum Reprod. 2007 Nov;22(11):2857-62.
7. Mohiyiddeen L et al. Tubal flushing for subfertility. Cochrane Database Syst Rev. 2015 May 1;(5):CD003718.
8. Izumi G et al. Oil-Soluble Contrast Medium (OSCM) for hysterosalpingography modulates dendritic cell and regulatory T cell profiles in the peritoneal cavity: a possible mechanism by which OSCM enhances fertility. J Immunol. 2017 Jun 1;198(11):4277-84.
9. Regulated fertility services: a commissioning aid – June 2009, from the Department of Health UK.
10. WHO. World Health Organization 2018. http://www.who.int/reproductivehealth/topics/infertility/definitions/en/.
11. Mascarenhas MN et al. National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med. 2012;9(12):e1001356.
12. American College of Radiology. ACR Practice parameter for the performance of hysterosalpingography. 2014.