Impact of oil-based contrast agents in hysterosalpingography on fertility outcomes in endometriosis: a retrospective cohort study

Reprod Biol Endocrinol. 2024 Feb 3;22(1):19. doi: 10.1186/s12958-024-01190-1.

Abstract

Background: Previous studies have suggested that oil-based contrast agents used during hysterosalpingography (HSG) in infertile patients can enhance fertility. However, limited research has investigated the effect of oil-based contrast medium specifically in individuals with endometriosis-related infertility.

Objective: This study aims to explore the impact of oil-based contrast medium on fertility outcomes in women with endometriosis-related infertility.

Methods: Conducted at the First Affiliated Hospital of Guangxi Medical University (January 2020 to June 2022), the study included 512 patients undergoing HSG. Patients were categorized into oil-based and non-oil-based groups, and after propensity score matching, demographic characteristics were compared. Main outcomes included clinical pregnancy rates, live birth rates, early miscarriage rates, and ectopic pregnancy rates.

Results: In our analysis, the Oil-based group showed significantly better outcomes compared to the Non-oil-based group. Specifically, the Oil-based group had higher clinical pregnancy rates (51.39% vs. 27.36%) and increased live birth rates (31.48% vs. 19.93%). This trend held true for expectant treatment, IUI, and IVF/ICSI, except for surgical treatment where no significant difference was observed. After adjusting for various factors using propensity score matching, the Non-oil-based group consistently exhibited lower clinical pregnancy rates compared to the Oil-based group. The Odds Ratio (OR) was 0.38 (95%CI: 0.27-0.55) without adjustment, 0.34 (0.22-0.51) in multivariable analysis, 0.39 (0.27-0.57) using inverse probability of treatment weighting (IPTW), and 0.22 (0.14-0.35) in propensity score matching.

Conclusion: Oil-based contrast medium used in HSG for women with endometriosis-related infertility is associated with higher clinical pregnancy rates and live birth rates compared to Non-oil-based contrast medium.

Keywords: Endometriosis; Fertility enhancement; HSG; Infertility; Oil-based contrast medium; Propensity score matching(PSM).

MeSH terms

  • China / epidemiology
  • Contrast Media
  • Endometriosis* / complications
  • Endometriosis* / diagnostic imaging
  • Female
  • Fertility
  • Humans
  • Hysterosalpingography
  • Infertility, Female* / diagnostic imaging
  • Infertility, Female* / etiology
  • Infertility, Female* / therapy
  • Live Birth
  • Pregnancy
  • Pregnancy Rate
  • Retrospective Studies

Substances

  • Contrast Media