A randomized controlled trial of tubal flushing with lipiodol for unexplained infertility.
OBJECTIVE
To test the hypothesis that, in couples with unexplained infertility, tubal flushing with an oil-soluble media (lipiodol) would increase the pregnancy rate within 6 months compared with expectant management.


METHODS
A prospective, randomized, controlled study in which couples were allocated to either a single treatment with lipiodol or no further action.


METHODS
Two tertiary referral centers for assisted reproduction.


METHODS
Couples with a diagnosis of primary or secondary unexplained infertility based on a normal semen analysis according to World Health Organization criteria, patent fallopian tubes at hysterosalpingography or laparoscopy, and ovulatory menstrual cycles based on midluteal phase progesterone levels or ultrasonic follicle tracking.


METHODS
In those patients randomized to lipiodol, a single treatment was performed.


METHODS
Biochemical (i.e., positive pregnancy test) and clinical (i.e., fetal heart on ultrasound scan) pregnancy rates.


RESULTS
Seventeen couples were randomized to lipiodol and 17 to expectant treatment. The higher pregnancy rate after lipiodol was statistically significant. There were no complications after lipiodol treatment.


CONCLUSIONS
There was a statistically significantly higher pregnancy rate in couples with unexplained infertility randomized to a single tubal flush with lipiodol compared with no treatment.
Nugent
David
D
Centre for Reproduction, Growth and Development, University of Leeds, LGI, Belmont Grove, Leeds, United Kingdom. dnhello@hotmail.com
Watson
Andrew J
AJ
Killick
Stephen R
SR
Balen
Adam H
AH
Rutherford
Anthony J
AJ
D000328:Adult; D003287:Contrast Media / Q000008:administration & dosage / Q000627:therapeutic use; D005187:Fallopian Tubes / Q000187:drug effects*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007247:Infertility, Female / Q000628:therapy*; D007459:Iodized Oil / Q000008:administration & dosage / Q000627:therapeutic use*; D018579:Patient Selection; D011247:Pregnancy / Q000706:statistics & numerical data*; D016896:Treatment Outcome
D003287:Contrast Media; D007459:Iodized Oil