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Related Experiment Videos

Tubal flushing for subfertility.

N Johnson1, P Vandekerckhove, A Watson

  • 1Department of Obstetrics & Gynaecology, University of Auckland, PO Box 92019, Auckland, New Zealand, 1003. n.johnson@auckland.ac.nz

The Cochrane Database of Systematic Reviews
|April 23, 2005
PubMed
Summary

Tubal flushing with oil-soluble contrast media significantly increases pregnancy and live birth rates compared to no intervention. Further research is needed to compare oil-soluble with water-soluble media for optimal fertility outcomes.

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Area of Science:

  • Reproductive Medicine
  • Infertility Treatment
  • Diagnostic Imaging

Background:

  • The potential fertility-enhancing effect of diagnostic tubal patency testing has been debated for decades.
  • The comparative efficacy of oil-soluble versus water-soluble contrast media for fertility enhancement remains unclear.
  • Current routine practice for fertility delay does not typically include tubal flushing.

Purpose of the Study:

  • To evaluate the impact of tubal flushing with oil- or water-soluble contrast media on subsequent fertility outcomes in infertile couples.

Main Methods:

  • A systematic review of randomized controlled trials was conducted, searching multiple databases up to March 2004.
  • Included trials compared tubal flushing with oil-soluble media, water-soluble media, or no treatment.

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  • Primary outcome was live birth; secondary outcomes included pregnancy, miscarriage, ectopic pregnancy, and complications.
  • Main Results:

    • Tubal flushing with oil-soluble media significantly increased the odds of live birth and pregnancy compared to no intervention.
    • No randomized controlled trials (RCTs) assessed water-soluble media versus no intervention.
    • While oil-soluble media showed a potential live birth benefit over water-soluble media, this finding requires cautious interpretation due to heterogeneity and conflicting trial quality.

    Conclusions:

    • Evidence supports the effectiveness of oil-soluble contrast media for tubal flushing in improving pregnancy and live birth rates compared to no intervention.
    • Further high-quality RCTs are necessary to compare oil-soluble and water-soluble media, and water-soluble media against no intervention.
    • Additional research is warranted to elucidate the mechanism behind the fertility-enhancing effects of oil-soluble media.