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Thyroid function in neonates conceived after hysterosalpingography with iodinated contrast.

N van Welie1, I Roest1,2, M Portela1

  • 1Department of Reproductive Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1118, 1081 HV, Amsterdam, the Netherlands.

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Summary

Preconceptional hysterosalpingography (HSG) with iodinated contrast, whether oil- or water-based, does not impact neonatal thyroid function. This finding supports the continued use of oil-based contrast in fertility evaluations.

Keywords:
hypothyroidismhysterosalpingographyiodineneonatal healthneonatal screeningoil-based contrast mediumwater-based contrast medium

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Area of Science:

  • Reproductive Endocrinology
  • Neonatal Health
  • Diagnostic Imaging

Background:

  • Hysterosalpingography (HSG) is a common fertility test using oil- or water-based contrast.
  • Oil-based contrast has higher iodine content than water-based contrast.
  • Previous studies suggested a potential risk of congenital hypothyroidism (CH) with oil-based contrast exposure.

Purpose of the Study:

  • To investigate if preconceptional hysterosalpingography (HSG) with iodinated oil-based contrast affects neonatal thyroid function compared to iodinated water-based contrast.
  • To assess the safety of oil-based contrast in HSG for neonatal thyroid health.

Main Methods:

  • Retrospective data analysis of the H2Oil randomized controlled trial.
  • Collected thyroid function test data from 140 neonates (76 oil-based, 64 water-based contrast).
  • Analyzed T4 and TSH levels from neonatal screening programs, comparing groups and contrast volume.

Main Results:

  • No significant difference in median T4 concentrations between neonates exposed to oil-based (87.0 nmol/l) versus water-based (90.0 nmol/l) contrast (P=0.13).
  • No neonates in either group screened positive for congenital hypothyroidism (CH).
  • No influence of contrast amount on T4 concentrations was observed.

Conclusions:

  • Preconceptional HSG with iodinated oil-based contrast does not adversely affect neonatal thyroid function.
  • The use of oil-based contrast in HSG is considered safe for offspring thyroid health.
  • Further research is recommended on maternal thyroid function and neurodevelopmental outcomes.