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Thyroid function after hysterosalpingography using an oil-soluble iodinated contrast medium

Keiko Mekaru1, Shigeru Kamiyama, Hitoshi Masamoto

  • 1Department of Obstetrics and Gynecology, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.

Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology
|October 30, 2008
PubMed

Insights

Hysterosalpingography (HSG) with lipiodol may affect thyroid function, potentially causing hypothyroidism, especially in women with pre-existing subclinical hypothyroidism. Monitoring thyroid function post-HSG is crucial for early detection and management.

Area of Science:

  • Endocrinology
  • Radiology
  • Infertility Management

Background:

  • Hysterosalpingography (HSG) is a common procedure for infertility evaluation.
  • Lipiodol, an oil-soluble iodinated contrast medium, is frequently used in HSG.
  • The impact of lipiodol on thyroid function requires further investigation.

Purpose of the Study:

  • To assess the effect of lipiodol-enhanced HSG on thyroid function in infertile women.
  • To identify potential risks and patient subgroups susceptible to thyroid dysfunction after HSG.

Main Methods:

  • Serum free thyroxine (FT4) and thyrotropin-stimulating hormone (TSH) levels were measured before and after HSG in 214 infertile women.
  • Patients were categorized based on pre-HSG thyroid function: euthyroid, subclinical hypothyroidism, and subclinical hyperthyroidism.
  • Thyroid function was monitored for several months following the procedure.

Main Results:

  • A significant increase in hypothyroidism development was observed in the subclinical hypothyroidism group post-HSG compared to euthyroid patients.
  • Three patients in the subclinical hypothyroidism group required thyroid hormone replacement therapy.
  • No significant changes were noted in the subclinical hyperthyroidism group.

Conclusions:

  • Thyroid function monitoring is recommended after HSG using lipiodol, particularly for patients with subclinical hypothyroidism.
  • Pre-HSG TSH and FT4 measurements are essential to identify at-risk individuals.
  • Early detection and management can prevent the progression of hypothyroidism.
Abstract

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