Safety of oil-based contrast medium for hysterosalpingography: a systematic review

Abstract

This work was an investigator-initiated study and partly funded by Guerbet, France. Guerbet is the manufacturer of Lipiodol® Ultra Fluid. The funders had no role in the study design, data collection, the analyses performed or the interpretation of the study data. Conflicts of interestsI.R. reports receiving travel fee for presenting at the ASRM 2019 from Guerbet. K.R. has nothing to disclose. N.W. has nothing to disclose. V.M. reports receiving travel-and speakers fee as well as research grants from Guerbet. K.D. reports receiving travel-and speakers fee from Guerbet. M.B. has nothing to disclose. B.W.M. is supported by a NHMRC Practioner Fellowship (GNT1082548). B.W.M. reports consultancy for ObsEva, Merck KGaA and Guerbet and travel and research grants from Merck KGaA and Guerbet. C.K. has nothing to disclose. Guerbet is the manufacturer of Lipiodol® Ultra Fluid.

Residual Peritoneal Lipiodol after HyCoSy Can Mimic Pelvic Inflammatory Disease or Endometriosis

“…Lipiodol is an oil based contrast solution used commonly for hysterosalpingography, and 85 cases of oil remnants have been reported in the literature (1). A lipogranuloma is a granulomatous inflammatory soft tissue reaction, consisting of lipid deposition and/or an oil-like substance.…”

Comparison of Hysterosalpingography With Laparoscopy in the Diagnosis of Tubal Factor of Female Infertility

“…This may result from insufficiency of contrast agent influx during the angiography operation or spasms of the lower genital tracts. Therefore, the reliability of HSG is always questionable, especially for the diagnosis of tubal occlusion (7,10,14). In addition, there were high diagnostic values and consistency of HSG compared with laparoscopy in the diagnosis of bilateral tube patency or occlusion, which was demonstrated by the very high sensitivity, specificity, positive predictive value, negative predictive value, and high Kappa value.…”

“…In addition, the diagnostic consistency in occlusion by HSG and by laparoscopy was demonstrated by kappa values of 0.47 [95% CI (0.399, 0.541), p < 0.001] and 0.574 [95% CI (0.505, 0.643), p < 0.001], respectively, which indicated moderate strength consistency. Considering the low cost and high efficiency of HSG in diagnosing infertility, many scholars recommend HSG as an auxiliary routine outpatient examination in the assessment of infertility (7,18). Hydrosalpinx is the morphological change in the fallopian tube resulting from chronic inflammation stimulation (19,20).…”

“…It determines the patency of fallopian tubes, the contour of the uterus, and the adjacent pelvic peritoneum in patients experiencing assessment for infertility. Sometimes, HSG gives us the first indication for the underlying reasons leading to infertility (6,7).…”

“…Although HSG provides us with a permanent record of the fluoroscopic examination of the uterine cavity and tubal patency, subtle changes such as pelvic adhesions and endometriosis, which influence fertility without any pelvic anatomy changes, can be missed (7)(8)(9). Laparoscopy can magnify some subtle differences in the fallopian tube or pelvic peritoneum.…”