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

Abstract

We conclude that thyroid function should be monitored closely after HSG using lipiodol to detect the development of hypothyroidism, particularly in patients with subclinical hypothyroidism, and TSH and FT4 measurements should be performed before HSG to identify patients at risk for hypothyroidism.

Changes in Serum Iodine Concentration, Urinary Iodine Excretion and Thyroid Function After Hysterosalpingography Using an Oil-Soluble Iodinated Contrast Medium (Lipiodol)

“…In the study by Mekaru, only thyroid function was measured just once several months after HSG (6). In our study, both serum thyroid function and urine iodine concentrations were evaluated prospectively over multiple time points following the exposure to lipiodol.…”

“…Moreover, excessive amounts of iodine transiently inhibit the synthesis of thyroid hormones (known as the WolffChaikoff effect) (4,5). Mekaru and colleagues (6) reported that hypothyroidism occurred after HSG using lipiodol in 214 patients, whereas another study showed that the extent of thyroid dysfunction in thyroid antibody-positive patients caused by excessive intake of iodine was more severe than those who were antibody negative (7). In addition, there have been cases of transient fetal goiter or transient neonatal hypothyroidism due to excessive iodine intake by the mother who became pregnant just after HSG with lipiodol (8,9).…”

Thyroid Dysfunction in Neonates Born to Mothers Who Have Undergone Hysterosalpingography Involving an Oil-Soluble Iodinated Contrast Medium

“…Mekaru et al [19] reported that 10 out of 28 Japanese women with subclinical hypothyroidism developed hypothyroidism after HSG involving the use of ethiodized oil. Kaneshige et al [20] also reported that 3 out of 22 Japanese euthyroid women showed transient subclinical hypothyroidism after ethiodized-oil HSG.…”

Iodine-induced thyroid dysfunction

“…In two small studies, subclinical hypothyroidism developed in four of 22 German patients [28] and in three of 56 US patients [29] 1 week following either coronary angiography or iodinated CT. Another Japanese report of 214 women (mean ± SD age 34.5 ± 4.6 years) described that those with pre-existing subclinical hypothyroidism were more likely to develop overt hypothyroidism than those who were euthyroid following hysterosalpingography (35 and 2%, respectively) [30]. …”