Uterine bathing with sonography gel prior to IVF/ICSI-treatment in patients with endometriosis, a multicentre randomised controlled trial

Lier, M.C.I.; Özcan, Hüseyin Çağlayan; Schreurs, A M F; Ven, Peter M. van de; Dreyer, Kim; Houwen, Lisette E.E. van der; Johnson, Neil; Vandekerckhove, Frank; Verhoeve, Harold R.; Kuchenbecker, Walter K. H.; Mol, Ben Willem J.; Lambalk, Cornelis B.; Mijatovic, Velja

doi:10.1093/hropen/hoaa054

Cited by 2 publications

(4 citation statements)

References 35 publications

(50 reference statements)

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“…34 participants from hysteroscopy group and 58 participants from the control group underwent a second embryo transfer procedure using frozen embryos. From the 34 patients in the hysteroscopy group, 21 had positive pregnancy test (61.76%) and in the control group, from the 58 participants, 25 Similar to the first transfer, none of the outcome measures in the second transfer were significantly different between 2 groups. However, the live birth rate was 20% higher in the intervention group.…”

Section: Frozen Embryo Transfer Resultsmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 89%

“…Some studies suggested the potential effect of immunomodulation triggered by uterine bathing using Lipiodol ® (23,24). In contrast, some other trials found no difference in using pharmacologically neutral gels for uterine bathing (25,26) Salehpour et al showed in their trial that intrauterine saline infusion using IUI catheter during IVF cycles could have a negative impact on pregnancy outcomes in RIF patients (27).…”

Section: Discussionmentioning

confidence: 99%

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Uterine Cavity Irrigation With Office Hysteroscopy During Ovarian Stimulation for IVF: A Randomized Controlled Trial

et al. 2022

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ObjectiveThis was a non-blinded randomized controlled study to evaluate whether endometrial irrigation via office hysteroscopy during the early follicular phase would lead to a higher level of live birth rates compared to no irrigation in the fresh embryo transfer cycle.MethodThe study was conducted in Tehran university of medical sciences from June 2015 to June 2016. women under the age of 40 with primary infertility without history of previous IVF/ICSI or hysteroscopic examination, were included. Controlled ovarian hyperstimulation was done. Hysteroscopy was performed in the early mid-follicular phase of a stimulation cycle (day 5-7) with a vaginoscopy approach and saline irrigation in hysteroscopy group. Embryo-transfer was done in the same cycle.Results228 patients completed their participation in the study. In the fresh cycle, clinical pregnancy rate was 46% in the hysteroscopy group and 40.43% in the control group. (p-value= 0.326, RR= 1.16 [95%CI: 0.862 to 1.56]). Live birth rate was 41.28% in the hysteroscopic group and 31.93% in the control group (p-value=0.143, RR= 1.293 [95%CI: 0.916 to 1.825]). For those patients having surplus cryopreserved embryos, after 2 months, a second embryo transfer was performed. The cumulative LBR was 44.05% in the hysteroscopic group and 32.25% in the control group (p-value=0.029, RR= 1.368 [95%CI: 1.031 to 1.815], RD= 11.9% [95%CI: 1.2% to 22.3%] and NNT= 8 [95%CI: 4 to 85]).ConclusionThe current study clearly demonstrated a significantly higher cumulative live birth rate in the intervention group.Clinical Trial Registration[https://www.irct.ir/trial/19586], identifier IRCT2016011022795N2.

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Section: Frozen Embryo Transfer Resultsmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Uterine Cavity Irrigation With Office Hysteroscopy During Ovarian Stimulation for IVF: A Randomized Controlled Trial

et al. 2022

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“…Lier M.C.I. performed an RCT in endometriosis patients in which gel was injected into the uterus before IVF/intracytoplasmic sperm injection (ICSI) treatment, and they did not find a favorable effect of uterine infusion [25], which suggests that the fertility-enhancing effects may be related to the properties of oil-based media. Lipiodol and ethiodized poppyseed oil are clinically available oil-based mediums, and Papaver somniferum seeds, the primary raw materials in oil-based media agents, contain natural opium [26].…”

Section: Discussionmentioning

confidence: 99%

Oil-soluble contrast medium bathing attenuated endometrial inflammation and improved endometrial receptivity in women with recurrent implantation failure: a descriptive study

Huang,

Mo,

Wang

et al. 2024

BMC Women's Health

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Background The oil-soluble contrast medium used in hysterosalpingography has been shown to have a fertility-enhancing effect, but the underlying mechanism is unclear, especially regarding the role of window of implantation (WOI). This study aimed to assess the endometrial immunological impact of the WOI before and after bathing with the oil-soluble contrast medium in women with recurrent implantation failure (RIF). Methods This descriptive study involved two medical centers between December 18, 2019, and December 30, 2020. We included infertile women who underwent three or more transfer cycles, cumulative transplantation of at least four high-quality cleavage-stage embryos or three high-quality blastocysts without clinical pregnancy, and high-quality frozen embryos that were still available for implantation. Patients received 5 ml of ethiodized poppyseed oil bathing, endometrial biopsy around bathing, and frozen-thawed embryo transfer (FET) within four menstrual cycles after bathing. Patients were excluded if failure to complete anyone. Data on the baseline characteristics and clinical data of the FET cycles were collected, and endometrial biopsy specimens were collected in the luteal phase before and after bathing and subjected to immunohistochemistry. The number of CD56 and CD138 positive cells and H-score of expression of ανβ-3 and HOXA10 in endometrium were collected. Results Thirty-four patients were initially enrolled in the study; ultimately, twelve patients with a median age of 32.5 years (range 27–40 years) completed the research. The median number of embryo transfer cycles was three (range 3–8). A total of 4 of 12 women (33.33%) were diagnosed with chronic endometritis before oil-soluble contrast bathing. After bathing, the median numbers of CD138-positive cells in endometrium decreased from 0.75 (range 0–13.5) to 0.65 (range 0–6), P = 0.035; additionally, the H-score of expression of ανβ-3 in endometrium increased from 148.50 ± 31.63 to 175.58 ± 31.83, P < 0.001. The thickness of the endometrium also significantly increased (8.90 ± 1.45 mm vs.10.11 ± 1.98 mm, P = 0.005). However, no consistent changes were found in the expression of CD56 and HOXA10 in the endometrium. Five patients experienced biochemical pregnancies (41.67%), four had clinical pregnancies (33.33%), and three achieved live births following oil-soluble contrast bathing (25%). Conclusions These results suggest that oil-soluble contrast medium bathing decreased CD138-positive cells and upregulated expression of ανβ-3 during WOI in patients with RIF. This histological impact of endometrium may result in enhanced fertility during FET cycles. Investigating the ability of intrauterine bathing with lower-dosage oil-soluble contrast to improve pregnancy in the RIF population is warranted.

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Uterine bathing with sonography gel prior to IVF/ICSI-treatment in patients with endometriosis, a multicentre randomised controlled trial

Cited by 2 publications

References 35 publications

Uterine Cavity Irrigation With Office Hysteroscopy During Ovarian Stimulation for IVF: A Randomized Controlled Trial

Uterine Cavity Irrigation With Office Hysteroscopy During Ovarian Stimulation for IVF: A Randomized Controlled Trial

Oil-soluble contrast medium bathing attenuated endometrial inflammation and improved endometrial receptivity in women with recurrent implantation failure: a descriptive study

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