Iodine and other factors associated with fertility outcome following oil-soluble contrast medium hysterosalpingography: a prospective cohort study

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Mathews, Divya M.Univ Auckland, Liggins Inst, Auckland, New Zealand.;Starship Childrens Hosp, Hlth New Zealand Te Whatu Ora, Auckland, New Zealand. (author)

Iodine and other factors associated with fertility outcome following oil-soluble contrast medium hysterosalpingography : a prospective cohort study

Article/chapterEnglish2024

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Frontiers Media S.A.2024
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LIBRIS-ID:oai:DiVA.org:uu-535796
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-535796URI
https://doi.org/10.3389/fendo.2024.1257888DOI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Objective: To examine factors associated with fertility following hysterosalpingography (HSG) using an oil-soluble contrast medium (OSCM).Design: In a prospective cohort study on 196 women undergoing OSCM HSG, we showed that iodine excess was almost universal (98%) and mild subclinical hypothyroidism was frequent (38%). Here, we report the analyses of secondary outcomes examining factors associated with the likelihood of pregnancy following the HSG.Setting: Auckland, New Zealand (2019-2021).Sample: 196 women with primary or secondary infertility who underwent OSCM HSG.Methods: Baseline and serial urine iodine concentrations (UIC) and thyroid function tests were measured over six months following the HSG. Pregnancy and treatment with levothyroxine during the study period were documented.Results: Following OSCM HSG, pregnancy rates were 49% in women aged <40 years (77/158) but considerably lower (16%) among those >= 40 years (6/38). Similarly, live birth rates were markedly lower in women >= 40 years (17%; 1/6) versus <40 years (73%; 56/77). 29% of participants were iodine deficient at baseline despite advice recommending iodine fortification. Following HSG, the likelihood of pregnancy in women with moderate iodine deficiency was 64% higher than in women with normal iodine levels (p=0.048). Among women aged <40 years who had subclinical hypothyroidism (n=75), levothyroxine treatment was associated with higher pregnancy rates compared to untreated women [63% (26/48) vs 37% (10/27), respectively; p=0.047].Conclusion: OSCM HSG was associated with higher pregnancy rates in women <= 40 than in those aged >40 years. Iodine deficiency was relatively common in this cohort, and increased iodine levels from OSCM exposure may contribute to the improved fertility observed with this procedure.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Reproduktionsmedicin och gynekologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Obstetrics, Gynaecology and Reproductive Medicine hsv//eng
fertility
hysterosalpingography
iodine
oil-soluble contrast medium
pregnancy
age
tubal patency
hypothyroidism

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Peart, Jane M.Auckland Radiol Grp, Auckland, New Zealand. (author)
Sim, Robert G.Auckland Radiol Grp, Auckland, New Zealand. (author)
Johnson, Neil P.Univ Adelaide, Robinson Res Inst, Adelaide, SA, Australia.;Univ Auckland, Fac Med & Hlth Sci, Dept Obstet & Gynaecol, Auckland, New Zealand.;Repromed Auckland, Auckland, New Zealand. (author)
O'Sullivan, SusannahAuckland Dist Hlth Board, Endocrinol Greenlane Clin Ctr, Auckland, New Zealand. (author)
Derraik, José G. B.Uppsala universitet,Perinatal, neonatal och barnkardiologisk forskning,Univ Auckland, Fac Med & Hlth Sci, Dept Paediatrics: Child & Youth Hlth, Auckland, New Zealand.;Chiang Mai Univ, Res Inst Hlth Sci, Environm Occupat Hlth Sci & Noncommunicable Dis Re, Chiang Mai, Thailand.(Swepub:uu)josde820 (author)
Hofman, Paul L.Univ Auckland, Liggins Inst, Auckland, New Zealand.;Starship Childrens Hosp, Hlth New Zealand Te Whatu Ora, Auckland, New Zealand. (author)
Univ Auckland, Liggins Inst, Auckland, New Zealand.;Starship Childrens Hosp, Hlth New Zealand Te Whatu Ora, Auckland, New Zealand.Auckland Radiol Grp, Auckland, New Zealand. (creator_code:org_t)

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In:Frontiers in Endocrinology: Frontiers Media S.A.151664-2392

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