K Dreyer1, R van Eekelen2, R I Tjon-Kon-Fat3, J W van der Steeg4, P Steures4, Mjc Eijkemans5, F van der Veen3, Pga Hompes1, Bwj Mol6, N van Geloven7. 1. Department of Obstetrics and Gynaecology, VU Medical Centre, PO Box 7057, 1007 MB, Amsterdam, the Netherlands. 2. Centre for Reproductive Medicine, Academic Medical Centre, PO Box 22660, 1100 DD, Amsterdam, the Netherlands; Biostatistics and Research Support, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, PO Box 85500, 3508 GA, Utrecht, the Netherlands. 3. Centre for Reproductive Medicine, Academic Medical Centre, PO Box 22660, 1100 DD, Amsterdam, the Netherlands. 4. Department of Obstetrics and Gynaecology, Jeroen Bosch Ziekenhuis, PO Box 90153, 5200 ME, Den Bosch, the Netherlands. 5. Biostatistics and Research Support, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, PO Box 85500, 3508 GA, Utrecht, the Netherlands. 6. Department of Obstetrics and Gynaecology, Monash University, c/o 27-31 Wright Street, Clayton, VIC 3168, Australia. 7. Medical Statistics, Department of Biomedical Data Sciences, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands. Electronic address: n.van_geloven@lumc.nl.
Abstract
RESEARCH QUESTION: Hysterosalpingography (HSG) with an oil-based contrast has been shown to increase ongoing pregnancy rates compared with HSG with water-based contrast, but it remains unclear if an effect of HSG occurs compared with no HSG. DESIGN: A secondary data-analysis of a prospective cohort study among 4556 couples that presented with unexplained subfertility in 38 clinics in the Netherlands between January 2002 and December 2004. A time-varying Cox regression with inverse probability of treatment weighing was used to analyse ongoing pregnancy rates in women after undergoing the HSG procedure (with the use of either water- or oil-based contrast media) compared with women who did not undergo HSG. RESULTS: The probability of natural conception within 24 months after first presentation at the fertility clinic was increased after HSG, regardless of the type of contrast medium used, compared with no HSG (adjusted hazard ratio 1.48, 95% CI 1.26 to 1.73, corresponding to an absolute increase in 6-month pregnancy rate of +6%). When this analysis was limited to HSGs that were made with water-contrast, the treatment effect remained (adjusted hazard ratio 1.40, 95% CI 1.16 to 1.70). CONCLUSIONS: HSG increases the ongoing pregnancy rate of couples with unexplained subfertility compared with no HSG, regardless of the contrast medium used. Results need to be validated in future, preferably randomized, studies.
RESEARCH QUESTION: Hysterosalpingography (HSG) with an oil-based contrast has been shown to increase ongoing pregnancy rates compared with HSG with water-based contrast, but it remains unclear if an effect of HSG occurs compared with no HSG. DESIGN: A secondary data-analysis of a prospective cohort study among 4556 couples that presented with unexplained subfertility in 38 clinics in the Netherlands between January 2002 and December 2004. A time-varying Cox regression with inverse probability of treatment weighing was used to analyse ongoing pregnancy rates in women after undergoing the HSG procedure (with the use of either water- or oil-based contrast media) compared with women who did not undergo HSG. RESULTS: The probability of natural conception within 24 months after first presentation at the fertility clinic was increased after HSG, regardless of the type of contrast medium used, compared with no HSG (adjusted hazard ratio 1.48, 95% CI 1.26 to 1.73, corresponding to an absolute increase in 6-month pregnancy rate of +6%). When this analysis was limited to HSGs that were made with water-contrast, the treatment effect remained (adjusted hazard ratio 1.40, 95% CI 1.16 to 1.70). CONCLUSIONS: HSG increases the ongoing pregnancy rate of couples with unexplained subfertility compared with no HSG, regardless of the contrast medium used. Results need to be validated in future, preferably randomized, studies.
Authors: R van Eekelen; K Rosielle; N van Welie; K Dreyer; M van Wely; B W Mol; M J Eijkemans; V Mijatovic; N van Geloven Journal: Hum Reprod Open Date: 2020-11-17
Authors: Khawaja B Waheed; Muneera A Albassam; Alaa-Ali G AlShamrani; Shayma A Aloumi; Muhammad S Amin; Lubna Rashid; Sarah M AlGodayan; Siti-Fatimah B Ahmad Journal: Saudi Med J Date: 2019-10 Impact factor: 1.484
Authors: N van Welie; K Dreyer; J van Rijswijk; H R Verhoeve; M Goddijn; A W Nap; J M J Smeenk; M A F Traas; H G M Rijnsaardt-Lukassen; A J C M van Dongen; P Bourdrez; J P de Bruin; A V Sluijmer; A P Gijsen; P M van de Ven; C B Lambalk; V Mijatovic; B W J Mol Journal: Hum Reprod Date: 2019-12-01 Impact factor: 6.918