Contrast media for hysterosalpingography: systematic search and review providing new guidelines by the Contrast Media Safety Committee of the European Society of Urogenital Radiology

Conclusions1. HSG with oil-based CM gives approximately 10% higher pregnancy rates.2. External validity is limited, as in five of nine RCTs, the CM used is no longer on the market.3.  Oil-based CM have potentially more side effects on the maternal thyroid function and on the peritoneum.4. Guideline: Maternal thyroid function should be tested before HSG with oil-based CM and monitored for 6 months after.Clinical relevance statementOil-based CM is associated with an approximately 10% higher chance of pregnancy compared to water-based CM after HSG. Although side effects are rare, higher iodine concentration and slower clearance of oil-based CM may induce maternal thyroid function disturbance and peritoneal inflammation and granuloma formation.Key Points•It is unknown which type of contrast medium, oil-based or water-based, is the optimal for HSG.•Oil-based contrast media give a 10% higher chance of pregnancy after HSG, compared to water-based contrast media.•From the safety perspective, oil-based CM can cause thyroid dysfunction and an intra-abdominal inflammatory response in the patient.
Source: European Radiology - Category: Radiology Source Type: research