油性与水溶性对比剂在输卵管造影中的有效性比较！

Study question

研究问题

What is the effectiveness of oil-based contrast during HSG compared to water-based contrast?

和水溶性对比剂相比，油性对比剂在输卵管造影（HSG）中的有效性如何？

Summary answer

摘要答案

HSG with oil-based contrast increased the live birth rate as compared to water-based contrast.

与水性对比剂相比，油性对比剂提高了HSG术后的活产率。

What is known already

众人皆知

Tubal flushing has long been thought to increase live birth rate in infertile couples. A large randomised clinical trial (RCT) in The Netherlands confirmed the long-term hypothesis that HSG with oil-based contrast (Lipiodolâ) increased the live birth rate as compared to HSG with water-based contrast. We assessed whether this treatment effect was also achieved with oil-based contrast in Chinese women.

长期以来，人们一直认为输卵管冲洗可以提高不孕夫妇的活产率。荷兰的一项大型随机临床试验（RCT）证实了这一假设，即使用油性对比剂（Lipiodol）进行输卵管造影术可以提高活产率，相比之下，使用水溶性对比剂的效果较差。我们评估了这种治疗效果是否也适用于中国女性。

Study design, size, duration

研究设计、规模、持续时间

We performed a prospective cohort study between May 4, 2020 and March 30, 2022. A total of 1187 women were included in the analysis.These women were categorized into two groups based on the contrast they used: the Oil-Soluble Contrast Media (OSCM) group, which employed poppy seed oil, consisting of 569 cases, and the Water-Soluble Contrast Media (WSCM) group, which used iodixanol, comprising 618 cases.

在2020年5月4日至2022年3月30日期间，我们进行了一项前瞻性队列研究。共有1187名女性被纳入分析。根据她们使用的对比剂，这些女性被分为两组：油性对比剂（OSCM）组，使用罂粟籽油，共有569例病例；水性对比剂（WSCM）组，使用碘克沙醇，共有618例病例。

Participants/materials, setting, methods

参与者/材料、地点、方法

This study was conducted at Shanghai Jiao Tong University International Peace Maternity and Child Health Hospital .The primary outcome was ongoing pregnancy rate within 6 months after the examination.Secondary outcomes included clinical pregnancies, miscarriage, ectopic pregnancy and thyroid Stimulating Hormone.

本研究在上海交通大学国际和平妇幼保健院进行，主要结果为检查后6个月内继续妊娠率，次要结果包括临床妊娠、流产、宫外孕和促甲状腺激素水平。

Main results and the role of chance

主要结果和机会的作用

The ongoing pregnancy rate of the oil group is significantly higher than that of the water group (24.1% versus 17.2%, rate ratio [RR], 1.53; 95% confidence interval [CI], 1.14 to 2.06; P = 0.004). Women in the oil group also achieved higher clinical pregnancy rate (32.2% versus 22.2%, RR, 1.67; 95% CI, 1.27 to 2.18, P < 0.001), higher live birth rate (23.9% versus 16.8%, RR, 1.56; 95% CI, 1.16 to 2.09, P = 0.003), and bore higher risk of miscarriage (8.0% versus 5.0%, RR, 1.67; 95% CI, 1.02 to 2.72, P = 0.04) than water group.

油性对比剂的持续妊娠率明显高于水溶性对比剂组（24.1%vs17.2%，比值比[RR]，1.53，95%置信区间[CI]，1.14至2.06; P=0.004），与水性对比剂相比，油性对比剂的女性也有更高临床妊娠率（32.2% vs 22.2%，RR，1.67; 95%CI，1.27至2.18，P < 0.001），活产率较高（23.9% vs 16.8%，RR，1.56; 95%CI，1.16至2.09，P=0.003），并且流产风险较高（8.0% vs 5.0%，RR，1.67; 95%CI，1.02至2.72，P=0.04）。

Limitations, reasons for caution

局限性、谨慎原因

The sample size along with the data was obtained from a cohort study in a single center.

样本量和数据是从单中心的队列研究中获得的。

Wider implications of the findings

研究结果的更广泛影响

Tubal flushing with oil-based contrast medium is an effective treatment to improve the pregnancy outcomes of infertile women that should be part of every infertility work-up.

使用油性对比剂进行输卵管冲洗是一种有效的治疗方法，可以改善不孕妇女的妊娠结果，应该成为不孕症检查的一部分。

参考文献：

M Lu, L Yan, J Zhang, O-023 Does flushing with oil-based contrast during hysterosalpingography (HSG) increase the live birth rate as compared to water-based contrast: a prospective cohort study, Human Reproduction, Volume 39, Issue Supplement_1, July 2024, deae108.023, https://doi.org/10.1093/humrep/deae108.023