100 Year Old 'Flushing Out' Technique Boosts Fertility, Helps Infertile Couples

100 year old medical technique, hysterosalpingography (HSG), increases the opportunities for infertile couples to achieve successful pregnancies.

Highlights:

The 'flushing out' technique was thought to boost fertility by removing the debris that hinders fertility.
The ancient procedure known as hysterosalpingography (HSG) involves flushing the fallopian tubes of women with either oil-based or water-based solutions, under X-ray.
Oil-based flushing helped in improving pregnancy rates and in avoiding the huge costs and emotions incurred with In Vitro Fertilization (IVF) treatment.

A 100-year-old medical technique, that involves flushing the fallopian tube of a woman using an iodized poppy seed oil has shown to have significant benefits in boosting fertility.

The large study, undertaken by a research team from Netherlands and Australia, provides a tremendous opportunity for infertile couples, to achieve a successful pregnancy without the need for In Vitro Fertilization (IVF).

Infertility - Causes - Diagnosis - Treatment - FAQs
Infertility is a condition wherein couples fail to achieve pregnancy or if the woman has been unable to carry a pregnancy that results in a live birth.

‘Flushing the fallopian tube of a woman with oil-based solution helps to boost the fertility and improve the outcome for women who would otherwise have to opt for expensive treatments like IVF.’

100-year-old Technique
The procedure known as hysterosalpingography (HSG) was first carried out in 1917. It is a dye test of the fallopian tube that is performed under X-ray. Since the 1950s, both water-based and oil-based solutions have been used for the test.

The study, known as H2Oil, recruited 1119 infertile women and divided them into two groups: oil-based and water-based solutions.

It then compared the benefits of flushing the fallopian tubes with either an oil-based or water-based solution.

In Vitro Fertilization (IVF) - Introduction To Infertility and Reproduction
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Lipiodol® Ultra-Fluid, an iodized solution of fatty acids from poppy seeds, was the oil-based product used for the study. This product is currently available in 47 countries around the world.

The research team included Professor Ben Mol, from the University of Adelaide's Robinson Research Institute, along with Dr Kim Dreyer and Dr Velja Mijatovic from the Department of Reproductive Medicine, VU University Medical Centre, Amsterdam, and a research team from 27 medical centres in the Netherlands.

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"Over the past century, pregnancy rates among infertile women reportedly increased after their tubes had been flushed with either water or oil during this X-ray procedure. Until now, it has been unclear whether the type of solution used in the procedure was influencing the change in fertility," says Professor Mol.

"Our results have been even more exciting than we could have predicted, helping to confirm that an age-old medical technique still has an important place in modern medicine," he says.

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What are the Benefits of Oil-Based Solution Over Water-Based Solution?
Successful pregnancies were achieved by 40% infertile women in oil group and 29% women in water group, within 6 months of performance of the technique.

"The rates of successful pregnancy were significantly higher in the oil-based group, and after only one treatment. This is an important outcome for women who would have had no other course of action other than to seek IVF treatment. It offers new hope to infertile couples," Professor Mol says.

In Vito Fertilization
In vitro fertilization (IVF), a form of assisted reproductive technology that involves the external fusion (outside the body) of a woman's egg and a man's sperm in a petridish. This technique helps a woman become pregnant.

It has helped millions of people become parents, after it was pioneered by Sir Robert Edwards and Patrick Steptoe in 1978.

Some drawbacks include:

Low success rate - Patients may have to undergo more than one cycle of the treatment before a successful pregnancy.
High cost - IVF treatment can be expensive, with high costs for blood tests involved and medications used.
Side-effects and risks - IVF increases the risk of developing ovarian hyper-stimulation syndrome (OHSS). It also increases the risk of ectopic pregnancy where the implantation takes place outside the uterus.
Premature and low-birth weight babies- Babies born after IVF treatment can be delivered prematurely and can have low birth weight due to the higher levels of estrogen associated with the treatment.
Multiple pregnancy- IVF treatments increase the risk of multiple pregnancy as more than one embryo is put into the uterus. Around 20-30% of IVF pregnancies can result in multiple pregnancies. Multiple pregnancies increase health risks to mother and baby.
Mental health - IVF treatment can be a stressful experience as it is physcally and emotional demanding.

Opinions
"It was long believed that testing a woman's fallopian tubes could have fertility benefits through 'flushing out' the kind of debris that hinders fertility. The reality is, we still don't really understand why there is a benefit, only that there is a benefit from this technique, in particular for women who don't present with any other treatable fertility symptoms," Professor Mol says.

The results of the study is published in The New England Journal of Medicine and the findings will be presented at the 13th World Congress on Endometriosis in Vancouver, Canada, by project leader Professor Ben Mol who is a member of the South Australian Health and Medical Research Institute's Healthy Mothers, Babies and Children theme.

References:

In vitro fertilization (IVF) - (https://medlineplus.gov/ency/article/007279.htm)
The advantages and disadvantages of IVF - (https://www.createhealth.org/news/2014/the-advantages-and-disadvantages-of-ivf)
Ben Mol et al. Oil-Based or Water-Based Contrast for Hysterosalpingography in Infertile Women. The New England Journal of Medicine; (2017) DOI: 10.1056/NEJMoa1612337

Source-Medindia