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Around 8-12% of couples worldwide are impacted by infertility.1 In 33-41% of these cases, the cause is female infertility.1
Infertility in women can be caused by numerous factors, the most important ones being diseases related to the reproductive system like polycystic ovary syndrome, endometriosis, uterine polyps, etc.2,4 Depending on the cause of infertility, treatments such as hormone therapy, induction of ovulation, superovulation, or assisted reproductive technologies (ART; such as in vitro fertilization or IVF) are available.4
But hormone therapy is associated with increased risk of breast cancer, while other methods can increase the risk of multiple pregnancies.4 But what happens when infertility is unexplained? How do you treat a problem without knowing the underlying cause of the problem?
Unexplained Female Infertility
Infertility in women means the inability to get pregnant (or maintain a pregnancy without miscarriage) after trying for at least a year (for women up to 35 years of age), or six months (for women over 35).3,4,5
Nearly 20% of infertility cases in the US are a result of unknown causes, also known as idiopathic infertility.5 This unexplained infertility could mainly occur because:
- the egg is unable to enter the fallopian tube due to a blockage,
- the embryo (fertilized egg) cannot move through the fallopian tube due to a blockage, or
- the embryo cannot attach itself onto the uterus.
Lipiodol Flushing: What Is It and How Does It Work
Lipiodol is a sterile form of iodized poppy seed oil.2,3,6 This oil-based dye is an alternative to regular contrast dyes that are used in reproductive imaging procedures like hysterosalpingography or HSG and has additional fertility-related benefits.2,3,6
An HSG is a test that allows the doctor to visualize the uterus using regular contrast dyes and check if there is any blockage in the fallopian tubes.2,3 Flushing the uterus with Lipiodol has been found to be effective in helping treat unexplained infertility in women.3,6
Lipiodol tubal flushing has been suggested to flush out any debris blocking the fallopian tubes, thus increasing the chances of pregnancy.3 Another possible reason is that Lipiodol prevents the body’s immune cells like macrophages to damage sperms when they enter the fallopian tube.3 It is also suggested that Lipiodol flushing makes the uterus more prepared for embryo attachment, which improves the chances of maintaining pregnancy.3 Additionally, the contrast agent may help improve the overall health and function of the reproductive system by reducing pelvic inflammation and promoting healing.8
Lipiodol Tubal Flushing: Candidates
Potential candidates for Lipiodol tubal flushing include:
- Women with a prior HSG showing normal unblocked fallopian tubes who are experiencing infertility.6
- Women with endometriosis who are infertile.6
Endometriosis and Infertility
Women with endometriosis who are experiencing infertility can especially benefit from Lipiodol tubal flushing and have been shown to witness a significant improvement in fertility in various studies.3,6
Lipiodol Tubal Flushing: Procedure
Lipiodol tubal flushing is a non-invasive outpatient procedure as an alternative to IVF.2,6 If successful patients avoid having to get IVF, which can cost over $10,000.
Patient will start an antibiotic two days prior to the procedure. At the start of the procedure a speculum is placed into the vagina and the cervix is cleaned with a sterile gauze. A small tube is then placed through the patient’s cervix followed by flushing of the uterus and fallopian tubes with the Lipiodol solution.6 The tube is then removed.
Patients may experience mild pain during the procedure, particularly when Lipiodol is introduced into the uterus.7 However, women who have undergone Lipiodol tubal flushing have reported significantly lower levels of procedure-related pain compared to flushing with other contrast dyes (such as water-based dyes).3
Lipiodol Tubal Flushing: Results
Lipiodol tubal flushing significantly increases the chances of pregnancy in women with unexplained infertility.3,6 Moreover, women with endometriosis are also more likely to get pregnant after Lipiodol tubal flushing.3,6 Overall, the results of multiple clinical trials indicate that 40-50% of the patients who undergo Lipiodol tubal flushing go on to achieve pregnancy and maintain it for a long term.7 In patients where Lipiodol tubal flushing alone does not help, using assisted reproductive technology, such as IVF, after Lipiodol flushing has been found to help achieve pregnancy.7
Lipiodol tubal flushing also offers many other additional benefits, as summarized below:
- The risk of complications associated with Lipiodol tubal flushing is quite low.3
- Allergic reactions or anaphylaxis have not been observed in clinical trials.7
- The risk of multiple pregnancies is also low compared to other infertility treatment methods such as IVF.3
However, it is important to note that the success of Lipiodol tubal flushing may vary depending on the specific cause of infertility and the individual patient's condition.
Overall, Lipiodol tubal flushing is a simple, non-invasive, well-tolerated and effective method to treat unexplained female infertility as well as infertility due to endometriosis. If you are suffering from unexplained infertility or endometriosis-related infertility, contact us today to discuss Lipiodol tubal flushing as a treatment option.
Why Choose Our Specialist for Fallopian Tube Flushing?
Our doctor is an image-guided specialist having performed over 5,000 image-guided procedures. He not only performs fallopian tube flushing but also treats blocked fallopian tubes. Our staff is also highly experienced with patients in this setting who are looking to get pregnant.
We have a high success rate at CVI not only because our physician is expertly skilled but also because we provide the physician with the best tools needed to treat fallopian tubes. We have a long-standing relationship and purchase directly from the manufacturer of Lipiodol. You can rest assured that at CVI we do not cut corners and only purchase the best and highest quality tools that our specialist requires.
1.Saeed, Y. and Liu, X., 2022. Mesenchymal stem cells to treat female infertility; future perspective and challenges: A review. International Journal of Reproductive BioMedicine (IJRM), pp.709-722.
3.Johnson, N.P., 2005. A review of the use of Lipiodol flushing for unexplained infertility. Treatments in Endocrinology, 4, pp.233-243.
4.Zhao, Y.X., Chen, S.R., Su, P.P., Huang, F.H., Shi, Y.C., Shi, Q.Y. and Lin, S., 2019. Using mesenchymal stem cells to treat female infertility: an update on female reproductive diseases. Stem Cells International, 2019.
5.Mustafa, M., Sharifa, A.M., Hadi, J., IIIzam, E. and Aliya, S., 2019. Male and female infertility: causes, and management. IOSR Journal of Dental and Medical Sciences, 18, pp.27-32.
6.Johnson, N.P., Farquhar, C.M., Hadden, W.E., Suckling, J., Yu, Y. and Sadler, L., 2004. The FLUSH trial—flushing with Lipiodol for unexplained (and endometriosis-related) subfertility by hysterosalpingography: a randomized trial. Human Reproduction, 19(9), pp.2043-2051.
7.Sekhon, J., Lee, E., Lo, G., Woolcock, J., Ramkrishnan, J., Menezes, M., Tan, S., Meagher, S. and Murphy, A., 2020. Lipiodol flush under ultrasound guidance in Australia. Australian and New Zealand Journal of Obstetrics and Gynaecology, 60(6), pp.965-969.
8.Lindequist, S., Justesen, P., Larsen, C. and Rasmussen, F., 1991. Diagnostic quality and complications of hysterosalpingography: oil-versus water-soluble contrast media–a randomized prospective study. Radiology, 179(1), pp.69-74.
The above information explains what is involved and the possible risks. It is not meant to be a substitute for informed discussion between you and your doctor, but can act as a starting point for such a discussion.