Johnson Neil P
University of Auckland and Fertility Plus, National Women's Hospital, Auckland Gynaecology Group, Auckland, New Zealand.
Treat Endocrinol. 2005;4(4):233-43. doi: 10.2165/00024677-200504040-00004.
There has been speculation for decades regarding the role of flushing women's fallopian tubes in improving the chance of pregnancy. More recent evidence has highlighted a possible specific role for lipiodol (ethiodized oil), an oil-soluble contrast medium, in the enhancement of fertility by these means. This systematic review was designed to assess the effectiveness of tubal flushing with various contrast media in improving the chance of pregnancy. The review was performed using Cochrane guidelines, including only data from randomized controlled trials. Results confirm the effectiveness of flushing with lipiodol in improving the chance of pregnancy and live birth. Although there was limited evidence to suggest a possible benefit of oil- over water-soluble contrast media, the answer to this question remains unclear. The specific groups who appear to benefit most from lipiodol flushing are couples with unexplained infertility, but particularly couples where the woman has endometriosis in the context of normal patent fallopian tubes. As a simple, low-cost, minimally invasive intervention that carries a low risk of complications and no increased risk of multiple pregnancy, lipiodol flushing may prove an appealing alternative to established fertility treatments for many couples.
数十年来，人们一直在猜测冲洗女性输卵管对提高怀孕几率的作用。最近的证据凸显了脂溶性造影剂碘油（乙碘油）在通过这些方法提高生育能力方面可能具有的特定作用。本系统评价旨在评估使用各种造影剂进行输卵管冲洗对提高怀孕几率的有效性。该评价按照Cochrane指南进行，仅纳入随机对照试验的数据。结果证实，用碘油冲洗在提高怀孕几率和活产几率方面是有效的。尽管证据有限，提示油溶性造影剂可能比水溶性造影剂更具优势，但这个问题的答案仍不明确。似乎从碘油冲洗中获益最大的特定人群是不明原因不孕的夫妇，尤其是女性输卵管通畅但患有子宫内膜异位症的夫妇。作为一种简单、低成本、微创的干预措施，并发症风险低且不会增加多胎妊娠风险，碘油冲洗可能对许多夫妇来说是现有生育治疗方法的一个有吸引力的替代方案。
