水溶性碘油造影剂子宫输卵管造影后与生育结局相关的碘和其他因素：一项前瞻性队列研究。

Iodine and other factors associated with fertility outcome following oil-soluble contrast medium hysterosalpingography: a prospective cohort study.

机构信息

Liggins Institute, University of Auckland, Auckland, New Zealand.

Starship Children's Hospital, Health New Zealand | Te Whatu Ora, Auckland, New Zealand.

出版信息

Front Endocrinol (Lausanne). 2024 Jun 20;15:1257888. doi: 10.3389/fendo.2024.1257888. eCollection 2024.

DOI:10.3389/fendo.2024.1257888

PMID:38974579

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11224778/

Abstract

OBJECTIVE

To examine factors associated with fertility following hysterosalpingography (HSG) using an oil-soluble contrast medium (OSCM).

DESIGN

In a prospective cohort study on 196 women undergoing OSCM HSG, we showed that iodine excess was almost universal (98%) and mild subclinical hypothyroidism was frequent (38%). Here, we report the analyses of secondary outcomes examining factors associated with the likelihood of pregnancy following the HSG.

SETTING

Auckland, New Zealand (2019-2021).

SAMPLE

196 women with primary or secondary infertility who underwent OSCM HSG.

METHODS

Baseline and serial urine iodine concentrations (UIC) and thyroid function tests were measured over six months following the HSG. Pregnancy and treatment with levothyroxine during the study period were documented.

RESULTS

Following OSCM HSG, pregnancy rates were 49% in women aged <40 years (77/158) but considerably lower (16%) among those ≥40 years (6/38). Similarly, live birth rates were markedly lower in women ≥40 years (17%; 1/6) versus <40 years (73%; 56/77). 29% of participants were iodine deficient at baseline despite advice recommending iodine fortification. Following HSG, the likelihood of pregnancy in women with moderate iodine deficiency was 64% higher than in women with normal iodine levels (p=0.048). Among women aged <40 years who had subclinical hypothyroidism (n=75), levothyroxine treatment was associated with higher pregnancy rates compared to untreated women [63% (26/48) vs 37% (10/27), respectively; p=0.047].

CONCLUSION

OSCM HSG was associated with higher pregnancy rates in women ≤40 than in those aged >40 years. Iodine deficiency was relatively common in this cohort, and increased iodine levels from OSCM exposure may contribute to the improved fertility observed with this procedure.

TRIAL REGISTRATION

This study is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR: 12620000738921) https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000738921.

摘要

目的

使用油溶性造影剂（OSCM）检查子宫输卵管造影（HSG）后与生育相关的因素。

设计

在对 196 名接受 OSCM HSG 的女性进行的前瞻性队列研究中，我们发现碘过量几乎是普遍的（98%），且轻度亚临床甲状腺功能减退症很常见（38%）。在这里，我们报告了分析次要结局的结果，这些结果检查了与 HSG 后怀孕可能性相关的因素。

地点

新西兰奥克兰（2019-2021 年）。

样本

196 名原发性或继发性不孕的女性，她们接受了 OSCM HSG。

方法

在 HSG 后六个月内测量基线和连续尿碘浓度（UIC）和甲状腺功能检查。在研究期间记录了怀孕和左旋甲状腺素治疗情况。

结果

在接受 OSCM HSG 后，年龄<40 岁的女性妊娠率为 49%（77/158），而年龄≥40 岁的女性妊娠率明显较低（16%）（6/38）。同样，年龄≥40 岁的女性活产率明显低于年龄<40 岁的女性（17%，1/6 比 73%，56/77）。尽管建议强化碘，但仍有 29%的参与者在基线时碘缺乏。HSG 后，碘中度缺乏的女性怀孕的可能性比碘正常水平的女性高 64%（p=0.048）。在年龄<40 岁且患有亚临床甲状腺功能减退症的女性中（n=75），与未接受治疗的女性相比，左甲状腺素治疗与更高的妊娠率相关[63%（26/48）比 37%（10/27），p=0.047]。