The therapeutic effect of hysterosalpingography in couples with unexplained subfertility: a post-hoc analysis of a prospective multi-centre cohort study

K. Dreyer, R. van Eekelen, R. I. Tjon-Kon-Fat, J. W. van der Steeg, P. Steures, M. J. C. Eijkemans, F. van der Veen, P. G. A. Hompes, B. W. J. Mol, N. van Geloven

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Research question: Hysterosalpingography (HSG) with an oil-based contrast has been shown to increase ongoing pregnancy rates compared with HSG with water-based contrast, but it remains unclear if an effect of HSG occurs compared with no HSG. Design: A secondary data-analysis of a prospective cohort study among 4556 couples that presented with unexplained subfertility in 38 clinics in the Netherlands between January 2002 and December 2004. A time-varying Cox regression with inverse probability of treatment weighing was used to analyse ongoing pregnancy rates in women after undergoing the HSG procedure (with the use of either water- or oil-based contrast media) compared with women who did not undergo HSG. Results: The probability of natural conception within 24 months after first presentation at the fertility clinic was increased after HSG, regardless of the type of contrast medium used, compared with no HSG (adjusted hazard ratio 1.48, 95% CI 1.26 to 1.73, corresponding to an absolute increase in 6-month pregnancy rate of +6%). When this analysis was limited to HSGs that were made with water-contrast, the treatment effect remained (adjusted hazard ratio 1.40, 95% CI 1.16 to 1.70). Conclusions: HSG increases the ongoing pregnancy rate of couples with unexplained subfertility compared with no HSG, regardless of the contrast medium used. Results need to be validated in future, preferably randomized, studies.
Original languageEnglish
Pages (from-to)233-239
Number of pages7
JournalReproductive BioMedicine Online
Volume38
Issue number2
Early online date2018
DOIs
Publication statusPublished - 1 Feb 2019

Cite this

Dreyer, K. ; van Eekelen, R. ; Tjon-Kon-Fat, R. I. ; van der Steeg, J. W. ; Steures, P. ; Eijkemans, M. J. C. ; van der Veen, F. ; Hompes, P. G. A. ; Mol, B. W. J. ; van Geloven, N. / The therapeutic effect of hysterosalpingography in couples with unexplained subfertility: a post-hoc analysis of a prospective multi-centre cohort study. In: Reproductive BioMedicine Online. 2019 ; Vol. 38, No. 2. pp. 233-239.
@article{423ade7dcf4b4975879c29afdc9f136d,
title = "The therapeutic effect of hysterosalpingography in couples with unexplained subfertility: a post-hoc analysis of a prospective multi-centre cohort study",
abstract = "Research question: Hysterosalpingography (HSG) with an oil-based contrast has been shown to increase ongoing pregnancy rates compared with HSG with water-based contrast, but it remains unclear if an effect of HSG occurs compared with no HSG. Design: A secondary data-analysis of a prospective cohort study among 4556 couples that presented with unexplained subfertility in 38 clinics in the Netherlands between January 2002 and December 2004. A time-varying Cox regression with inverse probability of treatment weighing was used to analyse ongoing pregnancy rates in women after undergoing the HSG procedure (with the use of either water- or oil-based contrast media) compared with women who did not undergo HSG. Results: The probability of natural conception within 24 months after first presentation at the fertility clinic was increased after HSG, regardless of the type of contrast medium used, compared with no HSG (adjusted hazard ratio 1.48, 95{\%} CI 1.26 to 1.73, corresponding to an absolute increase in 6-month pregnancy rate of +6{\%}). When this analysis was limited to HSGs that were made with water-contrast, the treatment effect remained (adjusted hazard ratio 1.40, 95{\%} CI 1.16 to 1.70). Conclusions: HSG increases the ongoing pregnancy rate of couples with unexplained subfertility compared with no HSG, regardless of the contrast medium used. Results need to be validated in future, preferably randomized, studies.",
author = "K. Dreyer and {van Eekelen}, R. and Tjon-Kon-Fat, {R. I.} and {van der Steeg}, {J. W.} and P. Steures and Eijkemans, {M. J. C.} and {van der Veen}, F. and Hompes, {P. G. A.} and Mol, {B. W. J.} and {van Geloven}, N.",
year = "2019",
month = "2",
day = "1",
doi = "10.1016/j.rbmo.2018.11.005",
language = "English",
volume = "38",
pages = "233--239",
journal = "Reproductive BioMedicine Online",
issn = "1472-6483",
publisher = "Elsevier",
number = "2",

}

Dreyer, K, van Eekelen, R, Tjon-Kon-Fat, RI, van der Steeg, JW, Steures, P, Eijkemans, MJC, van der Veen, F, Hompes, PGA, Mol, BWJ & van Geloven, N 2019, 'The therapeutic effect of hysterosalpingography in couples with unexplained subfertility: a post-hoc analysis of a prospective multi-centre cohort study' Reproductive BioMedicine Online, vol. 38, no. 2, pp. 233-239. https://doi.org/10.1016/j.rbmo.2018.11.005

The therapeutic effect of hysterosalpingography in couples with unexplained subfertility: a post-hoc analysis of a prospective multi-centre cohort study. / Dreyer, K.; van Eekelen, R.; Tjon-Kon-Fat, R. I.; van der Steeg, J. W.; Steures, P.; Eijkemans, M. J. C.; van der Veen, F.; Hompes, P. G. A.; Mol, B. W. J.; van Geloven, N.

In: Reproductive BioMedicine Online, Vol. 38, No. 2, 01.02.2019, p. 233-239.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - The therapeutic effect of hysterosalpingography in couples with unexplained subfertility: a post-hoc analysis of a prospective multi-centre cohort study

AU - Dreyer, K.

AU - van Eekelen, R.

AU - Tjon-Kon-Fat, R. I.

AU - van der Steeg, J. W.

AU - Steures, P.

AU - Eijkemans, M. J. C.

AU - van der Veen, F.

AU - Hompes, P. G. A.

AU - Mol, B. W. J.

AU - van Geloven, N.

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Research question: Hysterosalpingography (HSG) with an oil-based contrast has been shown to increase ongoing pregnancy rates compared with HSG with water-based contrast, but it remains unclear if an effect of HSG occurs compared with no HSG. Design: A secondary data-analysis of a prospective cohort study among 4556 couples that presented with unexplained subfertility in 38 clinics in the Netherlands between January 2002 and December 2004. A time-varying Cox regression with inverse probability of treatment weighing was used to analyse ongoing pregnancy rates in women after undergoing the HSG procedure (with the use of either water- or oil-based contrast media) compared with women who did not undergo HSG. Results: The probability of natural conception within 24 months after first presentation at the fertility clinic was increased after HSG, regardless of the type of contrast medium used, compared with no HSG (adjusted hazard ratio 1.48, 95% CI 1.26 to 1.73, corresponding to an absolute increase in 6-month pregnancy rate of +6%). When this analysis was limited to HSGs that were made with water-contrast, the treatment effect remained (adjusted hazard ratio 1.40, 95% CI 1.16 to 1.70). Conclusions: HSG increases the ongoing pregnancy rate of couples with unexplained subfertility compared with no HSG, regardless of the contrast medium used. Results need to be validated in future, preferably randomized, studies.

AB - Research question: Hysterosalpingography (HSG) with an oil-based contrast has been shown to increase ongoing pregnancy rates compared with HSG with water-based contrast, but it remains unclear if an effect of HSG occurs compared with no HSG. Design: A secondary data-analysis of a prospective cohort study among 4556 couples that presented with unexplained subfertility in 38 clinics in the Netherlands between January 2002 and December 2004. A time-varying Cox regression with inverse probability of treatment weighing was used to analyse ongoing pregnancy rates in women after undergoing the HSG procedure (with the use of either water- or oil-based contrast media) compared with women who did not undergo HSG. Results: The probability of natural conception within 24 months after first presentation at the fertility clinic was increased after HSG, regardless of the type of contrast medium used, compared with no HSG (adjusted hazard ratio 1.48, 95% CI 1.26 to 1.73, corresponding to an absolute increase in 6-month pregnancy rate of +6%). When this analysis was limited to HSGs that were made with water-contrast, the treatment effect remained (adjusted hazard ratio 1.40, 95% CI 1.16 to 1.70). Conclusions: HSG increases the ongoing pregnancy rate of couples with unexplained subfertility compared with no HSG, regardless of the contrast medium used. Results need to be validated in future, preferably randomized, studies.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85058637294&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/30579824

U2 - 10.1016/j.rbmo.2018.11.005

DO - 10.1016/j.rbmo.2018.11.005

M3 - Article

VL - 38

SP - 233

EP - 239

JO - Reproductive BioMedicine Online

JF - Reproductive BioMedicine Online

SN - 1472-6483

IS - 2

ER -