The FLUSH Trial--Flushing with Lipiodol for Unexplained (and endometriosis-related) Subfertility by Hysterosalpingography: a randomized trial

Neil Johnson, N P Johnson, C M Farquhar, W E Hadden, J Suckling, Y Yu, L Sadler
Human Reproduction · 2004 · vol. 19(9) , pp. 2043–2051 · doi:10.1093/humrep/deh418 · PMID:15271870 · W2125897827
article OA: bronze CC0 ⤵ 27 in-corpus citations
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Lipiodol flushing significantly increased pregnancy and live birth rates for women with endometriosis and normal reproductive organs compared to no intervention, but not for women without confirmed endometriosis.

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Abstract

BACKGROUND: To assess the effectiveness of flushing with the oil-soluble contrast medium lipiodol in women with unexplained infertility. METHODS: An open randomized controlled trial design in a single centre secondary and tertiary level infertility service setting. A total of 158 women with unexplained infertility were stratified into two populations: 96 women without confirmed endometriosis and 62 women with endometriosis who had normal Fallopian tubes and ovaries. Randomization was computer-generated, with allocation concealment by opaque sequentially numbered envelopes. Lipiodol flushing was tested versus no intervention. The main outcome measures were clinical pregnancy (assessed at 6 months following randomization) and live birth. RESULTS: Lipiodol flushing resulted in a significant increase in pregnancy [48.0 versus 10.8%, relative risk (RR) 4.44, 95% confidence interval (CI) 1.61-12.21] and live birth (40.0 versus 10.8%, RR 3.70, 95% CI 1.30-10.50) rates versus no intervention for women with endometriosis, although there was no significant difference in pregnancy (33.3 versus 20.8%, RR 1.60, 95% CI 0.81-3.16) or live birth (27.1 versus 14.6%, RR 1.86, 95% CI 0.81-4.25) rates for women with unexplained infertility without confirmed endometriosis. CONCLUSIONS: Lipiodol flushing is an effective treatment for couples with unexplained infertility (based on meta-analysis data), but is particularly effective for women with endometriosis who have normal Fallopian tubes and ovaries.

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Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Endometriosis Infertility, Female Infertility, Female Iodized Oil Adult Endometriosis Female Follow-Up Studies Humans Hysterosalpingography Infertility, Female Iodized Oil Iodized Oil Pregnancy Pregnancy Outcome Pregnancy Rate Therapeutic Irrigation

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