100-year-old fertility technique reduces need for IVF

May 18, 2017
Ben Mol as a baby (just a few weeks old) with his mother, Annemie Mol-Albers, 1965. Until he embarked on this study, Professor Mol had no idea that he himself was the result of a successful pregnancy following this medical procedure. Credit: Professor Ben Mol, University of Adelaide

Infertile couples have a major opportunity to achieve a successful pregnancy without the need for IVF, thanks to new research into a 100-year-old medical technique.

The now lesser known technique—which involves flushing the woman's with an iodised poppy seed oil—has been proven to have significant benefits for fertility, according to the largest study undertaken by a team involving researchers in the Netherlands and Australia.

The results of the study will today be published in The New England Journal of Medicine. They will also be presented at the 13th World Congress on Endometriosis in Vancouver, Canada, by project leader Professor Ben Mol, from the University of Adelaide's Robinson Research Institute, and a member of the South Australian Health and Medical Research Institute's Healthy Mothers, Babies and Children theme.

Known as the H2Oil study, the project compared the benefits of flushing the fallopian tubes with either an oil-based or water-based solution in 1119 women. With Professor Mol, this work was conducted by Dr Kim Dreyer and Dr Velja Mijatovic from the Department of Reproductive Medicine, VU University Medical Centre, Amsterdam, and a research team from 27 medical centres in the Netherlands.

100-year-old technique

The procedure, known as hysterosalpingography (HSG), is a dye test of the fallopian tubes conducted under X-ray. The procedure was first carried out in 1917, and since the 1950s both water-based and oil-based solutions have been used.

"Over the past century, pregnancy rates among infertile women reportedly increased after their tubes had been flushed with either water or oil during this X-ray procedure. Until now, it has been unclear whether the type of solution used in the procedure was influencing the change in fertility," says Professor Mol, who himself was conceived after his mother underwent such a procedure.

"Our results have been even more exciting than we could have predicted, helping to confirm that an age-old medical technique still has an important place in modern medicine," he says.

Results show clear benefits of oil-based solution

Almost 40% of infertile women in the oil group and 29% of in the water group achieved successful pregnancies within six months of the technique being performed.

The oil-based product used in the study was Lipiodol Ultra-Fluid, an iodised solution of fatty acids from poppy seeds. This product is currently available in 47 countries around the world.

"The rates of successful pregnancy were significantly higher in the oil-based group, and after only one treatment. This is an important outcome for women who would have had no other course of action other than to seek IVF treatment. It offers new hope to infertile couples," Professor Mol says.

The big question: why?

"It was long believed that testing a woman's fallopian tubes could have fertility benefits through 'flushing out' the kind of debris that hinders fertility. The reality is, we still don't really understand why there is a benefit, only that there is a benefit from this technique, in particular for women who don't present with any other treatable fertility symptoms," Professor Mol says.

"Further research would need to be conducted into the mechanisms behind what we're seeing. For now, and considering the technique has been used for 100 years without any known side-effects, we believe it is a viable treatment for infertility prior to couples seeking IVF.

"Not only is there a known benefit, but this flushing procedure is also a fraction of the cost of one cycle of IVF. Considering that 40% of women in the oil-based group achieved a successful pregnancy, that's 40% of couples who could avoid having to go through the huge costs and emotions associated with IVF treatment," he says.

Turning around infertility - a family history

Until he embarked on this study, Professor Mol had no idea that he himself was the result of a successful pregnancy following such a procedure.

In the 1960s, after being considered infertile for nine years, Professor Mol's mother underwent an HSG which, coincidentally, also used Lipiodol. "It was only after I started researching this technique that my family told me what had happened," Professor Mol says.

"My mother went from being infertile for many years to becoming pregnant, and I was born in 1965. I also have a younger brother. So it's entirely possible - in fact, based on our team's research, it's highly likely - that my brother and I are both the result of this helping my mother to achieve fertility."

What can infertile couples do?

"The use of used Lipiodol itself is not currently practiced widely, so the first thing couples need to do is to speak with their doctor about it," Professor Mol says.

"Professional bodies responsible for guidelines, funders of health care, and fertility clinics all have a role to play in assisting to make this intervention available to couples before IVF is started," he says.

This study received no financial assistance from the makers of Lipiodol. Professor Mol's research is supported by the National Health and Medical Research Council (NHMRC).

Explore further: IVF proven unnecessary for many infertile couples

More information: Kim Dreyer et al, Oil-Based or Water-Based Contrast for Hysterosalpingography in Infertile Women, New England Journal of Medicine (2017). DOI: 10.1056/NEJMoa1612337

Related Stories

IVF proven unnecessary for many infertile couples

November 3, 2011
A new study published in European Obstetrics & Gynaecology shows that the DuoFertility monitor and service used for six months gives the same chance of pregnancy as a cycle of in-vitro fertilisation (IVF) for many infertile ...

Blood test for chlamydia may predict pregnancy outcomes

October 19, 2015
A blood test that detects antibodies to the sexually transmitted bacteriumChlamydia trachomatismay be helpful in screening infertile women for pregnancy outcomes, according to a new study.

Couples with obesity may take longer to achieve pregnancy, study suggests

February 3, 2017
Couples in which both partners are obese may take from 55 to 59 percent longer to achieve pregnancy, compared to their non-obese counterparts, according to a study by researchers at the National Institutes of Health.

‘Infertile’ women may just need longer to conceive

February 20, 2012
(Medical Xpress) -- One-in-four women with a history of infertility can still end up having a baby without treatment, a new study from The University of Queensland (UQ) shows.

'Three-parent' baby born in Ukraine using new technique

January 18, 2017
A baby boy has been born in Ukraine to an infertile couple after the first ever use of a new technique using the DNA of three parents, the head of a Kiev fertility clinic said Wednesday.

3 in 10 women able to conceive naturally after infertility treatment

July 25, 2016
Women who have IVF/ICSI infertility treatments have a 29% chance of conceiving naturally within six years of the cessation of treatments. These are the findings of an Internet survey conducted by a group of gynaecologists ...

Recommended for you

Population health impact of infants born small for gestational age in low- and middle-income countries

August 18, 2017
In low-and middle-income countries, it is common for babies to be born of low birth weight, due to either inadequate growth in utero (fetal growth restriction) and/or preterm birth, (birth before 37 weeks gestation). Maternal ...

Hormone from fat tissue can give protection against polycystic ovary syndrome

August 10, 2017
Obesity and reduced insulin sensitivity are common in polycystic ovary syndrome, PCOS. New research based on animal studies, and to be published in the journal PNAS, reveals that the hormone adiponectin can protect against ...

Study in mice may reveal insights into causes of miscarriages for some women

August 9, 2017
Researchers at St. Michael's Hospital have identified how natural killer cells in the mouse placenta can cause a fetus to fail to grow in the womb or cause miscarriages.

Insomnia, sleep apnea nearly double the risk of preterm delivery before 34 weeks

August 9, 2017
Pregnant women who are diagnosed with sleep disorders such as sleep apnea and insomnia appear to be at risk of delivering their babies before reaching full term, according to an analysis of California births by researchers ...

Elective freezing of IVF embryos linked to higher pregnancy rates in some cases

August 1, 2017
A delay in transferring embryos to the mother improves the success of in vitro fertilization in certain cases, according to a study by scientists at the Stanford University School of Medicine, Celmatix Inc. and several other ...

Negative birth outcomes linked to air pollution exposure early in pregnancy, study finds

July 27, 2017
Exposure to air pollution early in a pregnancy could increase risk for preterm birth and low birth weight, according to a study led by researchers at NYU School of Medicine, and published on July 27 in Environmental Health ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.