Ioversol vs iopamidol in hysterosalpingography (HSG): Impact on natural pregnancy and assisted reproductive technology (ART) success in secondary infertility

IF 2.5 4区综合性期刊 Q2 MULTIDISCIPLINARY SCIENCES

Journal of Radiation Research and Applied Sciences Pub Date : 2025-09-10 DOI:10.1016/j.jrras.2025.101938

Yangqiu Jin , Ting Zhao

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引用次数: 0

Abstract

Purpose

While Hysterosalpingography (HSG) is pivotal for evaluating tubal patency, it is unclear if the choice between commonly used contrast agents affects fertility outcomes. This study aimed to determine if ioversol and iopamidol differ in their effects on natural pregnancy and subsequent assisted reproductive technology (ART) success rates.

Methods

This retrospective cohort study included 464 women with secondary infertility undergoing HSG (June 2021–May 2024). All patients were followed for 12 months post-HSG to assess outcomes. Patients were grouped based on contrast agent: ioversol (n = 235) or iopamidol (n = 229). Primary outcomes were natural pregnancy and ART success rates. Secondary outcomes included adverse events.

Results

Baseline characteristics were comparable between groups. The ioversol group demonstrated significantly higher cumulative natural pregnancy rates at 6 months (55.32 % vs. 37.50 %, P = 0.019), clinical pregnancy rates (47.66 % vs. 35.37 %, P = 0.007), and live birth rates (42.55 % vs. 32.75 %, P = 0.029). Ioversol also improved intrauterine insemination [IUI] outcomes (clinical pregnancy: 23.17 % vs. 10.13 %, P = 0.027), but vitro fertilization/intracytoplasmic sperm injection [IVF/ICSI] results were similar. The differential benefit in IUI but not IVF/ICSI suggests the effect is primarily localized to the tubal-uterine environment. Multivariate analysis confirmed ioversol use as an independent predictor for achieving natural pregnancy (odds ratio [OR]: 0.476; 95 % confidence interval [CI]: 0.322–0.704; P = 0.003). Adverse event rates were comparable (5.96 % vs. 9.17 %, P = 0.190).

Conclusion

Our findings suggest that ioversol may be more effective than iopamidol in improving natural pregnancy rates and IUI outcomes in women with secondary infertility undergoing HSG. Despite this study has retrospective and single-center limitations, our study provides valuable insights into the potential benefits of ioversol for enhancing fertility outcomes and suggests that clinical guidelines should consider recommending ioversol to optimize outcomes in secondary infertility.

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子宫输卵管造影（HSG）中Ioversol vs iopamidol：对继发性不孕症自然妊娠和辅助生殖技术（ART）成功的影响

目的虽然子宫输卵管造影（HSG）是评估输卵管通畅的关键，但目前尚不清楚常用造影剂的选择是否会影响生育结果。本研究旨在确定ioversol和iopamidol对自然妊娠和随后的辅助生殖技术（ART）成功率的影响是否不同。方法回顾性队列研究纳入464例继发性不孕症患者（2021年6月- 2024年5月）行HSG手术。所有患者在hsg后随访12个月以评估结果。患者根据造影剂进行分组：ioversol （n = 235）或iopamidol （n = 229）。主要结局为自然妊娠和ART成功率。次要结局包括不良事件。结果两组间基线特征具有可比性。ioversol组6月龄累积自然妊娠率（55.32% vs. 37.50%, P = 0.019）、临床妊娠率（47.66% vs. 35.37%, P = 0.007）和活产率（42.55% vs. 32.75%, P = 0.029）均显著高于ioversol组。Ioversol也改善了宫内人工授精（IUI）的结果（临床妊娠：23.17% vs. 10.13%, P = 0.027），但体外受精/胞浆内单精子注射（IVF/ICSI）的结果相似。IUI而非IVF/ICSI的不同益处表明，效果主要局限于输卵管-子宫环境。多因素分析证实，使用ioversol是实现自然妊娠的独立预测因子（优势比[OR]: 0.476； 95%可信区间[CI]: 0.322-0.704; P = 0.003）。不良事件发生率具有可比性（5.96%比9.17%,P = 0.190）。结论在继发性不孕症输卵管输卵管移植患者中，ioversol可能比iopamidol更有效地提高自然妊娠率和IUI结果。尽管这项研究具有回顾性和单中心局限性，但我们的研究为ioversol在提高生育结果方面的潜在益处提供了有价值的见解，并建议临床指南应考虑推荐ioversol来优化继发性不孕症的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Radiation Research and Applied Sciences MULTIDISCIPLINARY SCIENCES-

自引率

5.90%

发文量

130

审稿时长

16 weeks

期刊介绍： Journal of Radiation Research and Applied Sciences provides a high quality medium for the publication of substantial, original and scientific and technological papers on the development and applications of nuclear, radiation and isotopes in biology, medicine, drugs, biochemistry, microbiology, agriculture, entomology, food technology, chemistry, physics, solid states, engineering, environmental and applied sciences.