Cheap, effective alternative to IVF may be possible
Flushing the fallopian tubes has been very successful
The fertility industry could have a strong competitor after a cheap, simple, time-tested fertility remedy has been proved to be even more effective than IVF.
A 100-year-old medical technique which involves flushing the woman's fallopian tubes with an iodised poppy seed oil has been proven to have significant benefits for fertility, according to Australian and Dutch research published in the New England Journal of Medicine.
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.
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.
Almost 40% of infertile women in the oil group and 29% of infertile women 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.
“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. Writing in The Conversation, he noted that the technique has some big advantages over IVF:
Tubal flushing has several advantages over IVF, including that the benefit persists over time, while IVF only helps for the current cycle. Tubal flushing also helps achieve an otherwise natural conception, and its costs are around A$600, a fraction of the cost of a A$10,000 IVF cycle. IVF also has a heavy impact on emotional wellbeing and sometimes causes medical complications.
In our study, 40% of women undergoing HSG with an oil-based contrast achieved a successful pregnancy within six months. That’s 40% of couples with unexplained infertility who could avoid the huge financial and emotional costs associated with undergoing IVF treatment.
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 technique helping my mother to achieve fertility.”
“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 infertile couples to make this intervention available to couples before IVF is started.”
A leading Australian iVF practitioner, Dr David Molloy, dismissed the news, saying that IVF patients have more complex fertility issues. “They are totally different populations of patients,” he told the ABC. “One is a low-risk group starting out at the very start of their infertility journey that have got virtually nothing wrong with them, and our IVF patients are a higher risk group.”
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