Journal of the European Society for Gynaecological Endoscopy


Tubal flushing with oil-based contrast during transvaginal hydro laparoscopy, a case report

I. Roest 1,2,3, A.M. Hajiyavand 4, K.D. Dearn 4, M.Y. Bongers 1,3, V. Mijatovic 2, B.W.J. Mol 5, C.A.M. Koks 1

1 Department of Obstetrics and Gynaecology, Máxima MC, Veldhoven/Eindhoven, the Netherlands
2 Department of Reproductive Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Reproduction and Development, Amsterdam, the Netherlands
3 Grow research school for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
4 Mechanical Innovation and Tribology Group, Department of Mechanical Engineering, School of Engineering, University of Birmingham, Birmingham, B15 2TT, UK
5 Department of Obstetrics and Gynaecology, University of Monash, Melbourne, Australia.


Case report, Feasibility, Fertility, Oil-based contrast, Transvaginal hydro-laparoscopy

Published online: Jul 01 2022


Background: Oil-based contrast has been shown to have a fertility-enhancing effect during hysterosalpingography (HSG) but is not yet used during transvaginal hydro laparoscopy (THL).

Objective: To asses if additional tubal flushing with oil-based contrast during THL is feasible.

Materials and methods: Case report with video assessment. A healthy 29-year-old woman with primary unexplained subfertility, underwent a THL under local anaesthesia. First, chromopertubation was performed by methylene blue. Afterwards, tubal flushing with 3mL oil-based contrast (Lipiodol® UltraFluid, Guerbet) was performed.

Main outcome measures: In this case report we evaluated the feasibility of additional tubal flushing with oil- based contrast during THL, in terms of; the visibility of the oil-based contrast at the tubal fimbriae, the pain and acceptability scores.

Results: Both fallopian tubes were patent to methylene-blue as well as to oil-based contrast. Interestingly, the oil-based contrast came out of the fallopian tube in the form of free droplets with strong internal bonding. Furthermore, some residue of the droplets was visible on the surface of the peritoneal wall in the form of oily micro-droplets.

Conclusions: We present the first sub-fertile woman, in which additional tubal flushing with oil-based contrast during THL was performed. It is likely, that the residue of oily micro-droplets is also present inside the fallopian tube, where it may enhance the cilia movement by introducing lubrication. These lubricating characteristics of the oil-based contrast may be important for its fertility-enhancing effect. More research is necessary to confirm this hypothesis and the feasibility of tubal flushing with oil-based contrast during THL in more women.

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