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https://hdl.handle.net/2440/134539
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Type: | Journal article |
Title: | Transvaginal hydrolaparoscopy versus hysterosalpingography in the work-up for subfertility: a randomized controlled trial |
Author: | van Kessel, M.A. Tros, R. van Kuijk, S.M.J. Oosterhuis, G.J.E. Kuchenbecker, W.K.H. Bongers, M.Y. Mol, B.W.J. Koks, C.A.M. |
Citation: | Reproductive Biomedicine Online, 2021; 43(2):239-245 |
Publisher: | Elsevier |
Issue Date: | 2021 |
ISSN: | 1472-6483 1472-6491 |
Statement of Responsibility: | Mianne van Kessel, Rachel Tros, Sander van Kuijk, Jur Oosterhuis, Walter Kuchenbecker, Marlies Bongers, Ben Willem Mol, Carolien Koks |
Abstract: | Research question: Is transvaginal hydrolaparoscopy (THL) non-inferior to hysterosalpingography (HSG) as a first-line tubal patency test in subfertile women in predicting the chance of conception leading to live birth? Design: A multicentre, randomized controlled trial in four teaching hospitals in the Netherlands, which randomized subfertile women scheduled for tubal patency testing to either THL or HSG as a first-line tubal patency test. The primary outcome was conception leading to live birth within 24 months after randomization. Results: A total of 149 women were randomized to THL and 151 to HSG. From the intention-to-treat population, 83 women from the THL group (58.5%) conceived and delivered a live born child within 24 months after randomization compared with 82 women (55.4%) in the HSG group (difference 3.0%, 95% CI –8.3 to 14.4). Time to conception leading to live birth was not statistically different between groups. Miscarriage occurred in 16 (11.3%) women in the THL group, versus 20 (13.5%) women in the HSG group (RR = 0.66, 95% CI 0.34 to 1.32, P = 0.237), and multiple pregnancies occurred in 12 (8.4%) women in the THL group compared with 19 (12.8%) women in the HSG group (RR = 0.84, 95% CI 0.46 to 1.55, P = 0.58). Ectopic pregnancy was diagnosed in two women in the HSG group (1.4%) and none in the THL group (P = 0.499). Conclusion: In a preselected group of subfertile women with a low risk of tubal pathology, use of THL was not inferior to HSG as a first-line test for predicting conception leading to live birth. |
Keywords: | Hysterosalpingography; transvaginal endoscopy; transvaginal hydrolaparoscopy; tubal pathology; tubal testing; TVE |
Rights: | © 2021 Published by Elsevier Ltd on behalf of Reproductive Healthcare Ltd. |
DOI: | 10.1016/j.rbmo.2021.04.019 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/GNT1176437 |
Published version: | http://dx.doi.org/10.1016/j.rbmo.2021.04.019 |
Appears in Collections: | Obstetrics and Gynaecology publications |
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