Dr Jessup at Shire IVF offers women with endometriosis or unexplained infertility the chance to conceive naturally using Lipiodol. Lipiodol flushing is a procedure in which the endometrial cavity and fallopian tubes are flushed with an oil soluble contrast media comprised of iodine containing poppy seed oil. Lipiodol has been used for many decades to check whether a woman’s fallopian tubes open. Dr Jessup has been using lipiodol for over 10 years and has seen remarkable results both for women seeking to conceive naturally and for women with a number of failed embryo transfers.
There is now good quality evidence that oil-soluble contrast media enhances pregnancy rates. The procedure is particularly effective for couples in who have unexplained infertility and when the female partner has endometriosis. Not only does the lipiodol treatment flush out any debris from the fallopian tubes but studies suggest there is may be a “uterine bathing effect” which decreases endometrial inflammation and assists with implantation of embryos.
The FLUSH trial
Flushing with Lipiodol for Unexplained ( and Endometriosis related) Sub-fertility by Hysterosalpinography: a randomised trial, showed that in couples with unexplained infertility, 10% conceived naturally in the following 6 months. What was more interesting was that in the mild endometriosis group the pregnancy rate at six months was 48%.
Further research is needed to understand the mechanisms behind the treatment. In the past it was generally believe that the main effect of lipiodol was to “ flush out” any debris in the fallopian tubes but more recently longstanding beliefs hold that testing a woman’s fallopian tubes could have fertility benefits through ‘flushing out’ the kind of debris that hinders fertility. More recently its appears they’re maybe an additional ‘uterine bathing effect” in which the lipiodol acts on the endometrium to assist in the implantation of embryos. It may be this affect, that is responsible for the increased fertility outcomes in women with mild endometriosis. The Lipidol treatment may also be used for women having an embryo transfer where previous embryo transfers have been unsuccessful.
The procedure can be performed by Dr Jessup in her rooms.
Most people tolerate the flush well and it does not cause any significant discomfort, however you are advised to take some painkillers (two paracetamol) about two hours before. During the procedure, a vaginal speculum is inserted and imaging with a vaginal ultrasound scan is used. A small soft plastic catheter is inserted into the uterine cavity and up to 10ml of the lipiodol oil medium is infused into the uterine cavity under a small amount of pressure. If the fallopian tubes are open, the oil can be seen to flow through the tubes and spill out around the ovaries If they fallopian tubes are blocked, either the uterine cavity or the tubes themselves can be seen on ultrasound to be distended with the oil. This procedure will usually be performed in the first have of the menstrual cycle to ensure the woman is not in the very early stages of a natural pregnancy.
Lipiodol oil contains iodine and such, should not be used in women with an allergy to iodine. it is important to monitor thyroid function after the procedure as some women experience mild clinical hypothyroidism in the short term. To avoid infection, vaginal swabs are taken prior to the procedure or antibiotics are given after the procedure. In general, the lipiodol procedure in safe, effective and minimally invasive.