Objective: Investigation of the effects of liposoluble / watersoluble contrast media used in hysterosalpyngography on fertility in unexplained infertility cases.

Material and Method: Sixty primary or secondary infertile cases diagnosed as unexplained infertility were retrieved from the entire infertility cases admitted between June 1998 –March 2001 and they were analyzed by randomized, prospective, single blinded method and classified as the study group (G1=n:30, Lipiodol) and the control group (G2=n:30, Urovision). Hysterosalpyngography was provided two days after the end of menses. The patients who were diagnosed as unexplained infertility and with normal basal clinical and laboratory investigations for infertility have been just monitered for over three months after hysterosalpyngography was done. They were suggested to return back when menstruation delay occur. If pregnancy not achieved over 3 months patients directed for ovulation induction with clomiphene citrate + intrauterine insemination. Statistically Student T test, Mann Whitney U test and X² were used for continous, ordinal and nominal data, respectively. P value<0.05 was found significant and relative risk (%95 CI) was calculated.

Results: Rate of pregnancy was found to be 43.7% in study group whereas 10% in control group (p=0.007, X² test, RR=4, %95 CI=1.3-13). Lipiodol is more efficacious in secondary infertility cases and pregnancy rate was 55% in comparison to 5% (p=0.001, X²test, RR=11, %95 CI=1.5-77). No complication (vasovagal reaction, seizure, anaphylaxis, intravasation, embolus) was encountered during hysterosalpyngography. One secondary infertile case who was excluded from the study due to the failure of bilateral tubal passage during lipiodol hysterosalpingograpy; therefore not considered as an unexplained case .

Conclusion: Liposoluble contrast media used in infertility cases during hysterosalpyngography increase the rate of pregnancy significantly in respect to water soluble agents. This effect is much obvious particularly in secondary infertility cases. Use of liposoluble media can be proposed in unexplained cases.