A century-old fertility technique, often regarded as outdated, has been shown to work, representing a cheaper alternative to IVF. The team who verified its validity was led by Professor Ben Mol of the University of Adelaide, who in the course of the work discovered his mother used it after struggling to get pregnant.
In 1917, a procedure known as a hysterosalpingography (HSG) debuted. It involves flushing a woman's fallopian tubes with either water or oil-based solutions that contain a dye that shows up under X-rays. In addition to helping diagnose the causes of infertility, it has been adopted as a treatment for women trying to conceive. However, since the invention of in vitro fertilization (IVF), HSG has become less common and its effectiveness questioned.
Mol reported conception rates in the New England Journal Of Medicine of 1,119 women, who had been deemed infertile after years of trying to conceive, after they were given HSGs with either oil or water. Within six months of the HSG being performed, 29 percent of the women in the water-based group were pregnant, and the figure was almost 40 percent of those treated with Lipiodol® Ultra-Fluid, an iodised poppy seed oil. “Until now, it has been unclear whether the type of solution used in the procedure was influencing the change in fertility," Mol said in a statement.
HSG has been overlooked in recent years partially because the mechanism for its success is not understood. Hand waving about “flushing out” debris that impedes fertility has been unconvincing. The benefits of oil over water are even more mysterious. However, Mol told IFLScience another reason was that “IVF was a new thing, and new things often get introduced without evaluating the old.”
Mol also pointed out to IFLScience that IVF is an inherently expensive operation, allowing a healthy profit margin. HSG, on the other hand, is “a procedure every first year registrar can do.” Competition drives prices down, making fertility clinics unlikely to promote it.
Of course, infertility has varying causes; Mol's studies were done on women under the age of 38. He noted women over 40 are more likely to have problems caused by older eggs than the fallopian tubes. Nevertheless, Mol thinks it may also be worth using even for those also undergoing IVF.
It was only after Mol started investigating the effectiveness of HSG that his mother told him she had undergone a Lipiodol® HSG procedure after nine years of being considered infertile. Mol was born a few years afterwards, and also has 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," Mol said.