Childless couples offered new hope

By MARTIN JOHNSTON health reporter

Auckland medical researchers are holding out new hope for couples unable to have babies for unknown reasons.

In a study of unexplained infertility, National Women's Hospital specialists are flushing some women's internal reproductive organs with a liquid used in taking x-rays.

Of 15 women who have received the treatment, about five have become pregnant and at least one has given birth.

Study leader Dr Neil Johnson said yesterday that the treatment offered an exciting possibility for treating unexplained infertility.

"It would be a massive breakthrough in treating infertility as it is a less costly, less invasive option than other fertility treatments, such as IVF [in-vitro fertilisation] and there is no increased risk of multiple pregnancies," he said.

Dr Johnson said the preliminary results were promising, but the study had a long way to go.

Thousands of couples suffer from unexplained infertility. A sixth of couples have a fertility problem and in up to a quarter of those the cause is not known.

The study involves flushing some women's fallopian tubes with an oil-soluble substance called lipiodol.

The fallopian tubes extend from the uterus to the ovaries. They transport eggs and sperm and are where fertilisation occurs.

Lipiodol is a dye used in taking x-rays of the fallopian tubes, although it largely has been replaced by water-soluble dyes and laparoscopy - investigation with a tiny surgical camera mounted on a tube.

Dr Johnson said lipiodol flushing as an infertility treatment was the rebirth of an old idea.

"For a long time, GPs and gynaecologists have had a hunch that women, after they had their fallopian tubes tested - and that was done by flushing - may stand an increased chance of conceiving in the few months afterwards."

The role of lipiodol was unclear but there were several theories, including that the flushing action removed debris in the tubes that was impeding eggs or sperm.

But the National Women's laboratory was investigating whether lipiodol caused changes in the cells of the endometrium, the uterine lining, which made it receptive to an embryo.

Only 30 of the hoped-for 150 women have been enrolled in the study. Half are randomly selected to receive no treatment and none in this group has had a successful pregnancy.

Dr Johnson said the study's one-in-three pregnancy rate mirrored the results of small trials overseas. This rate might be as good as or better than the rate for IVF. Lipiodol flushing cost several hundred dollars, compared with at least $5000 for one cycle of IVF.

Another fertility specialist, Dr Richard Fisher, said his clinic, Fertility Associates, was trying to recruit participants for the lipiodol study.

"If something like the lipiodol study works, it would be a very attractive treatment to a significant number of people," he said.

But it was impossible to state what the study showed until far more than 30 women had taken part.

It was difficult to recruit couples with unexplained infertility to such a study because many feared they might be wasting valuable time receiving no treatment.

* Couples interested in taking part in the study can call National Women's on (09) 630-9943, extension 3235.