89 Safety of HSG with oil-based contrast medium 5 Table 2. Maternal thyroid function after HSG Study design Procedure Thyroid function pre-HSG Outcome Case reports Li et al., 2018 (64) China Oil-based contrast Unknown Fourteen women with increased urinary iodine content: 50% (7/14) (subclinical) hypothyroidism. All neonates tested negative during congenital thyroid screening Sasaki et al., 2017 (93) Japan Oil-based contrast Unknown Case of hypothyroidism, no treatment. Fetal goiter. Ma et al., 2016 (68) China Oil-based contrast 100ml Euthyroid Hyperthyroidism, no treatment, resolved spontaneously after 1.5 months Ishizuki et al., 1992 (54) Japan Lipiodol Graves’ disease Thyroiditis, goitre, treated with steroids for 2 months. Cohorts/RCT So et al., 2017 (101) Japan Lipiodol Max 5ml Euthyroid Oil-based contrast: 22.6% subclinical hypothyroidism after 1–30 days, 24.4% after 31–180 days. Water-based contrast: 9.5% subclinical hypothyroidism after 1–30 days, 3.6% after 31–180 days. Kaneshige et al., 2015 (56) Japan Lipiodol 6.1ml (4.09.0) Euthyroid, 27% goiter palpable 0% hypothyroidism (0/22). 13.6% (3/22) transient subclinical hypothyroidism. Mekaru et al., 2008 (73) Japan Lipiodol 5-10ml 76% euthyroid 12% subclinical hypothyroidism 12% subclinical hyperthyroidism Euthyroid: 4/180 (2.2%) hypothyroidism, 28/180 (15.6%) subclinical hypothyroidism, 2/180 (1.1%) subclinical hyperthyroidism. Subclinical hypothyroidism: 10/28 (35.7%) hypothyroidism, three required thyroid hormone replacement. 1/28 (3.6%) subclinical hyperthyroidism. Subclinical hyperthyroidism: 4/12 (33.3%) normalization, 2/12 (16.7%) unchanged. Slater et al., 1959 (100) USA Lipiodol Clinically euthyroid Oil-based contrast: 80% depression of iodine uptake, increase in protein-bound iodine for 4 months. Water-based contrast: no depression of iodine uptake. Increase in protein-bound iodine for 24–48 h. HSG = hysterosalpingography
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