Effect of X-ray exposure during hysterosalpingography on capabilities of female germ cells

• Published in: Journal of Assisted Reproduction and Genetics Vol. 38; no. 12; pp. 3233 - 3242
• Main Authors: Matsumoto, Hiroshi, Fukuda, Aisaku, Mizuno, Satoshi, Hashimoto, Shu, Morimoto, Yoshiharu
• Format: Journal Article
• Language: English
• Published: New York Springer Science and Business Media LLC 01.12.2021; Springer US; Springer Nature B.V
• Subjects: Adult; Birth Rate; Blastocyst; Blastocyst - radiation effects; Embryonic Development; Embryonic Development - radiation effects; Female; Fertilization in Vitro; Fertilization in Vitro - radiation effects; Germ cells; Gynecology; Human Genetics; Humans; Hysterosalpingography; Hysterosalpingography - adverse effects; In vitro fertilization; Laboratories; Live Birth; Male; Medicine; Medicine & Public Health; Oocyte Retrieval; Oocyte Retrieval - methods; Oocytes; Oocytes - radiation effects; Ovulation Induction; Ovulation Induction - methods; Pregnancy; Pregnancy Rate; Reproductive Medicine; Reproductive organs; Reproductive Physiology and Disease; Statistical analysis; X-Rays; X-Rays - adverse effects; IVF; Embryonic development; X-ray exposure; Hysterosalpingography
• ISSN: 1058-0468; 1573-7330; 1573-7330
• DOI: 10.1007/s10815-021-02347-2

Purpose To elucidate the effect of X-ray exposure during hysterosalpingography (HSG) on subsequent laboratory outcomes in in vitro fertilization (IVF). Methods A total of 1458 oocytes, consisting of 990 oocytes retrieved from 70 women (89 cycles) who underwent HSG prior to IVF and 468 oocytes from 45 women (57 cycles) who underwent IVF without HSG, were evaluated for their retrieval number, maturity, fertilization, and development post fertilization. X-ray exposure during HSG was recorded as reference air kerma (RAK) (mGy). Subjects were stratified according to the amount of RAK (Nil: IVF without HSG, L-RAK: RAK < 16.23, mH-RAK: RAK ≥ 16.23). The number of oocytes retrieved, oocyte maturation, fertilization, and embryo development was compared among 3 groups. Further, multivariate analyses were performed to investigate the effect of X-ray exposure on laboratory outcomes in IVF. Results There was a statistically significant difference in the fertilization rate among 3 groups (Nil: 71.6%, L-RAK: 80.5%, mH-RAK: 78.3%). The good-quality blastocyst rate in mH-RAK (46.2%) was significantly higher than L-RAK (35.3%) and Nil (32.4%). Multivariate analyses revealed that X-ray exposure was associated with higher fertilization, higher blastocyst development, and higher good-quality blastocyst development rates with adjustment for patient age, BMI, ovarian stimulation types, and fertilization methods. Association between X-ray exposure and the number of oocytes retrieved, and oocyte maturation was not confirmed. Conclusions The present study suggests that X-ray exposure of the female reproductive organs during HSG could enhance the potential of oocytes rather than adversely.