Medical Trial Finds Effective Alternative to IVF

By Patrick Goodenough | July 7, 2008 | 8:14pm EDT

Pacific Rim Bureau ( - A medical trial in New Zealand has established the effectiveness of a simple, inexpensive treatment for certain cases of human infertility. The treatment also offers an alternative to couples who have ethical concerns about the in-vitro fertilization (IVF) option.

Researchers in Auckland have found that flushing a special liquid through the reproductive organs of women with "unexplained infertility" or mild endometriosis - a problem affecting the womb lining -- significantly increases their chances of conceiving.

Unexplained infertility is the diagnosis given when the usual causes of infertility, such as the male factor or ovulation problems, have been ruled out but the cause remains unknown. Between 10 and 20 percent of infertility cases fall into that category.

Of 73 women in the study who received the treatment, 38 percent became pregnant within the following six months, compared to 16 percent in a similarly-sized control group -- women who received no treatment but continued to try for a baby.

The study leader, Dr. Neil Johnson of Auckland University, said Tuesday the results were "very, very exciting."

What was noteworthy, he said, was that the women with mild endometriosis benefited especially from the treatment. They were four-and-a-half times more likely to become pregnant than their counterparts in the control group.

Women with unexplained infertility were two times more likely to conceive than their counterparts in the control group.

The treatment entails having lipiodol, an oil-based medium used in x-rays, flushed through a woman's fallopian tubes and uteruses.

Johnson said it evidently was most effective in women with unexplained infertility or mild endometriosis, whose fallopian tubes had been found to be normal and unblocked, with no history of ectopic pregnancy, and no iodine allergy.

"The beauty of this is that it's a simple, relatively safe, low-invasive treatment option which might be a more appealing option than the high-tech or expensive fertility treatment option for some couples," he said.

The study is now complete and the researchers presented their findings at a regional obstetricians' and gynecologists' conference last week.

Johnson said they have now received approval from an ethics committee to offer the treatment more widely.

"They see no ethical objections for its use now as an innovative treatment in appropriately-selected patients, so we have that go-ahead and are now offering it [to couples after evaluation.]."

The lipiodol treatment will cost patients less than one-fifth of the amount they would pay for IVF treatment.

IVF offers ethical problems for some, in part because more embryos are usually created than are needed.

The "spares" may be stored for possible use by the parents in the future or be used by researchers for stem cell research, but that method is controversial because the embryo is destroyed in the process.

Some ethicists have argued that IVF, although widely accepted nowadays, gave rise to the "commodification" of human life.

A leading Auckland fertility clinic says its overall success rate for women undergoing IVF is around 38 percent - the same proportion as participants in the lipiodol study who fell pregnant.

One couple who was part of the research study told earlier they tried to have a baby for two-and-a-half years before the lipiodol flush, then conceived less than two months later.

A second couple, both in their 20s, struggled to conceive for a difficult two years - and then succeeded within "several months" of the lipiodol flush.

Lipiodol was formerly used in x-ray dye tests to establish whether fallopian tubes were blocked, but has been replaced by newer, water-soluble liquids.

In the Auckland treatment, a small amount of the liquid is inserted through the vagina and moves through the uterus and the fallopian tubes.

Johnson said earlier it remained unclear why the lipiodol is effective, but he thought it likely that the liquid prompted "some type of reaction from the body's immune cells that could enhance the likelihood of either fertilization or implantation of an embryo."

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