Conception Soon After Hysterosalpingography Linked to Lower Neurodevelopmental Scores in babies: Study

To understand the impact of preconception iodine exposure on neurodevelopment in a systematic manner, researchers have studied the school-aged children whose mothers were enrolled in the randomized controlled clinical trial study H2Oil (NCT05168228). The exposed group included children who were conceived six months after HSG, with either an oil-based contrast medium containing iodine at 480 mg/mL or a water-based contrast medium containing iodine at 250 mg/mL. In order to perform the comparison, investigators recruited a control group of healthy children, who were of comparable age, sex, and parent educational status, but were conceived naturally without fertility treatment (NTR9574).

Child IQ, behavior characteristics, and academic achievement were considered as the main outcome parameters. While special neuropsychological domains were assessed as secondary endpoints. Researchers have employed multivariate linear regression models fully adjusting for age, sex, and parent education status and applying false discovery rate correction to prevent artificial increase in statistical results. Also, the statistical team analyzed timing subgroups considering the number of weeks from the maternal HSG procedure to conception (less than four weeks, four to twelve weeks, and more than twelve weeks after HSG) by polynomial contrasts.

Key findings:

• The subsequent evaluation of the neurodevelopmental outcome was able to assess 69 children who were born 6 months after the maternal HSG and 44 children in the unexposed control group.
• The children who were conceived 6 months after the maternal HSG had lower mean IQ of 104.3 than the unexposed control group with a high mean IQ of 113.1, and this provided an adjusted estimate of –6.81 (95% CI, –10.97 to –2.65; p = 0.02).
• The children who were exposed to the test showed significantly low scores in information processing and attention control, and this resulted in an adjusted difference of –0.52 standard deviations (95% CI, –0.84 to –0.19; p = 0.02).
• There were no significant differences observed in behavior and academic performance.

In conclusion, it is necessary to carry out further research using large enough and well-powered cohorts to understand what possible consequences of exposure to HSG with iodinated contrast can have on neurodevelopmental outcomes of their children. This in vivo statistical data provides an essential empirical basis for contemporary reproductive safety and proves the need for thorough examination of preconception diagnostics instruments.

Reference:

Sarai M Keestra, Cece C Kooper, Nienke van Welie, Kim Dreyer, Rik van Eekelen, Tessa J Roseboom, Jaap Oosterlaan, Ben Willem Mol, Cornelieke Aarnoudse-Moens, Martijn J J Finken, Velja Mijatovic, Marsh Königs, Children's neurodevelopment at school age after hysterosalpingography with iodinated contrast: a cohort study, The Journal of Clinical Endocrinology & Metabolism, 2026;, dgag264, https://doi.org/10.1210/clinem/dgag264