Comparison of warm and cold contrast media for hysterosalpingography: a prospective, randomized study

Two hundred subjects were randomized to undergo hysterosalpingography (HSG) using a 37C or a roomtemperature contrast medium. The warm medium alleviated the pain and decreased vasovagal episodes during HSG.

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Yi-Yang Zhu, M.D., Ying-Zi Mao, M.D., Wei-Ling Wu, M.D.

Vol 97, Issue 6 , Pages 1405-1409



To compare the use of warm medium and cold medium for alleviating pain and side effects during hysterosalpingography (HSG).


Prospective randomized study.


University hospital.


Two hundred infertile women who needed HSG were recruited from January 2010 to June 2011. The exclusion criteria were acute low reproductive duct infection, known hypersensitivity to iodine, genital bleeding, or malignancy.


Subjects were randomized to undergo HSG using a medium prewarmed to 37°C or a medium at room temperature.

Main Outcome Measure(s):

Incidence of vasovagal episodes and visual analog scale (VAS) pain scores during HSG.


Patients' VAS pain scores during HSG were significantly lower in the warm media group initially but showed no statistical difference at 30 minutes after injection. Medium temperature showed a linear association with VAS score. The total number of vasovagal episodes was higher in the cold medium group.


Warm contrast medium alleviates the pain associated with HSG and decreases the incidence of vasovagal episodes during HSG.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.