Meryem KURU PEKCAN, Ayşe Seval ERDİNÇ, AYTEKİN TOKMAK, Ali İrfan GÜZEL, Gülçin YILDIRIM, MÜZEYYEN GÜLNUR ÖZAKŞİT, Yaprak ENGİN ÜSTÜN

İnfertil kadınlarda ioheksol kullanılarak yapılan histerosalpingografi tetkiki sonrası tiroid fonksiyonlarının değerlendirilmesi

Giriş ve Amaç: Suda çözünen non–iyonik radyoopak madde olan ioheksol (OmnipaqueTM) kullanılarak çekilen histerosalpingografi (HSG) öncesi ve sonrası serum serbest T3 (triiodotironin), serbest T4 (tiroksin) ve TSH düzeylerindeki değişiklikleri araştırmak.Gereç ve Yöntem: Prospektif olarak tasarlanan bu çalışma Ocak 2015 ve Mart 2015 tarihleri arasında Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi infertilite polikliniğine başvuran 45 infertil ötiroid hastada gerçekleştirildi. Hepatik hastalık, renal yetmezlik ve akut enfeksiyonu olan hastalarla tiroid hastalığı öyküsü olan ve lityum, amiadaron ve glukokortikoid gibi antitiroid ilaç kullanan hastalar çalışma dışında bırakıldı. Menstrüasyonları tamamlanan ve gebe olmadıkları gösterilen tüm hastaların HSG öncesi ve HSG sonrası 1. ayda serum serbest T3, serbest T4 ve TSH düzeyleri ölçüldü. Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 28,3±5,5 (20–40) olarak hesaplandı. İşlem öncesi serbest T3, serbest T4 ve TSH düzeyleri sırasıyla, 3,0±0,4pg/mL, 1,0±0,2 ng/dL, 2,2±1,5 mIU/mL iken işlem sonrası, 3,1±0,3 pg/mL, 0,9±0,8 ng/dL, 1,9±0,9 mIU/mL olarak ölçüldü. Serbest T4 ve TSH düzeylerindeki azalma istatistiksel olarak anlamlı bulunurken (p=0,016, p=0,026), serbest T3’deki azalma istatistiksel olarak anlamsızdı (p=0,083). Sonuç: Her ne kadar yarılanma ömrü dakikalarla sınırlı olsa da ioheksol kullanılarak çekilen HSG sonrası infertil kadınlarda tiroid fonksiyonlarında değişiklik meydana gelmektedir. Bu hastalarda işlem sonrası gelişebilecek tiroid disfonksiyonu akılda bulundurulmalıdır.

Anahtar Kelimeler:

Histerosalpingografi, iyot, kontrast madde, tiroid fonksiyon testi

Evaluation of thyroid functions after hysterosalpingography using iohexol in infertile women

Introduction and Aim: To investigate the changes in serum free T3 (triiodothyronine), free T4 (thyroxine) and TSH levels before and after hysterosalpingography (HSG) using iohexol (Omnipaque ™), a water-soluble non-ionic radiopaque substance. Material and Methods: This prospective study was conducted in 45 infertile euthyroid patients who applied to the infertility polyclinic of Zekai Tahir Burak Women's Health Education and Research Hospital between January 2015 and March 2015. Patients with hepatic disease, renal insufficiency and acute infection, patients with thyroid disease and those using antithyroid drugs such as lithium, amiadarone and glucocorticoid were excluded from the study. Serum free T3, free T4 and TSH levels were measured before HSG and at 1 month after HSG in all patients whose menstruation was completed and who were shown not to be pregnant. Results: The mean age of the patients included in the study was calculated as 28.3 ± 5.5 (20-40). The free T3, free T4 and TSH levels before the procedure were 3,0 ± 0,4 pg / mL, 1,0 ± 0,2 ng / dL, 2,2 ± 1,5 mIU / mL, respectively, 3,1± 0.3 pg / mL, 0.9 ± 0.8 ng / dL, 1.9 ± 0.9 mIU / mL, respectively. While the decrease in free T4 and TSH levels was statistically significant (p = 0.016, p = 0.026), the decrease in free T3 was statistically insignificant (p = 0.083). Conclusion: Though the half-life is limited to a few minutes, changes in thyroid function occur in infertile women after HSG using iohexol. In these patients, thyroid dysfunction which may develop after the procedure should be kept in mind.

Keywords:

Hysterosalpyngography, iodine, contrast agent, thyroid function test,

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