Comment:The quality of evidence is downgraded by limitations in study quality (unclear allocation concealment, blinding of outcome assessment, and incomplete outcome data) and by imprecise results (limited study size for each comparison).
A Cochrane review included 13 RCTs involving 2 914 participants. Tubal flushing with oil-soluble media versus no intervention (3 trials, n=381) was associated with a significant increase in the odds of live birth (OR 2.98, 95% CI 1.40–6.37) and pregnancy (OR 3.30, 95% CI 2.00–5.43). For the comparison of tubal flushing with oil-soluble media versus water-soluble media the increase in the odds of live birth (OR 1.49, 95% CI 1.05–2.11, n=1483) was based on two trials with heterogeneity and the higher quality trial showed no significant difference in live births or pregnancy. Water-soluble plus oil-soluble media versus water-soluble media alone showed no evidence of a significant difference in the odds of pregnancy (Peto OR 1.28, 95% CI 0.92 to 1.79) or live birth (Peto OR 1.06, 95% CI 0.64 to 1.77). There were no serious adverse event reported.