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Background: T-shaped uterus is a subclass of dysmorphic uteri according to the European Society of Human Reproduction and Embryology (ESHRE) classification. A T-shaped uterus might be related to poor reproductive outcomes or pregnancy complications. We aim to compare the success rates of fertilization (IVF) between individuals with a normal uterus and those with a T-shaped uterus identified through Hysterosalpingography.

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Study Question: Does preconceptional exposure to oil-based iodinated contrast media during hysterosalpingography (HSG) impact children's neurodevelopment compared with exposure to water-based alternatives?

Summary Answer: Our study found no large-sized effects for neurodevelopment in children with preconceptional exposure to oil-based iodinated contrast media during HSG compared with water-based alternatives.

What Is Known Already: HSG is widely used as a diagnostic tool in the female fertility work-up. Tubal flushing with oil-based iodinated contrast has been shown to enhance fertility outcomes in couples with unexplained infertility, increasing the chances of pregnancy and live birth compared with water-based alternatives.

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Background: Tubal diseases contribute significantly to secondary infertility, affecting 25-35% of couples seeking infertility treatment. Traditional methods for assessing tubal patency, such as laparoscopy and dye tests, are invasive, costly, and require specialized expertise. Hysterosalpingography (HSG) is an alternative, but it involves pain and radiation exposure.

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Background: Uterine cavity pathology may affect the endometrium or myometrium, resulting in distortion of the uterine cavity, and is responsible for 2%-5% of infertility. The methods for its assessment usually involve imaging modalities like pelvic ultrasonography, often transvaginal-(TVS), and hysterosalpingography-(HSG), with hysteroscopy-(HSC) as the gold standard. However, HSC is not readily available in resource-poor-settings.

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