Auto-Cross Linked Hyaluronan Gel Enhances Effects of Hysteroscopic Adhesiolysis Treatment in Patients with Moderate to Severe Intrauterine Adhesions

Abstract

Yuhua Zeng, Wei Ran, Li Lan, Aiping Wen, Qingqing Xiong, Lingbin Si, Min Yong

Background: Moderate to severe intrauterine adhesions affect women’s reproductive and mental health. Hysteroscopic surgery alone cannot improve the prognosis of IUA patients. The present study was to analyse whether auto-cross linked hyaluronan gel facilitates the hysteroscopic adhesiolysis treatment effect and reproductive performance of patients with moderate to severe IUA.
Methods: Patients with moderate to severe IUA and fertility desire were included in this retrospective study. A total of 47 patients received standard hysteroscopic adhesiolysis alone served as control group. A total of 38 patients received cHA gel injection at the end of hysteroscopic adhesiolysis were were included in the treatment group. The IUA recurrence rate, endometrial thickness, AFS score, clinical pregnancy rate, and live birth rate were analysed.
Results: The endometrial thickness (6.33±1.160 vs. 5.72±1.16 mm, P=0.029), clinical pregnancy rate [51.7 (26/42) vs. 14.29% (5/35); P=0.000) and live birth rate (36.2 vs.13.2%; P=0.000) were significantly higher in the treatment group compared with the control group, and the American Fertility Society score (P=0.018) was lower in the treatment group compared with the control group.
Conclusion: The combination therapy of cHA gel plus hysteroscopic adhesiolysis in patients with moderate to severe IUA resulted in a better outcome in decreasing the severity of IUAs, and improving the quality of endometrium and enhancing the live birth rate compared with hysteroscopic adhesiolysis alone.
Trial Registration: Clinical trial register number ChiCTR2100051670. Date of Retrospectively registered on September 30, 2021.

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