Gel group: surgery with intrauterine instillation of hyaluronic acid gel
Control group: surgery alone
Office hysteroscopy was planned at 6 to 8 weeks after surgery
Follow-up fertility surveys were sent at 6 months and 1 year after the end of the intervention
Rate of IUAs during the follow-up hysteroscopy
Gel group: 144 patients | Control group: 134 patients
The rate of IUAs was lower in the gel group than in the control group
Among the 110 responders to the surveys, the pregnancy rate after surgery was similar between the groups
For women undergoing D&C for miscarriage, instillation of hyaluronic acid gel reduced the rate of moderate to severe intrauterine adhesions by approximately 50%
Impact on fertility remains uncertain and requires an RCT with fertility as the primary objective
The authors state
As a first step, it may be reasonable to instill gel after surgery in patients who had a miscarriage and who present risk factors for IUAs, such as patients with infertility or those undergoing assisted reproductive technology
In this kind of population, a decrease of the rate of IUAs by half would be a considerable advantage
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