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ORIGINAL ARTICLE
Year : 2020  |  Volume : 9  |  Issue : 2  |  Page : 74-80

Comparison of autocross-linked hyaluronic acid gel and intrauterine device for preventing intrauterine adhesions in infertile patients: A randomized clinical trial


1 School of medicine, Shandong University; Center for Reproductive Medicine, Reproductive Hospital Affiliated to Shandong University, Shandong, China
2 Center for Reproductive Medicine, Reproductive Hospital Affiliated to Shandong University; Department of Obstetrics and Gynecology, Binzhou People's Hospital, Shandong, China
3 Center for Reproductive Medicine, Reproductive Hospital Affiliated to Shandong University; Center for Reproductive Medicine, The third affliated hospital of Zheng Zhou University, Jinan, China
4 Center for Reproductive Medicine, Reproductive Hospital Affiliated to Shandong University, Shandong, China
5 Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China

Correspondence Address:
Dr, Chang-Zhong Li
Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan 250000
China
Dr. Lei Yan
Reproductive Hospital Affiliated to Shandong University, 157 Jingliu Road, Jinan 250021
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/GMIT.GMIT_103_19

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Objectives: The objective of this study is to evaluate the efficacy of autocross-linked hyaluronic acid (HA) compared with intrauterine device (IUD) for preventing intrauterine adhesions (IUAs) in infertile patients after hysteroscopic adhesiolysis. Materials and Methods: A randomized clinical trial (ChiCTR-IOR-16007746). Upon completion of adhesiolysis, 3 ml of HA gel was placed into the uterine cavity in Group A; 3 ml of HA gel and an IUD were placed in Group B; and only an IUD was placed in Group C. A second hysteroscopic examination was performed in all patients at approximately 1 month postoperatively for the evaluation of IUA. The primary outcome measure was the effective rate of IUA prevention based on the American Fertility Society (AFS) scoring system. Results: Eighty-nine women were randomly distributed into two groups for intention to treat with 30 patients in Group A, 24 patients in Group B, and 35 patients in Group C. Patients were scored and stratified into three degrees and were enrolled using the simple random sampling method. The three groups were well balanced. There were no significant differences in age, endometrial thickness, the previous number of pregnancy, and the distribution of adhesion categories across mild, moderate, and severe between the three groups. The effective rate of IUA prevention, the AFS score after therapy, and the percentage improvements of Chinese score and AFS score before and after surgery were statistically significant difference between Groups A and C. The clinical pregnancy rate in Group A was higher than those in Groups B and C, but the difference was not statistically significant. Conclusion: HA gel has an advantage over an IUD in reducing IUA recurrence and decreasing adhesions.


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