To investigate auto-cross-linked hyaluronic acid gel for prevention of intrauterine adhesion (IUA) recurrence after hysteroscopic adhesiolysis.
A single-center, double blind, randomized controlled trial.
A tertiary university hospital.
272 patients with moderate to severe (American Fertility Society score ≥5) IUAs underwent hysteroscopic adhesiolysis.
Patients were randomized to receive standard care along with auto-cross-linked hyaluronic acid gel following surgery (treatment group) or standard care only (control group). All patients had second-look hysteroscopy at 4 weeks and hormonal therapy for 2 cycles after surgery.
260 patients were eligible and randomized while 245 patients successfully completed the study (n = 122 in treatment group; n = 123 in control group). Primary outcome measure was IUA recurrence at second-look hysteroscopy. Secondary outcome measures included improvement in American Fertility Society score and menstrual pattern. There was no significant difference with regard to IUA recurrence (31.1% vs 39.8%) or median American Fertility Society score at second-look hysteroscopy (2, interquartile range [2-4] vs 2, interquartile range [2-4]) or improvement in menstrual pattern at 3-months follow-up (87.7% vs 76.4%), in treatment and control groups, respectively.
The application of auto-cross-linked hyaluronic acid gel did not appear to improve IUA recurrence following hysteroscopic adhesiolysis.

Copyright © 2020. Published by Elsevier Inc.