Cross-linked hyaluronan gel to improve pregnancy rate of women patients with moderate to severe intrauterine adhesion treated with IVF: a randomized controlled trial

• Published in: Archives of gynecology and obstetrics 2020, Vol.301 (1), p.199-205
• Main Authors: Mao, Xiaoyan, Tao, Yu, Cai, Renfei, Zhang, Jie, Gao, Hongyuan, Chen, Qiuju, Kuang, Yanping, Zhang, Shaozhen
• Format: Article
• Language: English
• Subjects: Clinical trials; Endocrinology; General Gynecology; Gynecology; Human Genetics; In vitro fertilization; Medicine; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Pregnancy
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-019-05368-6

Purpose To evaluate whether the cross-linked hyaluronan (cHA) gel can improve the clinical pregnancy rate of patients with moderate to severe intrauterine adhesion (IUA) who underwent operative hysteroscopy followed by embryo transfer. Methods Women with moderate to severe IUA desiring to undergo embryo transfer were recruited in this randomized controlled trial. The patients were randomized on the day of receiving hysteroscopy. The control group received standard hysteroscopy, while cHA gel was applied to the treatment group at the end of hysteroscopy and 5–7 days after operation. All patients were expected to undergo in vitro fertilization (IVF)/intracytoplasmic sperm injection and frozen-thawed embryo transfer (FET). Results A total of 306 patients were enrolled in this study, of which 202 were assigned to the treatment group and 104 to the control group. Both the clinical pregnancy rate (26.3% [49/186] vs. 15.3% [13/85], P  = 0.045), the implantation rate (17.7% [57/322] vs. 9.8% [15/153], P  = 0.025), and the endometrial thickness on the day of embryo transfer (7.97 ± 1.37 vs. 7.50 ± 0.60 mm, P