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Posted by on Jan 29, 2020 in Infertility | 0 comments

In a nutshell

This study investigated if hyaluronic acid gels (HAGs) prevent intrauterine adhesions (IUAs) after a miscarriage (pregnancy loss).

They found that HAGs reduce IUAs and improve pregnancy rates (PRs) in these women. 

Some background

Intrauterine adhesions (IUAs) are common after a miscarriage. IUAs happen when a pregnancy is lost and scar tissue forms in the uterus (womb). This scar tissue can cause the uterus walls to stick together. IUAs can make it difficult to become pregnant again. Surgery can be used to remove the scar tissue. However, more scar tissue can form after surgery. 

Non-invasive methods may be better at preventing scar tissue build up. One option is hyaluronic acid gel (HAG). Hyaluronic acid is naturally found in the body. It is broken down very quickly by the body. A HAG lasts longer because the gel formula slowly releases it into the body. HAG is used in general surgery to prevent body tissues from sticking together. HAG has been used to treat IUAs. It is unclear if HAGs improve fertility outcomes after IUA treatment in women who had a miscarriage. 

Methods & findings

This study analyzed 4 other studies on HAG treatment for IUAs. These trials reported on fertility outcomes in 625 women. All women underwent some type of surgery to remove fetal tissue from the uterus after a miscarriage. 290 of these women had HAG treatment. HAG treatment was given after the surgery.  

IUA scores were improved in women treated with HAG. The rate of IUA recurrence after miscarriage was significantly lower by 56% in HAG-treated patients. The risk of moderate or severe IUAs was reduced by 82% with HAG treatment. HAG treatment was associated with a 94% increase in pregnancy rates. 

The bottom line

The authors concluded that HAGs reduce IUA reoccurrence after a miscarriage and improve pregnancy rates.

The fine print

The protocols of the studies analyzed were different. The number of patients in the individual studies was relatively small. A large controlled study would improve our understanding of these findings. 

Published By :

European journal of obstetrics, gynecology, and reproductive biology

Date :

Oct 22, 2019

Original Title :

Meta-analysis of the use of hyaluronic acid gel to prevent intrauterine adhesions after miscarriage.

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