The Role of Hyaluronan in Asherman’s Syndrome Therapy
| Authors | |
|---|---|
| Year of publication | 2015 |
| Type | Article in Periodical |
| Magazine / Source | Journal of gynecologic surgery |
| MU Faculty or unit | |
| Citation | |
| Doi | http://dx.doi.org/10.1089/gyn.2014.0129 |
| Field | Gynaecology and obstetrics |
| Keywords | Asherman´s syndrome; menstrual cycle; hormonal therapy; hyaluronan |
| Description | Prospective clinical evaluation comparing the therapy of Asherman’s syndrome in patients treated using hysteroscopic (HSK) adhesiolysis with insertion of 100% hyaluronic acid (HA) to a patient cohort with an inserted intrauterine device (IUD) and a control cohort. Design: Primary outcome—treatment for menstrual cycle problems. Secondary outcome—attainment of pregnancy after spontaneous conception within 1 year after the ending of hormonal therapy. Materials and Methods: Sixty patients treated from 1997 to 2014 for Asherman’s syndrome (in Stage II and III). Cohort A: Insertion of 100% HA (20 patients). Cohort B: Insertion of an IUD (18 patients). Cohort C: Without insertion of antiadhesion agent (22 patients). Primary and secondary goals were evaluated for all patients after a 3-month hormonal therapy. Results: The normal menstrual cycle was restored in 12 out of 20 patients in cohort A (60.0%), in 10 out of 18 patients in cohort B (55.5%), and 8 out of 22 patients in control cohort C (36.3%). A spontaneous pregnancy within 1 year after the end of the treatment was achieved by 14 out of 18 patients (77.7%) in cohort A, by 6 out of 10 patients (60.0%) in cohort B, and by 6 out of 14 patients (42.8%) in cohort C. Ten patients (55.5%) gave birth in cohort A, 4 patients (40.0%) in cohort B, and 4 patients (28.5%) in cohort C. Given the small number of the included patients, there was no statistically significant difference identified in any of the followed cohorts through the completed statistical analysis. Conclusion: Intrauterine insertion of hyaluronan after the completed HSK adhesiolysis enabled the recovery of the normal menstrual cycle for 60.0% of the patients and improved the implantation rate (77.7%) and take home baby rate (55.5%), compared to the group of patients with insertion IUD and with the control group. ( J GYNECOL SURG 31:250) |