• Qiaoyun Zhou, Xiaoyu Shi, Sotirios Saravelos, Xiaowu Huang, Yuting Zhao, Rui Huang, Enlan Xia, and Tin Chiu Li.
• Department of Hysteroscopic Center, Fuxing Hospital, The Eighth Clinical Medical College, Capital Medical University, Beijing (Drs. Shi, X. Huang, R. Huang, Li, Zhou, and Zhao, and Ms. Xia).
• J Minim Invasive Gynecol. 2021 Feb 1; 28 (2): 307-313.

Study ObjectiveTo investigate auto-cross-linked hyaluronic acid gel for the prevention of intrauterine adhesion (IUA) recurrence after hysteroscopic adhesiolysis.DesignA single-center, double-blinded randomized controlled trial.SettingA tertiary university hospital.PatientsTwo hundred seventy-two patients with moderate-to-severe (American Fertility Society [AFS] score ≥5) IUAs underwent hysteroscopic adhesiolysis.InterventionsThe patients were randomized to receive standard care along with auto-cross-linked hyaluronic acid gel after 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.Measurements And Main ResultsTwo hundred sixty patients were eligible and randomized; 245 patients successfully completed the study (n = 122 in treatment group, and n = 123 in control group). The primary outcome measure was IUA recurrence at second-look hysteroscopy. The secondary outcome measures included an improvement in the AFS score and menstrual pattern. There was no significant difference with regard to IUA recurrence (31.1% vs 39.8%) or median AFS score at second-look hysteroscopy (2, interquartile range [2-4] vs 2, interquartile range [2-4]) or improvement in the menstrual pattern at 3-month follow-up (87.7% vs 76.4%), in the treatment and control groups, respectively.ConclusionThe application of auto-cross-linked hyaluronic acid gel did not seem to improve IUA recurrence after hysteroscopic adhesiolysis.Copyright © 2020 AAGL. Published by Elsevier Inc. All rights reserved.

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