Experience of anti-adhesion barrier in the complex therapy of patients with uterine factor infertility

Abstract

N.I. Nasyrova1,2, Yu.E. Dobrokhotova2, L.A. Ozolinya2, M.Z. Argun1, K.V. Mirskaya1 1Central Clinical Hospital of Civil Aviation, Moscow, Russian Federation 2Pirogov Russian National Research Medical University, Moscow, Russian Federation Aim: to determine the efficacy of hyaluronic acid anti-adhesion barrier in the complex therapy of uterine factor infertility. Patients and Methods: the retrospective study included data from 95 female patients aged 23 to 39 years with various forms of intrauterine pathology. Female patients were divided into 2 groups: group 1 (n=36) — intraoperative injection of hyaluronic acid anti-adhesion barrier into the uterine cavity, group 2 (n=59) — no injection of gel. All patients underwent surgical treatment according to the generally accepted recommendations. Transvaginal ultrasound, analyzing the endometrial thickness and structure, was performed 3 months after the surgery. After conducting the corresponding complex treatment, the pregnancy frequency was evaluated for 24 months. Results: in the post-surgical period in group 1, there was a normal echographic endometrial image observed in 30 (83.3%) female patients, and in 6 (16.7%) there were indirect signs of chronic endometritis. In group 2, only 16 (27.1%) female patients had a normal echographic picture, while 15 (25.4%) showed signs of chronic endometritis, and 14 (23.7%) had the intrauterine adhesions, indicated a high probability of intrauterine synechiae recurrence without the use of an anti-adhesion barrier. The total number of female patients who implemented reproductive life planning was 28 (77.8%) in group 1 and 31 (52.5%) in group 2 (p<0.05). Conclusion: it was shown that there was a high risk of intrauterine synechiae after intrauterine interventions with subsequent disorder of reproductive function. The use of hyaluronic acid anti-adhesion barrier during intrauterine surgical interventions can be considered as prevention of intrauterine post-surgical adhesions. The administration of hyaluronic acid anti-adhesion barrier into the uterine cavity significantly improved the reproductive prognosis in female patients with uterine factor infertility. Keywords: infertility, uterine factor infertility, intrauterine synechiae, anti-adhesion barrier, hyaluronic acid. For citation: Nasyrova N.I., Dobrokhotova Yu.E., Ozolinya L.A., Argun M.Z., Mirskaya K.V. Experience of anti-adhesion barrier in the complex therapy of patients with uterine factor infertility. Russian Journal of Woman and Child Health. 2023;6(4):326–331 (in Russ.). DOI: 10.32364/2618-8430-2023-6-4-1.