Efficacy of hyaluronic acid on the prevention of intrauterine adhesion and the improvement of fertility: A meta-analysis of randomized trials. (May 2022)

• Record Type: Journal Article
• Authors: Liu, Yi-Ran; Liu, Bao; Yang, Bo-Ping; Lan, Yi; Chi, Yu-Gang
• Is Part Of: Complementary therapies in clinical practice. Volume 47(2022)
• Publication Date: 2022-05
• Subjects: Curettage -- Hyaluronic acid -- Hysteroscopy -- Infertility -- Meta-analysis; Integrative medicine -- Periodicals; Integrative medicine -- Research -- Periodicals; Alternative medicine -- Periodicals; 615.5
• DOI: 10.1016/j.ctcp.2022.101575
• Languages: English
• ISSNs: 1744-3881

Abstract

Abstract: Background: and purpose:Intrauterine adhesion (IUA) and re-adhesion were common problems in women of childbearing age. The aim of our research was to evaluate the efficacy of hyaluronic acid gel on preventing IUA and improving the fertility. Methods: A systematic search for randomized controlled trial (RCT) articles that tested the effectiveness of using hyaluronic acid gel during intrauterine surgery in prevention of IUA and improvement of fertility was performed in PubMed, Medline, Embase, the Cochrane Library and clinicaltrials.gov until December 2020. Data were extracted independently and analyzed using RevMan statistical software version 5.3. Results: Twelve articles (11 studies) were deemed eligible for inclusion. There was a significantly reduced proportion of IUA after using hyaluronic acid gel during intrauterine operation (OR 0.39, 95% CI 0.29 to 0.52). It has significantly reduced the incidence of moderate-to-severe IUA after using hyaluronic acid gel, but no effect on the mild IUA. In addition, our analysis showed that the hyaluronic acid gel group was associated with a significant increased incidence of pregnancy (OR 1.64, 95% CI 1.08 to 2.50). Conclusion: Our analysis confirmed that using hyaluronic acid gel during intrauterine operation seemed to be more helpful for patients with high risk of IUA. However, larger and well-designed studies would be desired in the future to confirm its efficacy and safety in protecting fertility. Highlights: Hyaluronic acid gel significantly reduced moderate-to-severe intrauterine adhesion. Hyaluronic acid gel had no effect on mild intrauterine adhesion. Hyaluronic acid gel significantly enhanced the rate of pregnancy and live birth. Hyaluronic acid gel had no effect on the incidence of ectopic pregnancy and abortion.