Objective To investigate the endometrial receptivity of biological amniotic products after hysteroscopic intrauterine adhesion separation (TCRA). Methods A retrospective analysis for clinical data of 64 cases of women who received TCRA because of medium or heavy IUA in the Affiliated Hospital of Medical School, Ningbo University from November 2019 to November 2020 was performed. The 64 cases were divided into the following two groups according to the method of TCRA postoperative readhesion prevention: an experimental group (biological amniotic products were placed after TCRA with chitosan), and a control group (chitosan was placed after TCRA). Each group was 32 cases. The Chinese Intrauterine Adhesion Grating and Scoring Standard proposed by Chinese Clinical Diagnostics Experts of Intrauterine Adhesion in 2015 was used to diagnose the degree of intrauterine adhesions. All patients received artificial cycle treatment of estrogen progesterone for 2 months. The endometrial thickness, uterine artery resistance parameters and pregnancy rate were compared between the two groups. Results One month after operation, the endometrial thickness of the experimental group and the control group were (5.89±0.84) mm and (4.37± 0.52) mm, respectively, the differences were statistically significant (T=8.689,P<0.01). Two months after operation, the endometrial thickness of the experimental group and the control group were (8.38±0.84) mm, (7.17±1.00) mm, the differences were statistically significant (t＝5.215, P<0.01). At the second hysteroscopy, the readhesion rate of the experimental group was 6.25%, and that of the control group was 18.75%, with statistical significance (P<0.05). There were statistical differences in the arterial blood flow parameters and pregnancy rate between the two groups. Conclusions The implantation of biological amniotic membrane products after the separation of moderate or severe intrauterine adhesions can increase the thickness of the endometrium and improve the blood circulation of the uterus and the receptivity of the endometrium, ultimately increase the pregnancy rate. Therefore, the implantation of biological amniotic membrane products can be an effective and feasible neoadjuvant treatment for clinical treatment of intrauterine adhesions.
Key words
Intrauterine adhesion; Biological amniotic products; Intrauterine adhesion separation /
Endometrial receptivity
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