Heparin Solution Versus Anti-adhesion Barrier Gel for Intrauterine Adhesions Prevention After Operative Hysteroscopy

NCT ID: NCT05257213

Last Updated: 2025-05-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-02-14

Study Completion Date

2026-02-28

Brief Summary

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The aim of this study is to compare the efficacy of intrauterine application of heparin solution to the use of hyaluronic acid barrier gel for the prevention of intrauterine adhesion formation after operative hysteroscopy.

Detailed Description

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In this trial the investigators aim to evaluate and compare the effect of heparin solution to anti-adhesive hyaluronic barrier gel administration immediately after operative hysteroscopy on post-surgical complications (incidence, extent and severity of intrauterine adhesions, abnormal menstrual cycle pattern) and fertility.

Patients undergoing operative hysteroscopy will be identified and invited to participate in the trial. At 4 to 8 weeks after the initial surgery, a follow-up, diagnostic hysteroscopy will be performed to identify indications for subsequent operative procedure and classify intrauterine adhesions according to extent of uterine cavity affected and type of formation found. Data on subsequent persistent irregular menstrual bleeding and pregnancy success up to 12 months following treatment will also be collected.

Conditions

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Intrauterine Adhesion

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Comparison between two active intrauterine treatments administered immediately post surgery
Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Participants
Patients will be under general anaesthesia during surgical procedure when the allocated treatment will be administered.

Study Groups

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Heparin solution

Administration of 3 ml heparin solution into the uterine cavity via a syringe immediately post operative hysteroscopy.

Group Type ACTIVE_COMPARATOR

Heparin solution

Intervention Type DRUG

3 ml saline solution containing 5000 IU heparin.

Anti-adhesion barrier gel

Intrauterine application of 2 ml biodegradable anti-adhesion barrier gel immediately post operative hysteroscopy.

Group Type ACTIVE_COMPARATOR

Anti-adhesion barrier gel

Intervention Type DRUG

2 ml biodegradable barrier gel containing sodium hyaluronate (10 mg/ml), sodium chloride (8.5 mg/ml), disodium hydrogen phosphate (0.34mg/ml), sodium dihydrogen phosphate (0.14 mg/ml) and water for injection (QS to weight).

Interventions

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Heparin solution

3 ml saline solution containing 5000 IU heparin.

Intervention Type DRUG

Anti-adhesion barrier gel

2 ml biodegradable barrier gel containing sodium hyaluronate (10 mg/ml), sodium chloride (8.5 mg/ml), disodium hydrogen phosphate (0.34mg/ml), sodium dihydrogen phosphate (0.14 mg/ml) and water for injection (QS to weight).

Intervention Type DRUG

Other Intervention Names

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HEP AAB

Eligibility Criteria

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Inclusion Criteria

* female sex
* indication for operative hysteroscopy including one or more of the following:
* infertility,
* irregular bleeding,
* oligo-/amenorrhea,
* Asherman syndrome,
* G0-G3 fibroids,
* dysmorphic uterus.

Exclusion Criteria

* ongoing pregnancy,
* genital cancer,
* pelvic inflammatory disease,
* excessive uterine bleeding.
Minimum Eligible Age

25 Years

Maximum Eligible Age

50 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Nadezhda Women's Health Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Nadezhda Women's Health Hospital

Sofia, Sofia, Bulgaria

Site Status RECRUITING

Nadezhda Women's Health Hospital

Sofia, , Bulgaria

Site Status RECRUITING

Countries

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Bulgaria

Central Contacts

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Georgi Stamenov

Role: CONTACT

+359888269839

Facility Contacts

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Georgi Stamenov, MD

Role: primary

888269839 ext. 359

Margarita Ruseva, MSc

Role: backup

889150267 ext. 359

Zornitsa Buteva, MD

Role: primary

+359895603362

References

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Healy MW, Schexnayder B, Connell MT, Terry N, DeCherney AH, Csokmay JM, Yauger BJ, Hill MJ. Intrauterine adhesion prevention after hysteroscopy: a systematic review and meta-analysis. Am J Obstet Gynecol. 2016 Sep;215(3):267-275.e7. doi: 10.1016/j.ajog.2016.05.001. Epub 2016 May 10.

Reference Type BACKGROUND
PMID: 27173082 (View on PubMed)

Valle RF, Sciarra JJ. Intrauterine adhesions: hysteroscopic diagnosis, classification, treatment, and reproductive outcome. Am J Obstet Gynecol. 1988 Jun;158(6 Pt 1):1459-70. doi: 10.1016/0002-9378(88)90382-1.

Reference Type BACKGROUND
PMID: 3381869 (View on PubMed)

Nappi C, Di Spiezio Sardo A, Greco E, Guida M, Bettocchi S, Bifulco G. Prevention of adhesions in gynaecological endoscopy. Hum Reprod Update. 2007 Jul-Aug;13(4):379-94. doi: 10.1093/humupd/dml061. Epub 2007 Apr 23.

Reference Type BACKGROUND
PMID: 17452399 (View on PubMed)

van Wessel S, Hamerlynck T, Schutyser V, Tomassetti C, Wyns C, Nisolle M, Verguts J, Colman R, Weyers S, Bosteels J. Anti-adhesion Gel versus No gel following Operative Hysteroscopy prior to Subsequent fertility Treatment or timed InterCourse (AGNOHSTIC), a randomised controlled trial: protocol. Hum Reprod Open. 2021 Feb 16;2021(1):hoab001. doi: 10.1093/hropen/hoab001. eCollection 2021.

Reference Type BACKGROUND
PMID: 33623830 (View on PubMed)

Lee WL, Liu CH, Cheng M, Chang WH, Liu WM, Wang PH. Focus on the Primary Prevention of Intrauterine Adhesions: Current Concept and Vision. Int J Mol Sci. 2021 May 13;22(10):5175. doi: 10.3390/ijms22105175.

Reference Type BACKGROUND
PMID: 34068335 (View on PubMed)

Other Identifiers

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3/11022022

Identifier Type: -

Identifier Source: org_study_id

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