Intrauterine Use of Autologous Platelet-Rich Plasma in Management of Asherman Syndrome: A Randomized Controlled Trial

Background: Operative hysteroscopy with lysis of intrauterine adhesions is a viable treatment option for Asherman syndrome. However, with all forms of adhesion resection, there is a high rate of reformation of intrauterine adhesions. The current study will focus on a unique technique to evaluate the use of platelet rich plasma over an inflated balloon versus conventional method (inflated balloon).Aim: This study aim to assess the efficacy of the platelet rich plasma in preventing reformation of intrauterine adhesions after adhesiolysis in cases of Asherman syndrome.Materials and Methods: This study was conducted in Ain-Shams Maternity Hospital (Early Cancer Detection and Endoscopy Unit) during the period between July 2019 and February 2020. Forty patients seeking for conception with a history of primary or secondary infertility with severe intrauterine adhesions; 20 patients (case) injected with PRP and 20 patients (control) with IU balloon.Results: Our study showed a significant increase of menses duration among the PRP group post-operative (3.0±1.1) days and preoperative menses duration (1.5±1.4) days compared to balloon post-operative (1.9±1.6) and preoperative (1.5±1.6) days. The study also showed significant increase of menses amount among the PRP group post-operative (5.2±3.7) pads, and preoperative menses duration (1.0±1.0) pads compared to balloon post-operative (2.9±3.2) and preoperative (0.9±0.9) pads.Conclusion: Platelet rich plasma after operative hysteroscopy has high efficacy and safety in improvement of menses duration, amount and adhesion score in cases suffering from severe intrauterine adhesions and decreasing postoperative adhesions.