title: Hyaluronic acid fluid agents for the prevention of adhesions after fertility-preserving gynecological surgery: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  To investigate the role of hyaluronic acid-based fluid agents in the prevention of adhesions after fertility-preserving gynecological surgery.
  
  
  METHODS
  Meta-analysis.
  
  
  METHODS
  The authors searched the Cochrane Menstrual Disorders and Subfertility Group Specialized Register of Controlled Trials, The Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE for randomized controlled trials of hyaluronic acid fluid agents compared with no treatment or placebo.
  
  
  METHODS
  Women undergoing fertility-preserving gynecological surgery.
  
  
  METHODS
  Hyaluronic acid fluid agents.
  
  
  METHODS
  [1] Prevalence and change in adhesion severity at second-look laparoscopy and [2] live birth rate.
  
  
  RESULTS
  Four studies were included in the meta-analysis. The use of hyaluronic acid agents was associated with a decrease in the prevalence of adhesions at second-look laparoscopy (odds ratio, 0.31; 95% confidence interval, 0.19 to 0.51) and a lesser chance of deterioration of preexisting adhesions (odds ratio, 0.28; 95% confidence interval, 0.12 to 0.66). There was, however, no evidence for improvement in the prevalence of adhesions (odds ratio, 1.55; 95% confidence interval, 0.82 to 2.92).
  
  
  CONCLUSIONS
  There is evidence that hyaluronic acid agents may decrease the prevalence of adhesions and prevent the deterioration of preexisting adhesions. However, because of the limited number of studies available, this evidence should still be interpreted with caution.
authors.affiliation: The Academic Unit of Reproductive and Developmental Medicine, The University of Sheffield and Sheffield Teaching Hospitals, Jessop Wing, Sheffield, UK. m.metwally@sheffield.ac.uk <m.metwally@sheffield.ac.uk>
authors.forename: Mostafa
authors.initials: M
authors.lastname: Metwally
authors.forename: Dylan
authors.initials: D
authors.lastname: Gorvy
authors.forename: Andrew
authors.initials: A
authors.lastname: Watson
authors.forename: Tin Chiu
authors.initials: TC
authors.lastname: Li
mesh_terms: D005260:Female; D005298:Fertility / Q000187:drug effects*; D006801:Humans; D006820:Hyaluronic Acid / Q000494:pharmacology* / Q000627:therapeutic use; D007247:Infertility, Female / Q000188:drug therapy / Q000517:prevention & control* / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic / Q000379:methods* / Q000639:trends*; D000267:Tissue Adhesions / Q000453:epidemiology / Q000517:prevention & control / Q000601:surgery
chemical_list: D006820:Hyaluronic Acid