Interceed and Estrogen Reduce Uterine Adhesions and Fibrosis and Improve Endometrial Receptivity in a Rabbit Model of Intrauterine Adhesions.

Abstract

Intrauterine adhesions (IUA) remain a major cause of infertility. Interceed, a regenerated cellulose adhesion barrier, is used to prevent adhesions in abdominal cavity. This study aimed to determine whether Interceed could reduce adhesions and tissue fibrosis and improve endometrial receptivity (ER) in rabbit. Rabbits were randomized into 6 groups: sham operation, Interceed control, IUA model, Interceed therapy, estrogen therapy, and combination therapy. Four rabbits per group were euthanized to evaluate adhesion severity on the day before intervention and day 7, 14, and 28 after intervention. Number of endometrial glands and degree of endometrial fibrosis acted as markers for adhesion severity. Pseudopregnancy was induced in the remainder, and 8 rabbits per group were killed for assessing ER on days 6, 7, and 8 of pseudopregnancy by ανβ3 integrin and pinopode. We found that Interceed or estrogen therapy led to significant improvement in the adhesion severity on day 28 after intervention, respectively, compared to IUA model group (all P < .05). However, after combination therapy, such improvement achieved comparable to sham operation group as early as day 14 after intervention (glands, P = .711, fibrosis, P = .154). Among the IUA models treated, ER was highest after combination therapy on day 7 of pseudopregnancy, similar to sham operation group (integrin, P = .352, pinopode, P = .154). In conclusion, Interceed and estrogen reduce adhesions and tissue fibrosis and improve ER in a rabbit model and may be novel therapeutic approaches for infertility resulting from IUA.