To observe the effect and safety of dydrogesterone combined with estradiol valerate on preventing the intrauterine re-adhesion after intrauterine adhesion (IUA) surgery.

The patients after IUA surgery were divided into control group and treatment group according to the cohort method. The control group was given oral estradiol valerate tablets (2 mg every time, twice a day) immediately after surgery and stopped after 30 days of continuous oral administration, and on the basis of the control group; the treatment group received dydrogesterone tablets (10 mg each time, once a day) from the 20^th day until the next menstruation. Both groups were treated for 2 menstrual cycles. The efficacy, endometrial receptivity ultrasound parameters [endometrial thickness, endometrial volume, vascular index (VI), blood flow index (FI), vascular blood flow index (VFI)], sex hormones [estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH)], adverse reactions and occurrence of re-adhesion were compared between the two groups.

Forty-eight cases in treatment group and 44 cases in control group were finally included. After 2 menstrual cycles of treatment, the total effective rates in treatment group and control group were 95.83% (46 cases/48 cases) and 81.82% (36 cases/44 cases), respectively (P<0.05). After 2 menstrual cycles of treatment, the endometrial thicknesses in treatment group and control group were (7.88±1.02) and (7.12±0.86) mm; the endometrial volumes were (3.02±0.97) and (2.57±0.73) cm³; VI values were 1.21±0.59 and 0.88±0.57; FI values were 29.87±5.12 and 27.56±4.63; VFI values were 1.12±0.43 and 0.83±0.36; E2 levels were (239.62±25.47) and (168.91±20.12) pmol·L^-1; FSH levels were (8.94±2.02) and (10.63±2.14) U·L^-1; LH levels were (13.38±2.16) and (15.27±2.59) U·L^-1, respectively (all P<0.05). The adverse drug reactions in treatment group were mainly breast tenderness and digestive tract discomfort; and the adverse drug reactions in control group were mainly breast tenderness, digestive tract discomfort and headache. The total incidence rates of adverse drug reactions in treatment group and control group were 14.58% (7 cases/48 cases) and 11.36% (5 cases/44 cases), respectively (P>0.05). The incidence rates of re-adhesion in treatment group and control group were 6.25% (3 cases/48 cases) and 20.45% (9 cases/44 cases) (P<0.05).

Dydrogesterone combined with estradiol valerate has a significant effect on preventing intrauterine re-adhesion after IUA surgery, and it can effectively improve the endometrial receptivity and sex hormones levels of patients, and it has medication safety.