Fertility restored
To help women who have difficulty conceiving a child due to poor uterine healing, chemists atIBMM have designed a unique and innovative device. A real revolution for patients suffering from intra-uterine adhesions.
Caesarean section, curettage, fibroid removal, uterine revision... there are many surgical procedures performed on the uterus. These common procedures are far from harmless. They can lead to the formation of intra-uterine adhesions. " These highly invasive surgical procedures can sometimes lead to healing problems: the walls of the uterus are held together by a band of connective tissue, known as intra-uterine adhesions, or synechiae", explains Xavier Garric, a teacher-researcher at theInstitut des Biomolécules Max Mousseron (IBMM).
Recurrent miscarriages
The problem: these adhesions have major repercussions on health and fertility. They can lead to problems with menstrual evacuation and cause intense pain," explains the researcher, " but above all, they are the leading mechanical cause of infertility. Synechia can prevent implantation, the stage following fertilization during which the embryo implants in the uterine wall. "And when implantation does occur, they also prevent the normal development of the fetus in the uterine cavity. The result: women with intrauterine adhesions suffer repeated miscarriages and fail to carry a pregnancy to term. " Synechia is responsible for one in five miscarriages," says the researcher.
To eliminate these synechiae, patients have to undergo hysteroscopy, an operation during which the surgeon passes through the cervix to insert a camera and cut away the adhesions. This is not always a definitive solution: "In 40% to 50% of cases, the adhesions reform after the operation," says Xavier Garric.
In discussions with Stéphanie Huberlant and Vincent Letouzey, practitioners in the gynecology-obstetrics department of the CHU in Nîmes, France, Xavier Garric's team realized that there were significant gaps in the therapeutic arsenal available to gynecological surgeons. That's where the chemists come in. Their idea? "To create an anti-adhesion barrier to be inserted into the uterus after any operation likely to cause synechiae. A device that could also be used after hysteroscopic surgery to sever adhesions, in order to prevent recurrence.
"There is already a hyaluronic acid gel used for this purpose, which is injected into the uterus after surgery to prevent adhesions. Unfortunately, this product rapidly liquefies and is eliminated in 24 to 48 hours, whereas the uterine mucosa takes between 4 and 6 days to reform after an operation, so the product doesn't stay in place long enough to fully play its role", explains the chemist.
New polymer
Xavier Garric and his collaborator Salomé Leprince have taken up the challenge of synthesizing a new polymer, biodegradable in 15 days, which would prevent adhesions by spreading out in the uterus to prevent the walls from coming into contact.
"We tested 15 polymers before finding the ideal candidate," explains the researcher.
They have designed a device consisting of a thin sheet of this new polymer. Inserted like an IUD, it unfolds in the uterus, acting as a barrier to prevent its walls from sticking together during healing. It then becomes a gel that is naturally evacuated vaginally.
To support the development of this new product, Xavier Garric founded Womed with Gonzague Issenmann, Dr. Stéphanie Huberlant and SATT AxLR, which in 2018 won the grand prize in the i-Lab innovative company creation competition, organized each year by the French Ministry of Higher Education, Research and Innovation. The anti-adhesion device won over the jury. " We're very proud to be recognized for the solution we're bringing to the tens of thousands of women who wish to conceive a child but are deprived of doing so due to poor uterine healing," says Gonzague Issenmann, CEO of Womed.
Clinical trials
This success also crowns a collaboration between doctors and chemists specializing in the development of new materials. "A better analysis of clinical needs has enabled us to design and develop a solution that is easy for doctors to use and that meets patients' needs.
The next step for Womed is to launch clinical trials. Xavier Garric explains: "Eventually, this will involve almost 150,000 patients a year in France. It would be a real revolution for these women. And for the children who will certainly be born thanks to this innovative device...