[LUM#10] Regained Fertility
To help women who are having difficulty conceiving due to poor uterine healing, chemists atthe IBMM have developed a unique and innovative device. This is a true breakthrough for patients with intrauterine adhesions.
Cesarean section, dilation and curettage, fibroid removal, uterine revision… there are many surgical procedures performed on the uterus. These are common procedures, yet they are far from harmless. In fact, they can lead to the development of intrauterine adhesions. “These highly invasive surgical procedures sometimes lead to healing problems: the walls of the uterus stick together via a band of connective tissue—this is what we call intrauterine adhesions, or synechiae, ” explains Xavier Garric, Professor the Max Mousseron Institute of Biomolecules (IBMM).
Recurrent Miscarriages
Problem: These adhesions have significant repercussions on health and fertility. “They can lead to problems with menstrual flow and cause intense pain, ” explains the researcher, “but above all, they are the leading mechanical cause of infertility.” Synechiae can prevent implantation, the stage following fertilization during which the embryo implants itself in the uterine lining. “And even when implantation does occur, they also prevent the normal development of the fetus within the uterine cavity.” As a result, women with intrauterine adhesions experience recurrent miscarriages and are unable to carry a pregnancy to term. “Synechiae are responsible for one in five miscarriages, ” the researcher notes.
To remove these synechiae, patients must undergo a hysteroscopy, a procedure in which the surgeon inserts a camera through the cervix to cut the adhesions. This solution is not always permanent: “In 40% to 50% of cases, the adhesions reform after the procedure, ” laments Xavier Garric.
While discussing the issue with Stéphanie Huberlant and Vincent Letouzey, physicians in the Department of Obstetrics and Gynecology at the Nîmes University Hospital, Xavier Garric’s team realized just how significant the gaps are in the therapeutic arsenal available to gynecologic surgeons. That’s where the chemists come in. Their idea? “To create an anti-adhesion barrier to be inserted into the uterus after any procedure likely to cause the formation of synechiae.” This device would also be used after an operative hysteroscopy performed to sever adhesions, in order to prevent recurrence.
“There is already a hyaluronic acid gel used for this purpose; it is injected into the uterus after surgery to prevent adhesions. Unfortunately, this product liquefies quickly and is eliminated within 24 to 48 hours, whereas the uterine lining takes between 4 and 6 days to reform after surgery; therefore, the product does not remain in place long enough to fully fulfill its role,” explains the chemist.
New polymer
Xavier Garric and his colleague Salomé Leprince have taken on the challenge of synthesizing a new polymer—one that is biodegradable within 15 days—which would prevent adhesions by spreading throughout the uterus to keep the walls from coming into contact with one another.
"We tested 15 polymers before finding the ideal candidate," explains the researcher.
The researchers developed a device consisting of a thin sheet of this new polymer. Inserted like an IUD, it unfolds inside the uterus and acts as a barrier to prevent the uterine walls from sticking together during healing. It then turns into a gel that is naturally expelled through the vagina.
To support the development of this new product, Xavier Garric, along with Gonzague Issenmann, Dr. Stéphanie Huberlant, and SATT AxLR, founded the company Womed, which in 2018 won the grand prize in the i-Lab innovative startup competition, organized annually by the Ministry of Higher Education, Research, and Innovation. The anti-adhesion device won over the jury. “We are very proud to be recognized for the solution we will provide to the tens of thousands of women who wish to conceive a child but are unable to do so due to poor healing of their uterus, ” says Gonzague Issenmann, CEO of Womed.
Clinical Trials
This success also marks the culmination of a collaboration between doctors and chemists specializing in the development of new materials. “By better analyzing clinical needs, we were able to design and develop a solution that is easy for doctors to use and meets patients’ needs.”
The next step for Womed: the launch of clinical trials. “In total, this could eventually benefit nearly 150,000 patients per year in France,” says Xavier Garric. “It would be a true revolution for these women.” And for the children who will certainly be born thanks to this innovative device…
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