[The HY-Per trial: A negative randomized surgical trial with strong implications for the management of spontaneous...

Here we present the results of the HY-Per single-blind randomized controlled trial. This trial compared the surgical management of incomplete spontaneous miscarriages by hysteroscopy vs. vacuum aspiration. This trial aimed to demonstrate the advantage of hysteroscopy for fertility within two years of miscarriage management compared to vacuum aspiration in light of retrospective data from the literature. This study, published in the JAMA, included 574 patients in 15 French centers, without demonstrating a significant difference between the two groups: 62.8% of patients in the "hysteroscopy" arm and 67.6% in the "aspiration" arm had an ongoing pregnancy (difference, -4.8% [95% CI: -13% to 3.0%]; P=0.23) with a similar complication rate in both groups. The results of this study provide a solid answer to a common clinical question: operative hysteroscopy is not superior to endouterine aspiration in the surgical treatment of incomplete spontaneous miscarriages.