Other names
Types
Causes
Symptoms
Diagnostic tests
Drug treatments
Dietary molecular supplements
Immunity-booster / regenerative / stem-cell–oriented” drugs
Surgeries
Prevention tips
When to see a doctor (now vs. later)
What to eat and what to avoid
Frequently asked questions

Intrauterine adhesions (IUA) are bands of scar tissue that form inside the uterus. These bands can make parts of the uterine cavity stick together. When the lining of the uterus (the endometrium) is injured and then heals abnormally, thin “filmy” bands or thick “dense” scars may develop. The scars can partly block the cavity or, in severe cases, almost close it. IUAs can lead to lighter periods or no periods, pelvic pain during menstrual cycles, trouble getting pregnant, miscarriage, or problems with the placenta in future pregnancies. The condition is acquired (not present at birth) and often follows procedures or infections involving the uterine lining. PMC+3NCBI+3PMC+3

Intrauterine adhesions (IUA) are bands of scar tissue that form inside the uterus and sometimes the cervix. These scars “stick” the inner walls together, change the shape of the uterine cavity, and can block the opening of the fallopian tubes. IUAs most often happen after a pregnancy-related procedure (for example, dilatation and curettage after miscarriage, after delivery, or after retained placenta), or after other uterine surgery. Infections like genital tuberculosis are a less common cause but are important in some countries. Symptoms can include lighter periods or no periods, pelvic cramps, infertility, recurrent miscarriage, and problems with the placenta in future pregnancies. The most accurate test is hysteroscopy, a tiny camera passed into the uterus to look and treat at the same time. The main treatment is hysteroscopic adhesiolysis (careful cutting of the scar tissue). After surgery, doctors often use short-term measures (estrogen tablets/patches, a soft balloon or an IUD as a temporary “stent,” and/or anti-adhesion gels) to reduce the risk of the scars coming back. PMC+2ACOG+2

The endometrium has a surface layer that sheds each month and a deeper “basal” layer that regenerates it. Deep injury to that basal layer—especially soon after pregnancy, miscarriage, or delivery when the lining is thin—can heal with scar tissue instead of healthy lining. That scarring creates bridges between the walls of the uterus, which then affects menstrual flow and fertility. PMC+1

Other names

Doctors may also call IUAs Asherman syndrome, uterine synechiae, intrauterine synechiae, or post-curettage uterine adhesions. All these terms describe scarring inside the uterine cavity that leads to symptoms such as abnormal periods, infertility, or pregnancy problems. National Organization for Rare Disorders+1

Types

You will see different “types” based on what the scars look like, how much they block the cavity, and where they are. Knowing the type helps doctors plan treatment and estimate the chance of recovery.

By thickness and appearance

Filmy adhesions: thin, web-like bands that are easier to separate during hysteroscopy (a tiny camera inside the uterus).
Dense/fibrous adhesions: thick, tough scars that may need careful cutting and have a higher chance of coming back. PMC+1

By extent/severity

Mild: small areas stuck; most of the cavity is open; periods may be normal or just lighter.
Moderate: more areas stuck; smaller open space; symptoms more obvious.
Severe: cavity mostly blocked or the cervix/upper uterus occluded; periods very light or absent; fertility more affected. (Many classification systems exist, but all rely on what is seen at hysteroscopy.) cdn.mednet.co.il+2jmig.org+2

By location

Fundal/cornual adhesions: near the top of the uterus or the tube openings.
Cervical canal adhesions: scarring narrows or closes the passage through the cervix.
Diffuse adhesions: scars scattered throughout. PMC

By trigger

Pregnancy-related (post-partum or post-miscarriage) IUA: after delivery, miscarriage, or procedures done soon after pregnancy.
Non-pregnancy IUA: after other uterine surgery, infections, or radiation. FertSterT+1

Causes

Dilation and curettage (D&C) after miscarriage
Scraping the inside of the uterus can injure the basal layer of the lining. When healing, scars may form and bridge the uterine walls. Risk is higher if the procedure is done soon after pregnancy, when the lining is especially thin. PMC+1
D&C after delivery (post-partum)
Curettage to remove retained tissue after birth can scar the cavity. Post-partum adhesions are a classic trigger for Asherman syndrome. Obstetrics & Gynecology
Repeated uterine instrumentation
Multiple procedures—such as repeated D&Cs—add up the risk of deep endometrial injury and scarring. PMC
Hysteroscopic surgery using heat/energy
Removing fibroids or polyps with electrical energy can damage the basal endometrium and cause dense, fibrous adhesions during healing. ScienceDirect
Myomectomy that opens the uterine cavity
Surgical removal of fibroids that exposes the cavity can lead to scarring if the lining is damaged. PMC
Endometrial ablation
Destroying the lining to treat heavy bleeding can leave raw surfaces that heal together, creating adhesions and sometimes obstructed bleeding. PMC
Retained products of conception (RPOC)
Persistent tissue after miscarriage or delivery can inflame the cavity; treatment and healing can produce adhesions, especially if sharp curettage is required. PMC
Post-partum endometritis (bacterial infection)
Infection after delivery or miscarriage can inflame and damage the basal layer, predisposing to scarring. PMC
Genital tuberculosis (TB)
TB can attack the endometrium and cause severe scarring and cavity obliteration, especially in regions where TB is prevalent. PMC
Schistosomiasis or other chronic infections
Parasitic or chronic uterine infections can lead to inflammation, fibrosis, and adhesions, though this is less common. PMC
Uterine artery embolization (UAE)
Reduced blood flow to the lining during UAE for fibroids may rarely contribute to endometrial damage and adhesion formation. PMC
Cesarean section scar involvement
When the cavity or cervix is disrupted near a prior cesarean scar, localized synechiae can develop. PMC
Intrauterine device (IUD) complications with infection
An IUD does not usually cause IUA, but if severe endometritis occurs around an IUD, scarring can follow. PMC
Radiation therapy
Pelvic radiation can damage the endometrium’s ability to regenerate, leading to scarring. PMC
Asherman after placenta accreta treatment
Surgical management of abnormally attached placentas can injure the lining and create scars. PMC
Septic abortion
Severe infection after unsafe or complicated abortion can damage the basal layer and scar the cavity. PMC
Aggressive suction procedures
Overly vigorous suction curettage can strip the endometrium too deeply and increase adhesion risk. PMC
Postsurgical hematometra with inflammation
Trapped blood and inflammation after cervical blockage or surgery can encourage scarring. PMC
Congenital anomalies with surgery
While adhesions are acquired, surgery to correct congenital uterine anomalies (like a septum) can cause local scarring if the basal layer is injured. PMC
Severe intrauterine inflammation of any cause
Any intense inflammation that reaches the basal endometrium can replace healthy tissue with fibrous scars. PMC

Symptoms

Very light periods (hypomenorrhea)
Less tissue is shed because scarred areas cannot build normal lining. Cleveland Clinic
No periods (secondary amenorrhea)
If much of the lining is scarred or the outflow tract is blocked, bleeding may stop. Cleveland Clinic
Cyclic pelvic pain without bleeding
Blood may build up behind adhesions or a closed cervix, causing cramping during expected menses. National Organization for Rare Disorders
Infertility
An embryo needs a healthy lining to implant; scarring reduces surface area and receptivity. PMC+1
Recurrent miscarriage
Even if conception occurs, an uneven or scarred lining may not support the pregnancy. PMC
Abnormal uterine bleeding patterns
Some people have spotting or unpredictable flow due to irregular cavity shape. National Organization for Rare Disorders
Pain with intercourse (sometimes)
Not classic, but pelvic floor tension and chronic pelvic pain may be present in some cases. PMC
Placenta accreta spectrum in later pregnancies
Scarring can make the placenta attach too deeply, leading to serious obstetric risks. Unbound Medicine
Preterm labor risk (later pregnancy)
Placental problems linked to scarring can raise risks in pregnancy. BioMed Central
Small uterine cavity on imaging
Tests may show a narrowed or irregular cavity caused by scar bridges. NCBI
Difficulty with embryo transfer or IUIs
Cervical adhesions can make passage of instruments harder. PMC
Retained menstrual blood (hematometra)
If outflow is blocked, blood can collect, causing swelling and pain. PMC
Post-procedure pelvic infection symptoms
Fever, tenderness, or foul discharge after a procedure may precede scarring. PMC
Psychological stress, anxiety, or depression
Fertility problems and pain can significantly affect mental health. ScienceDirect
Sometimes no symptoms
Mild, filmy adhesions can be silent and found only during fertility work-up. PMC

Diagnostic tests

Important note: There is no blood test or electrical test that can directly diagnose IUAs. Diagnosis relies on history, pelvic exam, and imaging—especially hysteroscopy. Hysteroscopy is the gold standard because it lets the doctor see the scars directly and treat them at the same time. NCBI+2PMC+2

A) Physical examination

General and abdominal exam
Doctors check for pain, tenderness, fever, or abdominal masses. This rules out other problems and looks for signs of infection or trapped blood. (Physical exam supports, but does not confirm, IUA.) PMC
Speculum exam
The cervix and vagina are inspected for discharge (infection), bleeding, or scarring at the cervical opening that might block menstrual flow. PMC
Bimanual pelvic exam
The uterus is gently felt to assess size, shape, and tenderness. A small, fixed, or tender uterus can suggest scarring or other causes that need imaging. PMC
Vital signs
Fever, high heart rate, or low blood pressure can point to infection or acute complications that must be handled before imaging or procedures. PMC

B) “Manual” office tests and procedures

Office uterine sounding
A thin sterile rod is gently passed through the cervix. Resistance or inability to pass may suggest cervical adhesions or a blocked path, prompting further imaging. (This is not definitive and must be done carefully.) PMC
Attempted endometrial sampling (biopsy)
If very little tissue is obtained from multiple areas, scarring is suspected. Biopsy is more useful to exclude infection (like TB) or other diseases. PMC
Outpatient diagnostic hysteroscopy (office hysteroscopy)
A tiny camera is placed through the cervix to look directly at the cavity. This is the most accurate way to see adhesions, grade their severity, and sometimes treat them right away. PMC+1
Cervical dilation assessment
Gentle, graded dilation can reveal narrowing from cervical adhesions and is often part of preparation for hysteroscopy. PMC

C) Laboratory and pathology tests

Pregnancy test (urine or blood hCG)
Always check first in people with missed periods to avoid harming an unrecognized pregnancy and to guide the timing of procedures. PMC
Complete blood count (CBC)
Looks for anemia from abnormal bleeding or signs of infection (elevated white cells) after a procedure or miscarriage. PMC
Inflammatory markers (CRP/ESR)
Non-specific tests that can support a diagnosis of active infection or inflammation when symptoms fit. PMC
Endometrial TB testing (AFB stain, GeneXpert, culture) when indicated
In countries where genital TB is more common, targeted tests on endometrial samples are critical because TB-related IUAs are often severe. PMC
STD testing when infection is suspected
Testing for pathogens (e.g., chlamydia, gonorrhea) helps guide treatment of endometritis that can damage the endometrium. PMC
Pathology from endometrial curettings/biopsy
Histology may show fibrosis, chronic inflammation, or granulomas (in TB). While pathology does not grade adhesions, it can confirm causes. PMC

D) Electrodiagnostic tests

No electrodiagnostic test diagnoses IUAs. Studies like ECG or nerve tests are sometimes done for anesthesia fitness before surgery, but they do not detect uterine scarring. Your doctor focuses on hysteroscopy and imaging instead. PMC

E) Imaging tests

Transvaginal ultrasound (TVUS)
A standard first look. It may show an irregular or small cavity, trapped fluid (hematometra), or other problems (fibroids, polyps). However, ultrasound alone can miss filmy adhesions. BioMed Central
Saline infusion sonohysterography (SIS or SHG)
Sterile saline is infused into the uterus during ultrasound. The fluid outlines the cavity, making gaps and bridges visible. SHG is more accurate than HSG for many intrauterine defects and is safe, quick, and inexpensive. PMC+1
Hysterosalpingography (HSG)
An X-ray with contrast dye shows the shape of the cavity and whether tubes look open. It can suggest filling defects from adhesions, but it may not show the exact nature of the scars. Accuracy for specific lesions is variable. FertSterT+1
Diagnostic hysteroscopy (again, as the gold standard)
Direct visualization identifies whether adhesions are filmy or dense, their location, and their extent. It also allows immediate treatment (hysteroscopic adhesiolysis). NCBI+2PMC+2
MRI (select cases)
MRI is used when the cavity is nearly or totally blocked or when the cervix is involved; it helps show the overall anatomy and any other causes of obstruction. NCBI+1
3D ultrasound (where available)
Three-dimensional imaging can map cavity shape and may help before and after hysteroscopic treatment, though hysteroscopy still guides final decisions.

Non-pharmacological treatments (therapies & others)

Office diagnostic hysteroscopy with gentle “no-touch” lysis of filmy bands
Purpose: restore normal cavity shape early. Mechanism: direct visualization and mechanical separation with the scope tip or micro-scissors; filmy adhesions often peel away with distension pressure. PMC
Operative hysteroscopic adhesiolysis (scissors preferred for dense bands, energy only when needed)
Purpose: safely cut fibrous bridges/plates. Mechanism: under direct vision, cold scissors reduce thermal injury; electrosurgery used sparingly. PMC
Ultrasound-guided adhesiolysis
Purpose: reduce perforation risk in severe disease. Mechanism: real-time US shows uterine wall thickness while cutting. PMC
Short-term intrauterine balloon stent (e.g., pediatric Foley) after surgery
Purpose: keep cavity walls apart while healing. Mechanism: physical spacing for 7–14 days to prevent surfaces from sticking together. PMC
Temporary IUD as spacer (selected cases)
Purpose: alternative to balloon to separate walls. Mechanism: mechanical barrier; removed after healing. Evidence mixed. PMC
Cross-linked hyaluronic acid anti-adhesion gel placed at the end of surgery
Purpose: reduce re-scarring. Mechanism: viscoelastic barrier coats raw endometrium during re-epithelialization; meta-analyses show reduced recurrence. ScienceDirect+1
Second-look hysteroscopy at 2–8 weeks
Purpose: detect early re-adhesions and release them when they are still soft. Mechanism: early mechanical lyses prevent maturation of scars. PMC
Saline infusion sonohysterography follow-up
Purpose: noninvasive check of cavity restoration between procedures. Mechanism: saline outlines cavity to spot re-bridging. PMC
Prevention: ultrasound-guided or vacuum aspiration for miscarriage/retained tissue (instead of blind sharp curettage when feasible)
Purpose: lower trauma to basal endometrium. Mechanism: less scraping and targeted removal reduces injury that leads to scars. ACOG
Avoid/limit endometrial ablation in people who may want future fertility
Purpose: prevent extensive cavity scarring. Mechanism: ablation destroys endometrium and can produce adhesions; not appropriate for fertility preservation. RCOG
Schedule intrauterine surgery in the proliferative phase
Purpose: optimize visualization and healing when estrogen is naturally higher. Mechanism: thinner lining and better re-epithelialization. sls.org
Gentle cervical dilation with small steps
Purpose: minimize cervical tears and new scarring. Mechanism: controlled dilation with small dilators under vision. PMC
Minimize thermal energy during hysteroscopy
Purpose: reduce thermal damage to basal layer. Mechanism: prefer cold scissors; use energy only when needed. PMC
Fertility counseling and timed conception after healing
Purpose: attempt pregnancy when cavity and lining have recovered to improve outcomes. Mechanism: allows endometrium to re-grow before embryo implantation. Frontiers
High-risk pregnancy surveillance after prior IUA
Purpose: detect placenta previa/accreta early. Mechanism: targeted ultrasound/anatomy scans in future pregnancies. Lippincott Journals
Treat and clear chronic endometritis or TB (diagnose first)
Purpose: remove inflammatory drivers of fibrosis. Mechanism: infection control reduces ongoing scarring; (drug therapy handled below). ScienceDirect
Intrauterine platelet-rich plasma (PRP) as a biologic adjunct (procedure)
Purpose: promote endometrial regeneration and reduce recurrence (emerging). Mechanism: growth factors from platelets may stimulate healing; growing meta-analytic support, but protocols vary. PubMed+1
Patient education on symptom tracking (flow amount, cycle length, pain)
Purpose: early detection of re-scarring. Mechanism: prompt follow-up if periods become scant or painful again. PMC
Shared decision-making with severity grading
Purpose: align expectations (may need staged surgeries). Mechanism: AFS/ESGE grades correlate with prognosis and re-intervention risk. PMC
Multidisciplinary care in severe/recurrent cases
Purpose: combine hysteroscopy expertise, infectious disease (for TB), fertility medicine, and high-risk obstetrics. Mechanism: coordinated plan improves safety and outcomes. PMC

Drug treatments

(Each includes a 150-word style summary—kept concise for space—with class, typical dose/time where evidence exists, purpose, mechanism, and important side effects. Many are adjuncts; core cure is surgical.)

Estradiol / Estradiol valerate (estrogen therapy) — Hormone; typical oral 2–6 mg/day for ~3–6 weeks post-op, often with a short course of progestin at the end of each cycle.
Purpose: support endometrial regrowth and reduce early re-adhesion. Mechanism: estrogen stimulates proliferation and re-epithelialization of the denuded endometrium after adhesiolysis, helping keep raw surfaces from sticking. Evidence: guidelines recommend postoperative estrogen, though optimal dose/route is not fixed (studies use 2–12 mg/day; RCTs and cohort studies suggest similar efficacy at 2–6 mg with fewer side effects at lower doses). Side effects: breast tenderness, nausea, headache, thromboembolism risk in high-risk patients; avoid if contraindicated (e.g., estrogen-dependent cancer). Frontiers+2PMC+2
Medroxyprogesterone acetate (MPA) or micronized progesterone (progestins) — Hormone; e.g., MPA 10 mg/day for 10–14 days after an estrogen course.
Purpose: organize a withdrawal bleed and support maturation of the newly formed lining. Mechanism: progestin transforms proliferative endometrium and helps shed unstable tissue, potentially reducing surface adhesions. Side effects: mood change, bloating, spotting; avoid in progesterone-sensitive cancer. (Adjunct to postoperative estrogen.) PMC
Combined oral contraceptives (COCs) — Ethinyl estradiol + progestin for 1–3 cycles post-op.
Purpose: provide steady hormones and scheduled bleeds while the cavity heals. Mechanism: continuous endometrial cycling may limit raw opposing surfaces. Side effects: similar to estrogens/progestins; consider VTE risk. Evidence extrapolated; used pragmatically. PMC
Antibiotics for confirmed infection or chronic endometritis — Drug class varies (e.g., doxycycline-based regimens after testing); TB needs multidrug therapy per national guidelines.
Purpose: remove infectious triggers that perpetuate fibrosis. Mechanism: eradication of bacteria or Mycobacterium tuberculosis reduces inflammation and scarring. Side effects: drug-specific; ensure diagnosis first. ScienceDirect
Low-dose aspirin (selected infertility protocols; off-label) — Antiplatelet 75–100 mg daily
Purpose: improve uterine blood flow; Mechanism: antiplatelet/vasodilatory effects; Evidence: limited/mixed for thin endometrium/IUA; use case-by-case. Side effects: gastritis, bleeding risk. MDPI
Pentoxifylline + Vitamin E (tocopherol) — Methylxanthine antioxidant combo; e.g., pentoxifylline 800 mg/day + vitamin E 1000 IU/day for weeks–months in thin-endometrium cases.
Purpose: improve microcirculation and reduce fibrosis. Mechanism: pentoxifylline improves RBC flexibility and microvascular flow; vitamin E has antifibrotic antioxidant effects. Evidence: small studies suggest improved thickness and pregnancy in resistant thin endometrium; not IUA-specific and quality is low. Side effects: nausea, dizziness (pentoxifylline); vitamin E at high dose increases bleeding risk. PubMed+1
Sildenafil (often vaginal/oral; off-label) — PDE-5 inhibitor; various regimens such as 25 mg vaginally q.i.d. in studies.
Purpose: improve endometrial blood flow and thickness in selected infertility patients. Evidence: mixed; some RCTs/cohorts show thicker lining and better flow, others show no benefit. Side effects: headache, flushing, systemic hypotension (caution with nitrates). PMC+2FertSterT+2
Tamoxifen (off-label in thin endometrium protocols) — SERM; short courses.
Purpose/mechanism: estrogen agonist effect on endometrium can thicken lining; Evidence: limited and mixed; not standard for IUA; Side effects: hot flashes, thromboembolism risk, endometrial effects—use specialist oversight. MDPI
G-CSF (granulocyte colony-stimulating factor) intrauterine infusion — Biologic; procedural drug.
Purpose: promote lining growth in refractory thin endometrium. Evidence in IUA: increases thickness but does not reliably prevent recurrence; data evolving. Side effects: cramps, spotting; systemic effects are uncommon with intrauterine dosing. PubMed
Topical intrauterine hyaluronic acid (device/gel—biomaterial adjunct rather than a “drug”)
Purpose: short-term barrier to reduce re-adhesion; Evidence: multiple meta-analyses show reduced IUA and possible improved pregnancy; Adverse effects: rare cramping/spotting. PubMed+1
Short-course NSAIDs (e.g., ibuprofen) after surgery — Analgesics
Purpose: pain control so patients can mobilize; Mechanism: COX inhibition; Side effects: dyspepsia, kidney risk; not disease-modifying. PMC
Tranexamic acid for heavy breakthrough bleeding (selected cases) — Antifibrinolytic
Purpose: reduce excessive bleeding during recovery; Mechanism: stabilizes clots; Side effects: VTE risk in predisposed patients. (Supportive, not anti-adhesion.) PMC
Short-course antibiotics around surgery only when indicated
Purpose: treat documented infection; Mechanism: reduces infectious complications; routine prophylaxis solely to prevent IUAs is not evidence-based. PMC
Vaginal estradiol (patch or gel) as an alternative to oral
Purpose: same as oral estrogen with possibly fewer systemic effects; Evidence: similar endometrial support in small studies. Side effects: local irritation. Frontiers
Progesterone-only cycling when estrogen contraindicated
Purpose: limited; may be used to manage bleeding patterns; Evidence: weaker than combined regimens. PMC
Short luteal GnRH agonist (experimental protocols for thin endometrium)
Purpose/mechanism: modulate receptivity; Evidence: inconsistent; specialist use only. Frontiers
Low-dose vaginal misoprostol (pre-op) for cervical softening
Purpose: easier, gentler entry → less trauma. Mechanism: ripens cervix; Side effects: cramping. PMC
Topical intrauterine PRP (biologic; procedural)
Purpose/mechanism: growth factors to enhance regeneration and reduce recurrence; Evidence: growing meta-analytic support; protocols vary; consider in trials/specialist centers. Side effects: minimal (autologous). PubMed+1
Iron therapy if anemic
Purpose: correct anemia from irregular bleeding; Mechanism: builds hemoglobin; Side effects: GI upset. Supportive care. PMC
Folic acid/prenatal vitamins when trying to conceive
Purpose: optimize preconception health; Mechanism: prevent neural-tube defects; Side effects: rare. (General fertility best-practice.) PMC

Important: Apart from estrogen/progestin and barrier gels, most “medical” agents for lining growth (sildenafil, pentoxifylline + vitamin E, G-CSF, etc.) have limited or mixed evidence specifically for IUA; use only with a specialist who can explain benefits and uncertainties. MDPI

Dietary molecular supplements

Supplements do not dissolve adhesions. They may support general reproductive health or endometrial blood flow; evidence for IUA is limited. Always discuss interactions.

Vitamin E (tocopherol): antioxidant; studied with pentoxifylline in thin endometrium; dosing often 400–1000 IU/day in studies; possible bleeding risk at high dose. PubMed
L-arginine: nitric-oxide precursor; theoretical vasodilation; evidence limited; typical 3–6 g/day. MDPI
Coenzyme Q10: mitochondrial support; mixed fertility data; common dose 100–300 mg/day. MDPI
Omega-3 fatty acids (EPA/DHA): anti-inflammatory; 1–2 g/day; general reproductive health support. MDPI
Folate (400–800 µg/day): preconception standard; prevents neural-tube defects; not an anti-adhesion therapy. PMC
Vitamin D: immune modulation; correct deficiency to ≥30 ng/mL; reproductive data suggest benefit when deficient. MDPI
Iron (if anemic): ferritin-guided replacement; improves energy and readiness for pregnancy; dose per lab results. PMC
Melatonin (2–5 mg at night): antioxidant; early fertility data; limited IUA-specific evidence. MDPI
Curcumin (turmeric extract): anti-inflammatory; theoretical anti-fibrotic properties; evidence in IUA is preclinical; monitor for bleeding with anticoagulants. MDPI
Resveratrol: antioxidant/SIRT activator; very limited human fertility data; not IUA specific. MDPI

Immunity-booster / regenerative / stem-cell–oriented” drugs

Intrauterine PRP (autologous) — Growth-factor concentrate from your own blood; early meta-analyses suggest reduced recurrence and improved lining/pregnancy after adhesiolysis; protocols vary; still evolving. PubMed+1
G-CSF intrauterine infusion — May thicken lining; did not prevent recurrence in a controlled IUA study; consider only in trials/specialist care. PubMed
Mesenchymal stem-cell–based approaches (experimental) — Bone marrow/menstrual blood–derived cells studied for thin endometrium/IUA; promising but investigational. BioMed Central
Platelet-lysate or PRP-derived gels (experimental biomaterials) — Combination scaffolds aim to deliver growth factors locally; early data only. Wiley Online Library
Hyaluronic-acid–based regenerative gels — Primarily a barrier; some formulations incorporate bioactive molecules to aid regeneration; supportive evidence for adhesion prevention. jmig.org
Estrogen-loaded local delivery systems (research stage) — Aim to release estrogen inside the cavity with fewer systemic effects; not yet standard. Frontiers

Surgeries

Hysteroscopic adhesiolysis with cold scissors (first-line)
Procedure: under camera guidance, thin and dense bands are cut systematically to reopen the cavity and tubal openings; often outpatient. Why: safest way to precisely remove scars and restore anatomy. PMC
Hysteroscopic adhesiolysis with limited electrosurgery
Procedure: bipolar electrode used sparingly for thick fibrous plates or when bleeding obscures view. Why: helps cut dense tissue while controlling bleeding; minimize energy to protect endometrium. PMC
Ultrasound-guided adhesiolysis for severe IUA
Procedure: external transabdominal ultrasound during hysteroscopy to track instrument tip and wall thickness. Why: reduces perforation risk when landmarks are lost. PMC
Placement of temporary intrauterine balloon or IUD (at end of surgery)
Procedure: soft balloon or IUD left for ~1–2 weeks (balloon) or per protocol. Why: mechanical separation during re-epithelialization to lower re-adhesion. PMC+1
Second-look hysteroscopy (staged surgery)
Procedure: brief follow-up scope 2–8 weeks later to release early, filmy re-adhesions. Why: improves final cavity shape and may improve reproductive outcomes. PMC

Prevention tips

Prefer ultrasound-guided vacuum aspiration over blind curettage when possible. ACOG
Avoid endometrial ablation if future fertility is desired. RCOG
Use gentle technique and the smallest instruments needed during intrauterine procedures. PMC
Schedule procedures in the proliferative phase when feasible. sls.org
Treat documented infections (including TB) before or after surgery as indicated. ScienceDirect
In high-risk cases, consider anti-adhesion gel at the end of surgery. PubMed
Use temporary balloon/IUD as a spacer in selected severe cases. PMC
Plan a second-look hysteroscopy to catch early re-scarring. PMC
Limit thermal energy; prefer cold scissors for cutting. PMC
Ensure post-op follow-up (period tracking, imaging if symptoms recur). PMC

When to see a doctor (now vs. later)

See a gynecologist soon if your periods became very light or stopped after a miscarriage, delivery, abortion, or uterine surgery—especially with cramps but little flow. Early evaluation allows easier treatment. NCBI
Seek urgent care if you have fever, severe pelvic pain, or heavy bleeding after a uterine procedure. PMC
See a fertility specialist if you have infertility or recurrent miscarriage and a history suggesting cavity scarring. Lippincott Journals

What to eat and what to avoid

Eat: iron-rich foods (lean meats, legumes, greens), folate-rich foods (leafy greens, beans), vitamin-D sources (oily fish, fortified foods), and plenty of fruits/vegetables for general anti-inflammatory support. Hydrate well. These choices help overall reproductive health and correct anemia if present. PMC

Avoid/limit: smoking (reduces uterine blood flow), heavy alcohol, excess trans-fats/ultra-processed foods, and high-dose unproven supplements without clinician input (some increase bleeding risk or interact with medicines). Diet cannot remove adhesions; surgery does. PMC

Frequently asked questions

Can adhesions go away on their own?
No. True intrauterine scar bands usually need hysteroscopic treatment. PMC
What is the best test?
Hysteroscopy—it sees scars directly and can treat at the same time. Sonohysterography is a good noninvasive screen. PMC+1
Will my periods come back after treatment?
Often yes, especially with mild–moderate disease; severe cases may need staged procedures. PMC
What are my chances of pregnancy after surgery?
Pooled estimates suggest ~59% conceive and ~46% have live birth after adhesiolysis overall, but outcomes depend on severity and age. Frontiers
Do I need estrogen after surgery?
Most specialists prescribe short courses; dose/route vary (many use 2–6 mg/day estradiol for 3–6 weeks, with progestin). Frontiers+1
Are balloons, IUDs, or gels helpful?
A hyaluronic-acid gel reduces recurrence; spacers (balloon/IUD) are commonly used in selected cases. PubMed+1
What about PRP or G-CSF?
PRP shows encouraging data for reducing recurrence and improving thickness; G-CSF may thicken lining but did not prevent recurrence in IUA in one study. Both are adjuncts with evolving evidence. PubMed+1
Can medications alone fix IUA?
No. Medicines support healing after scars are cut; they don’t dissolve mature adhesions. PMC
How many surgeries might I need?
Some need only one. Dense/severe disease can need staged procedures plus a second-look to keep the cavity open. sls.org
Is HSG enough to diagnose?
HSG helps map extent but can miss fine bands; hysteroscopy remains the reference test. PMC
Can endometrial ablation cause adhesions?
Yes, and it’s generally not recommended for people who might want future pregnancy. RCOG
When should I try to conceive after treatment?
After your clinician confirms a normal cavity and adequate lining (often after one or two cycles and/or a second-look). Frontiers
Are pregnancy risks higher after IUA?
Yes—placental problems (previa/accreta) can be more common; pregnancies need careful monitoring. Lippincott Journals
Does TB matter in my country?
In TB-prevalent regions, genital TB is an important (treatable) cause—testing is key when suspected. ScienceDirect
Which prevention step makes the biggest difference?
Avoiding blind, forceful curettage when safer options exist, and using anti-adhesion gel in high-risk surgeries. ACOG+1

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: September 24, 2025.

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Intrauterine Adhesions