Can uterine adhesions come back after surgery?

Yes, there’s a chance of recurrence, especially if the adhesions were severe. That’s why your doctor may use a balloon or IUD and prescribe estrogen therapy to keep the uterine walls apart during healing.

Will I need IVF after treating uterine adhesions?

Not necessarily. Many women conceive naturally once the adhesions are removed and the uterus heals. IVF is only considered if natural conception doesn’t happen after a reasonable time or if there are other fertility issues.

How will I know if the treatment has worked?

You’ll likely notice your periods becoming regular again. Your doctor may also do follow-up scans or a second hysteroscopy to confirm that the uterus has healed properly and no new adhesions have formed.

How Uterus Scars Are Treated to Help You Conceive

When you're trying to get pregnant and things aren't going as planned, hearing about something like uterine adhesions can be scary and confusing. The good news is that this condition can be treated. Many women have healthy pregnancies after they learn how to take care of themselves.

What Are Uterine Adhesions?

Scar tissue forms inside your uterus and causes uterine adhesions, which are also known as Asherman's syndrome. This tissue can cause the walls of your uterus to stick together. Sometimes, these adhesions are thin and not very strong. But sometimes they can be thick and cover a lot of the uterus.

These scars often form after surgeries like a D&C (dilation and curettage), especially if there was an infection or the same procedure was done more than once. Other things that can cause it are:

Complicated caesarean deliveries
Fibroid removal surgeries
Pelvic infections, such as tuberculosis (more common in developing countries)

How Do Uterine Adhesions Affect Fertility?

You might not even know you have uterine adhesions until you face problems like:

Difficulty getting pregnant
Irregular or very light periods
No periods at all (amenorrhoea)
Repeated miscarriages

This scar tissue can make it hard for the embryo to attach to your uterus in the right way. In bad cases, it can stop the sperm from getting to the egg or stop periods from happening at all. That's why it's important to find out what it is and treat it if you want to get pregnant.

How Are Uterine Adhesions Diagnosed?

Before we talk about treatment, we need to make sure you really do have uterine adhesions. Here's how your doctor might do that:

Hysteroscopy: This test is the most accurate. Through the cervix, a thin camera is put into your uterus. It makes it easy for your doctor to see the adhesions.
Sonohysterography (saline ultrasound): It is a type of ultrasound that uses fluid to get a better look at your uterus.
HSG (Hysterosalpingography): It is an X-ray test that shows what is inside your uterus and fallopian tubes.

After your doctor confirms the diagnosis, treatment usually begins.

Treatment Options for Uterine Adhesions

The goal of treatment is to get rid of the scar tissue and bring your uterus back to its normal shape and function. This will make it easier for you to get pregnant. This is what it usually means:

1. Hysteroscopic surgery

This is the most common and effective way to treat uterine adhesions. Your doctor cuts and removes the scar tissue with small tools that go through a hysteroscope during a hysteroscopic adhesiolysis.

You are usually under general or local anaesthesia, so you won’t feel any pain during the procedure.
Since the surgery is done through your vagina and cervix, no external cuts are made.
Most women go home the same day.

Your uterus needs time to heal after surgery. But getting rid of the adhesions often makes it much more likely that you will get pregnant, especially if the condition was found early and isn't too bad.

2. Preventing the adhesions from coming back

If the right steps aren't taken, scar tissue can come back after surgery. Your doctor might suggest the following to stop this:

A balloon or intrauterine device (IUD): Placed inside your uterus for a few days or weeks to keep the walls from sticking together.
Estrogen therapy: Hormone treatment helps the lining of your uterus grow back normally.
Antibiotics (if needed): To avoid infections during healing.

After a few weeks, your doctor may also schedule a second hysteroscopy to see if any adhesions have returned.

3. Follow-Up and monitoring

After treatment, it's important to monitor your menstrual cycle and the health of your uterus. Your doctor may suggest:

Ultrasounds to check the uterine lining thickness
Blood tests to track hormone levels
Trying for pregnancy once your uterus has healed, typically within 1–3 months

If you're not able to conceive naturally, your doctor might guide you towards assisted reproductive technologies (ART) like IVF. But many women do get pregnant naturally after treatment if the adhesions were successfully removed.

What If Your Adhesions Are Severe?

In some cases, especially when adhesions are extensive or have damaged large areas of your uterus, treatment becomes more challenging. If you’ve had repeated surgeries and the lining still doesn’t grow back properly, your doctor may discuss other fertility options with you, such as:

Surrogacy
Adoption
In very rare and extreme cases, a uterine transplant

But such cases are rare. Most women with mild to moderate uterine adhesions respond well to treatment and can conceive successfully afterwards.

How Soon Can You Try for Pregnancy After Treatment?

This depends on how severe your adhesions were and how well your uterus has healed. In general:

If your uterus heals well and your periods return normally, you can usually start trying within 1 to 3 months.
In more complex cases, your doctor may advise waiting a little longer and may do follow-up tests to make sure your uterus is ready.

Uterine scars may sound worrying, but they don’t have to stand in the way of your dream of becoming a parent. With the right treatment and care, many individuals go on to conceive and enjoy healthy pregnancies. Remember to consult with your doctor to get the right treatment sooner.

FAQs On How Uterus Scars Are Treated To Help You Conceive

Can uterine adhesions come back after surgery?
Yes, there’s a chance of recurrence, especially if the adhesions were severe. That’s why your doctor may use a balloon or IUD and prescribe estrogen therapy to keep the uterine walls apart during healing.
Will I need IVF after treating uterine adhesions?
Not necessarily. Many women conceive naturally once the adhesions are removed and the uterus heals. IVF is only considered if natural conception doesn’t happen after a reasonable time or if there are other fertility issues.
How will I know if the treatment has worked?
You’ll likely notice your periods becoming regular again. Your doctor may also do follow-up scans or a second hysteroscopy to confirm that the uterus has healed properly and no new adhesions have formed.