Hydrogel-Based Systems in Intrauterine Adhesions: Bridging the Gap from Bench to Bedside

Intrauterine adhesions are a significant cause of female infertility, necessitating advanced therapeutic approaches beyond conventional surgery. Hydrogel-based systems have emerged as a promising strategy due to their unique biochemical and physical properties, which support endometrial regeneration and prevent adhesion recurrence. This review provides a focused overview of the composition, classification, and functional characteristics of hydrogels in intrauterine adhesion therapy. It also discusses recent advancements in hydrogel applications, highlighting their roles as both physical barriers and delivery platforms for drugs, cytokines, cells, and extracellular vesicles. Although certain hydrogels, particularly hyaluronic acid-based formulations, have demonstrated progress in clinical settings, significant challenges persist. These include the need for precise spatiotemporal control over therapeutic release, biodegradability aligned with tissue remodeling, and addressing long-term safety concerns. The review also summarizes innovative design strategies aimed at enhancing hydrogel functionality, such as stimuli-responsive, visualized, and 3D-printed hydrogels tailored for personalized treatments. In conclusion, this review emphasizes the importance of bridging laboratory innovations with clinical applicability through standardized manufacturing practices, robust preclinical models, and interdisciplinary collaboration. The ultimate goal is to fully harness the potential of hydrogels to restore uterine function, improve reproductive outcomes, and achieve live births.