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Current treatments, including hysteroscopic adhesiolysis combined with hormonal therapy or physical barriers, show high recurrence and cannot simultaneously target these interconnected pathways. Here, we developed an injectable ROS\u2010responsive hydrogel (GPP) loaded with cerium\u2013tannic acid metal\u2010phenolic nanozymes (CeTA) that exhibit superoxide dismutase (SOD)\u2010 and catalase (CAT)\u2010mimetic activities. Unlike passive barriers, its boronate ester\u2010crosslinked network remains stable under physiological conditions but is selectively cleaved in ROS\u2010rich inflammatory microenvironments, enabling on\u2010demand, lesion\u2010localized CeTA delivery. In vitro, by scavenging excess superoxide and hydrogen peroxide, CeTA alleviated oxidative stress, restored mitochondrial membrane potential, promoted macrophage repolarization from the pro\u2010inflammatory M1 to the anti\u2010inflammatory M2 phenotype, and reversed TGF\u2010\u03b21\u2010induced fibrosis in endometrial stromal cells. In a rat IUA model, CeTA@GPP hydrogel restored uterine antioxidant enzyme activity, suppressed TGF\u2010\u03b21 expression and myofibroblast activation, and enhanced cell proliferation and angiogenesis; transcriptomic profiling confirmed coordinated down\u2010regulation of the inflammation, oxidative stress, and fibrosis pathways. Accordingly, CeTA@GPP hydrogel promoted structural and functional endometrial regeneration and improved endometrial receptivity. By integrating minimally invasive injectability, physical barrier protection, and intelligent ROS\u2010responsive multi\u2010target bioactivity, CeTA@GPP hydrogel provides a promising strategy for IUA.<\/jats:p>","DOI":"10.1002\/advs.77510","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T02:24:52Z","timestamp":1788143092000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An Injectable ROS\u2010Responsive Nanozyme Hydrogel Regulates the Uterine Microenvironment to Prevent Intrauterine Adhesions"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4187-8906","authenticated-orcid":false,"given":"Peixian","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong\u2010Hong Kong\u2010Macao Greater Bay Area Higher Education Joint Laboratory of Maternal\u2010Fetal Medicine The Third Affiliated Hospital, Guangzhou Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0040-0875","authenticated-orcid":false,"given":"Jian","family":"Song","sequence":"additional","affiliation":[{"name":"Research Centre of Basic Integrative Medicine, School of Basic Medical Sciences Guangzhou University of Chinese Medicine  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong\u2010Hong Kong\u2010Macao Greater Bay Area Higher Education Joint Laboratory of Maternal\u2010Fetal Medicine The Third 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