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Although hysteroscopic adhesiolysis remains the primary clinical treatment, the rate of postoperative re\u2013adhesion is still high, especially in patients with moderate\u2013to\u2013severe IUA. Moreover, mechanical separation alone is often insufficient to restore intact endometrial architecture and reproductive function. Hydrogels, with their hydrated three\u2013dimensional networks, extracellular matrix (ECM)\u2013mimicking properties, injectability, biodegradability, tissue adhesion, and tunable delivery capacity, have evolved from passive barrier materials into multifunctional therapeutic platforms capable of regulating the pathological microenvironment and promoting tissue regeneration. Recent advances in responsive, self\u2013healing, adhesive, antioxidant, and bioactive cargo\u2013loaded hydrogels have expanded their applications from preventing adhesion formation toward functional endometrial reconstruction. In this review, we summarize recent progress in hydrogel\u2013based IUA therapy, focusing on material composition, structural design, functional modification, therapeutic mechanisms, and translational considerations. Particular emphasis is placed on disease\u2013informed hydrogel engineering strategies that integrate the unique anatomical characteristics of the uterine cavity, injury\u2013associated microenvironment, and dynamic stages of endometrial repair. This perspective provides insights into the development of next\u2013generation hydrogel systems for preventing re\u2013adhesion and restoring reproductive function.<\/jats:p>","DOI":"10.3390\/gels12090811","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:25:56Z","timestamp":1788542756000},"page":"811","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Engineering Hydrogels for Intrauterine Adhesion Therapy and Endometrial Regeneration"],"prefix":"10.3390","volume":"12","author":[{"given":"Hanlin","family":"Li","sequence":"first","affiliation":[{"name":"School of Acupuncture, Moxibustion, Tuina and Rehabilitation Medicine, Hunan University of Chinese Medicine, Changsha 410208, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiacheng","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Acupuncture, Moxibustion, Tuina and Rehabilitation Medicine, Hunan University of Chinese Medicine, Changsha 410208, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhong","sequence":"additional","affiliation":[{"name":"School of Acupuncture, Moxibustion, Tuina and Rehabilitation Medicine, Hunan University of Chinese Medicine, Changsha 410208, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiai","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Acupuncture, Moxibustion, Tuina and Rehabilitation Medicine, Hunan University of Chinese Medicine, Changsha 410208, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boheng","family":"Zheng","sequence":"additional","affiliation":[{"name":"School of Mechanical and Automotive Engineering, Xiamen University of Technology, Xiamen 361024, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingzhe","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Mechanical and Automotive Engineering, Xiamen University of Technology, Xiamen 361024, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shicong","family":"Niu","sequence":"additional","affiliation":[{"name":"School of Mechanical and Automotive Engineering, Xiamen University of Technology, Xiamen 361024, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8783-6227","authenticated-orcid":false,"given":"Weijun","family":"Li","sequence":"additional","affiliation":[{"name":"Fujian Key Laboratory of Functional Materials and Application, School of Materials Science and Engineering, Xiamen University of Technology, Xiamen 361024, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4973-772X","authenticated-orcid":false,"given":"Yu","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Acupuncture, Moxibustion, Tuina and Rehabilitation Medicine, Hunan University of Chinese Medicine, Changsha 410208, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"rbaf013","DOI":"10.1093\/rb\/rbaf013","article-title":"Development and functional evaluation of recombinant type III collagen intrauterine implant gel","volume":"12","author":"Wang","year":"2025","journal-title":"Regen. 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