Intrauterine adhesion (IUA) is a common endometrial disease and one of the main causes of infertility in women of childbearing age. Current treatment strategies, such as hysteroscopic adhesion resection, hysteroscopic transcervical resection of adhesion (TCRA), the use of local hormone drugs, and anti-adhesion scaffold implantation, do not provide a satisfactory pregnancy outcome for moderate-severe IUA, which presents a great challenge in reproductive medicine. With the development of material engineering, various bioactive and functional hydrogels have been developed using natural and synthetic biomaterials. These hydrogels are not only used as barely physical barriers but are also designed as vectors of hormone drugs, growth factors, and stem cells. These characteristics give bioactive hydrogels potentially important roles in the prevention and treatment of IUA. However, there is still no systematic review or consensus on the current advances and future research direction in this field. Herein, we review recent advances in bioactive hydrogels as physical anti-adhesion barriers, in situ drug delivery systems, and 3D cell delivery and culture systems for seeded cells in IUA treatment. In addition, current limitations and future perspectives are presented for further research guidance, which may provide a comprehensive understanding of the application of bioactive hydrogels in intrauterine adhesion treatment.

宫腔粘连（IUA）是一种常见的子宫内膜疾病，也是育龄妇女不孕的主要原因之一。目前的治疗策略，如宫腔镜粘连切除术、宫腔镜经宫颈粘连切除术（TCRA）、局部激素药物的使用、防粘连支架植入等，对于中重度IUA并不能提供满意的妊娠结局，这对中重度IUA来说是一个很大的挑战。生殖医学的挑战。随着材料工程的发展，利用天然和合成生物材料开发了各种生物活性和功能性水凝胶。这些水凝胶不仅用作物理屏障，还被设计为激素药物、生长因子和干细胞的载体。这些特性赋予生物活性水凝胶在 IUA 的预防和治疗中潜在的重要作用。然而，对该领域的当前进展和未来研究方向仍没有系统的综述或共识。在此，我们回顾了生物活性水凝胶作为物理防粘连屏障的最新进展，原位IUA 治疗中用于种子细胞的药物输送系统以及 3D 细胞输送和培养系统。此外，还提出了当前的局限性和未来的前景，以供进一步的研究指导，这可以为生物活性水凝胶在宫腔粘连治疗中的应用提供全面的了解。