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How can scar tissue inside the uterus interfere with embryo implantation?

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Diagram showing the female reproductive system with labeled ovaries, fallopian tubes, uterus, and vagina, alongside hormone pathways and the process from ovulation to fertilization and early embryo development. — infertility Major structures and hormones involved in the initiation of pregnancy. Also seen, at right, is the development of an egg cell (ovum) from follicle to embryo.

Scar tissue within the uterus, often referred to as adhesions, can significantly interfere with the process of implantation.

Successful implantation requires the fertilized egg to attach to and burrow into a healthy, receptive endometrium. This process relies on the uterine lining being properly prepared by progesterone, which increases blood supply and nutrient secretion to support the developing embryo.1

When intrauterine scar tissue is present—frequently as a result of procedures like dilation and curettage following repeated abortions—it disrupts the integrity of the endometrial lining. These adhesions create an environment that is physically or physiologically unsuitable for the embryo to adhere to or invade the deeper tissue. By compromising the surface where the egg must burrow, scar tissue prevents the embryo from establishing the necessary connection to the uterus, thereby leading to infertility.21