How Can a Utero-Ovarian Adhesion Be Released – and Is It Really Necessary?

Dear Dr. Sandra Yene Amougui,

During my pelvic ultrasound, I was told that my ovary is stuck to my uterus… Is this serious? Could it explain my pelvic pain or why I’m struggling to get pregnant?

Sophie *Name anonymized

Dear Sophie,

Thank you for your question — it’s a common concern, and you’re not alone in feeling worried after hearing such a finding on ultrasound.When the ovary is described as “stuck” to the uterus, this often refers to what we call a utero-ovarian adhesion — an abnormal connection between pelvic organs caused by adhesions. In some cases, it’s completely harmless. In others, it may be linked to chronic pelvic pain or fertility issues. Let’s take a closer look.

What is a utero-ovarian adhesion?

A utero-ovarian adhesion means the ovary is no longer free to move normally in the pelvis, but is instead attached to the uterus. This is usually due to adhesions, thin bands of scar tissue that form after inflammation or surgery.

These adhesions may result from:

• Pelvic or abdominal surgery (e.g., cesarean section, appendectomy, endometriosis surgery),

• Pelvic infections (e.g., salpingitis, endometritis),

• Chronic inflammatory diseases, especially endometriosis.

  
  

Is it serious?

Not always.Many adhesions are asymptomatic and discovered incidentally during ultrasound or laparoscopy.

However, in some cases, they can:

• Restrict the movement of the fallopian tubes, making natural conception more difficult,

• Cause chronic pelvic pain,

• Be associated with severe endometriosis or other deep pelvic lesions.

Every case is different, and whether treatment is needed depends on your symptoms, fertility goals, and additional test results.

Is surgery always necessary?

No.Surgical release of adhesions (called adhesiolysis, usually done via laparoscopy) is only considered if the adhesion causes significant pain or, in some cases, fertility issues.

The procedure involves:

• Visualizing the pelvic organs,

• Gently separating the ovary, uterus or fallopian tubes if they are "trapped" by adhesions,

• Restoring normal anatomical mobility.

However, like any surgery, laparoscopy carries risks — including the formation of new adhesions. That’s why surgery is not always the first choice.

Are there alternatives? And what about antibiotics?

If the adhesion is isolated, without signs of active infection or severe pain, simple monitoring may be enough. Further imaging (such as pelvic MRI) or a fertility evaluation may be helpful.

As for antibiotics, here’s the key point:

Adhesions are not an infection.

Antibiotics do not treat adhesions unless there is clear evidence of an active infection (e.g., high fever, acute pain, lab markers of inflammation).Unfortunately, some patients are given antibiotics "just in case", but this is not medically justified. Unnecessary antibiotics can disturb the vaginal and gut microbiome, leading to other complications.

When is surgery worth considering?

Surgery may be recommended in specific situations, such as:

• Unexplained infertility, especially after repeated IVF failures,

• Chronic, debilitating pelvic pain,

• Imaging or clinical signs suggestive of advanced endometriosis.

  
  

In summary

An ovary stuck to the uterus is not always a serious or alarming finding.

• It may be completely benign, especially if discovered incidentally.

• Surgery is only indicated when the adhesion has a real clinical impact (pain, infertility).

• Antibiotics are only useful in confirmed or strongly suspected cases of infection.

If you're unsure, consult a gynecologist who can assess your individual case in the context of your symptoms and reproductive goals.

Warm regards,

Dr. Sandra Yene Amougui