Study on the effect of magnetic thermal vibration therapy combined with Femoston on endometrial repair in postoperative patients with moderate to severe intrauterine adhesions

Background Intrauterine adhesions can persist or recur after hysteroscopic adhesiolysis because of impaired endometrial regeneration and reduced uterine perfusion. This trial aims to evaluate whether magnetic thermal vibration therapy (MTVT) added to sequential estradiol–dydrogesterone therapy enhances postoperative endometrial repair in women with moderate-to-severe intrauterine adhesions. Methods In this single-center, assessor-blinded, parallel-group randomized controlled trial, 176 women were assigned 1:1 to Femoston alone or Femoston plus MTVT. Participants were recruited between January 10, 2024, and October 17, 2025. MTVT was administered three times weekly for six weeks. The primary outcome was change in endometrial thickness at 8–10 weeks after the surgical procedure. Secondary outcomes included menstrual blood loss, menstrual duration, uterine artery pulsatility and resistance indices, three-dimensional endometrial perfusion indices, quality of life, adherence, and adverse events. Analyses followed the intention-to-treat principle with multiple imputation and baseline-adjusted ANCOVA. Results Follow-up was completed by 166 participants. Mean endometrial thickness increased by 1.07 ± 0.47 mm with Femoston and 1.48 ± 0.60 mm with Femoston plus MTVT. The adjusted between-group difference was 0.391 mm (95% CI, 0.191–0.591; P < 0.001). Endometrial response occurred in 39.0% and 66.7% of participants, respectively (adjusted RR, 1.66; 95% CI, 1.22–2.24; P = 0.001). The combined intervention improved menstrual blood loss (adjusted difference, 5.55 points; P = 0.002), menstrual duration (0.45 days; P < 0.001), quality of life (2.51 points; P < 0.001), uterine artery PI (−0.12; P < 0.001) and RI (−0.031; P < 0.001), and perfusion indices VI (0.33; P = 0.022), FI (0.84; P = 0.002), and VFI (0.20; P = 0.003). Overall adverse-event rates were similar between groups. Conclusion Adding MTVT to Femoston improved short-term endometrial thickness, menstrual recovery, and uterine perfusion without increasing overall adverse-event incidence. Multicenter trials incorporating hysteroscopic recurrence and reproductive outcomes are warranted.