The thickening of the anterior wall of the uterus may be due to the following reasons: 1. The thickening of the anterior wall is caused by adenomyosis confined to the anterior wall of the uterus. 2. There may be localized fibroids, which may lead to thickening of the anterior wall. 3. There may be other pathologies, such as uterine sarcoma, which may lead to thickening of the anterior wall of the uterus by ultrasound. In addition, it is possible that the inflammation of the anterior wall causes the uterus to appear in a hyperplastic state, which can lead to thickening of the anterior wall. It is recommended to combine clinical history with clinical symptoms to give a comprehensive analysis. If necessary, blood can be drawn for gynecologic tumor triple test to understand whether there is a possibility of malignant changes, and CT scan can also be used to further confirm the diagnosis.