If there is damage to the basal layer of the endometrium, it is possible to detect it by ultrasound. Damage to the basal layer of the endometrium is usually caused by trauma, or excessive endometrial surgery, like endometrial electrosurgery, injury to the endometrium caused by abortion, or damage caused by uterine operations like episiotomy or IUD removal. Clinically, ultrasound can be used to see if the basal layer is uniformly echogenic, and also to see if the thickness of the endometrium is normal. If the basal layer of the endometrium is damaged, generally ultrasound can reveal that the endometrium is too thin, the basal layer is unevenly echogenic, and there may be calcification and liquefaction. Generally, the degree of damage to the basal layer of the endometrium can be more accurately determined by hysteroscopy.