Uneven thickness of the endometrium is in most cases due to the sequelae of surgical operations and in some cases due to uterine adhesions. Usually, patients with uneven uterine thickness have polypoid changes in the endometrium, causing the endometrium to appear uneven. In addition, intrauterine operations such as curettage, abortion aspiration, hysteroscopic endometrial excision, as well as endometrial polyp surgery and surgery for submucosal fibroids can affect the endometrium and cause uneven thickness, with associated clinical symptoms seen in reduced menstrual flow, persistent spotting vaginal bleeding, and bleeding during menstruation.