Asherman’s Syndrome is a condition caused by damage to the endometrial cavity and in particular the endometrial lining of the uterus. The condition can cause problems with your periods and with fertility.
What is Asherman's Syndrome?
Asherman’s Syndrome is an uncommon iatrogenic condition, ie it is almost always caused by medical intervention. When you have this condition there is scar tissue inside your uterus or cervix which can alter the shape of the uterus and prevent normal endometrial function. Asherman’s Syndrome causes a change in menstrual flow: lighter periods or no menstruation at all. Critically the sundrome can lead to difficulties falling pregnant.
Any surgical procedure instruments used inside the uterus can cause Asherman’s Syndrome but some are much more likely to do so. The highest risk occurs with procedures done just after pregnancy has finished and your uterus is involuting, reverting back to its normal size and shape. Any surgical procedure inside the uterus at any time can cause problems though.
"I believe that prevention is the best option where possible and hence perform high risk hysteroscopic surgeries such as retained products after pregnancy under direct vision. I also regularly offer medical treatment for miscarriage, not just surgical D+C."
Asherman’s Syndrome diagnosis
What is a hysteroscopy?
Treating this condition
Managing Asherman’s Syndrome
The best course to manage this condition is prevention. Clinical awareness of high-risk situations is crucial in order to minimise the risks. If surgery is really needed then the gentlest procedure possible should be performed. Surgery under direct vision, using an operative hysteroscope, is usually better than old-fashioned “blind” procedures.
Fertility Specialist of WA
Asherman’s Syndrome and fertility
If you have this condition and you wish to conceive then restoration of the uterine cavity is needed, aiming for the return of a normal endometrial size and shape. This will be done with an operative hysteroscopy under direct vision. Additional treatments may include antibiotics, estrogen hormones, an IUD and anti-adhesion barriers such as Oxiplex and Hyaluronic acid.
The avoidance of any further procedures which can re-injury the endometrium is critical. Once already damaged it is easier to cause further damage and injury.
For more information, visit the International Asherman’s Association