What is Asherman’s Syndrome, and how does it affect fertility?
Asherman’s Syndrome is a condition where the walls of the uterus are scarred. In severe cases, the walls of the uterus can adhere to each other. Asherman’s is named after an Israeli gynecologist who first noticed it among women who had surgical treatments and then stopped getting their periods. It can occur after a D&C (dilation and curettage), a procedure used in a variety of circumstances: a missed or incomplete miscarriage; a delivery with a retained placenta; an elective abortion. About 90 percent of Asherman’s cases are caused by pregnancy-related D&Cs, although the scarring can also sometimes happen following c-sections or surgery to remove fibroids or polyps. It’s more frequent among women who have had several D&C procedures.
Symptoms of Asherman’s Syndrome include light or missed periods, or pain around the time of your period without a lot of bleeding. Your doctor can diagnose the condition with a hysteroscopy (a procedure where a viewing device is inserted through the cervix). In mild to moderate cases, a surgeon can remove the adhesions, so the endometrial lining can heal normally. But in more severe cases, the extensive scarring can make getting pregnant problematic. Some physicians will prescribe estrogen supplements to help stimulate healing in the area and/or place a temporary splint or balloon inside the uterus to keep the walls from sticking together. For more information and help with online support, see www.ashermans.org.
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