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What is Asherman's syndrome?

Asherman’s syndrome is a rare condition characterized by fibrosis of the endometrium, caused by the formation of intrauterine adhesions from scar tissue. This typically develops after surgical procedures on the intrauterine cavity, specifically following Dilation and Curettage (D&C).

The endometrium that lines the internal cavity of the uterus is composed of two layers: the functional layer adjacent to the uterine cavity that sheds during menstruation, and the underlying basal layer adjacent to the muscular wall that regenerates the functional layer. Trauma to the basal layer may lead to the development of scar tissue resulting in adhesions that can occlude the intrauterine cavity and compromise the response to hormones. As a result, patients may experience secondary menstrual irregularities characterized by a decrease in menstrual flow, duration of bleeding, disproportionate pain during menstruation and ovulation, future obstetric complications, endometriosis and infertility.

Asherman’s syndrome affects women of all races and ages equally but tends to occur with increased frequency in women who have had repeated Dilation and Curettage (D&C) performed for elective medical abortion or for retained products of conception following a miscarriage, vaginal delivery or cesarean section. The prevalence of Asherman’s syndrome is thought to be approximately 20 percent in the general population and between 5-40 percent of women with recurrent miscarriage, medical termination, surgical abortion or retained products of conception.

The treatment for Asherman’s syndrome involves hysteroscopic surgery, which uses small instruments and a camera placed into the uterus through the cervix to visualize the uterine cavity. Surgery procedures to cut and remove the adhesions or scar tissue can cure Asherman’s syndrome in most women, but sometimes more than one procedure is necessary, depending on the severity of disease and the difficulty of treatment. Women who have had difficulties getting pregnant because of Asherman’s syndrome may have a successful pregnancy after treatment. However, the other factors that affect fertility and pregnancy may still apply. Complications of hysteroscopic gynecologic surgery are uncommon and include bleeding, perforation of the uterus and pelvic infection. In some cases, treatment of Asherman’s syndrome will not cure infertility.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.