What is Asherman's syndrome?

Asherman's syndrome is a condition where scar tissue forms inside your uterus. This makes there less space inside your uterus. It is like the walls of a room getting thicker, making the room itself smaller.

This condition can cause pain in your lower belly and unusual bleeding from your uterus, and it can sometimes make it harder to get pregnant. Asherman’s syndrome can be treated, and treatment often helps with the symptoms.

Who gets Asherman's syndrome?

Asherman's syndrome is a condition you get when scar tissue forms in your uterus. It can happen due to surgery, infections, or cancer treatments.

The following risk factors might contribute to increasing the risk of Asherman's syndrome:

• Having had surgery on your uterus before, such as a hysteroscopy, a difficult D&C, or a cesarean section (c-section).
• History of pelvic infections
• Having had cancer treatments

Is Asherman's syndrome genetic?

Asherman's syndrome is usually not a genetic disease. This means you get this condition because of something that happens to you, like surgery, treatment, or infection, and it cannot be passed down from your parents.

What are the possible symptoms of Asherman's syndrome?

You can have any of the following symptoms of Asherman's syndrome. The symptoms include:

• Having very light periods.
• Not having periods or having unusual bleeding from your uterus.
• You feel strong cramps or pain in your lower belly.
• You have trouble getting pregnant or staying pregnant.

However, you may not have symptoms of Asherman's syndrome at all. You may also still experience normal periods. Then, when you feel some discomfort in your pelvis or experience unusual periods, reach out to your healthcare provider.

What causes Asherman's syndrome?

Asherman's syndrome happens when scar tissue forms inside your uterus, which makes less space inside and can sometimes block your cervix. This can happen for different reasons, but one of the most common is surgery on your uterus or cervix.

The causes of Asherman's syndrome may include:

• Operative hysteroscopy: This is a surgery where your doctor puts a camera inside your uterus and then cuts out and removes growths using special tools.
• Dilation and curettage (D&C): This is a surgery where the cervix is opened and tissue is scraped from the uterus. The tissue can be from the lining of the uterus or from a miscarriage or abortion. This usually does not cause scarring unless there is an infection.
• Cesarean section (c-section): This is a surgery to deliver a baby. Sometimes, c-sections can cause scar tissue, especially if you had stitches to stop heavy bleeding and there was an infection at the time. Otherwise, it is not likely that a c-section would cause Asherman's syndrome.
• Infections: Infections usually do not directly cause Asherman's syndrome. But if you get an infection during surgery on your uterus, like a D&C or c-section, you may be at risk for Asherman's syndrome. Some infections that could lead to this include cervicitis and pelvic inflammatory disease (PID).
• Radiation treatment: Sometimes, a treatment like radiation can cause scar tissue to form in your uterus. Radiation therapy is used for conditions like cervical cancer, but it can lead to scar tissue that causes Asherman's syndrome.

Can an IUD cause Asherman's syndrome?

An intrauterine device (IUD) is a type of long-term birth control that is inserted into your uterus and remains there for a specific period, usually several years. When an IUD is placed in your body, there is always a risk of infection and the formation of scar tissue. However, there is no proven link between IUDs and Asherman's syndrome, and they are not commonly associated with this condition.

How is Asherman's syndrome diagnosed?

Asherman's syndrome is usually diagnosed when you either have symptoms of the condition such as pelvic pain, amenorrhea (absence of menstruation), abnormal uterine bleeding or an inability to conceive and maintain pregnancy. Your medical history may contribute to a diagnosis of Asherman's syndrome. If you have undergone a dilation and curettage (D&C) procedure, a cesarean section (c-section), radiation therapy, or experienced a pelvic infection, your doctor may test you for Asherman's syndrome. These procedures and conditions can all lead to the development of this syndrome.

When you go to your healthcare provider for an appointment, they will review your medical history. If you have had any pelvic surgeries that are not included in your medical records, be sure to inform your provider. This information is crucial for diagnosing Asherman's syndrome. Your provider will perform a physical examination, but to view scar tissue inside your uterus, your provider will use a sonohysterogram. For a sonohysterogram, your provider places a small amount of saline solution inside your uterine cavity through a small catheter. They conduct a transvaginal ultrasound to check for tissue blocking the cavity or cervix.

What imaging tests can be used to diagnose Asherman’s syndrome?

Imaging tests help the doctor visualize your inner body parts. Some tests provide a view of a high resolution, and others offer much less detail. Some imaging tests can be performed at the surface of your skin with minimal to no preparation, while others are much more complex procedures.

Some diagnostic imaging tests for Asherman's syndrome include:

• Ultrasound: The imaging test uses sound waves to image your inner organs. It can be done from outside as an ultrasound scan. A type of test is also done within, referred to as the transvaginal ultrasound. In this method of test, a thin wand is inserted into the vaginal.
• Hysteroscopy: This involves inserting a narrow tube with a camera at the tip to visualize your uterus. Your doctor introduces it in the vagina and goes through your cervix to your uterus. This process will allow a detailed look within your uterus to your provider and allows treating Asherman's syndrome.
• Saline infusion sonography: This imaging test uses ultrasound combined with a saline solution-a mix of salt and water-to give a clear picture of the inside of your uterus. The fluid distends your uterus so that your provider can get details of the shape and defects of your uterine cavity. This will provide your provider with a detailed view of your reproductive organs.

How is Asherman's syndrome treated?

There are various treatments for Asherman's syndrome. In an appointment with your doctor, you may want to talk about what this condition has meant for you, including what kind of discomfort you have felt, and how you hope you might be able to conceive again in the future. Sometimes, if the woman has no symptoms, an actual treatment might be no treatment. However, if you plan to have future pregnancies, there are treatment options available that can help remove scar tissue. Treatment can also alleviate cramps and pelvic pain.

The primary goal of treatment for Asherman’s syndrome is to eliminate scar tissue and restore the uterus to its original size and shape. Effective treatment can help:

• Relieve pain
• Restore a normal menstrual cycle
• Increase the chances of pregnancy for those who are pre-menopausal

To remove the adhesions in the uterus, your healthcare provider may use a procedure called hysteroscopy. During hysteroscopy, a thin tool known as a hysteroscope is inserted through the vagina, through the cervix, and into the uterus, allowing the provider to visually inspect the uterine cavity and remove any scar tissue. It is important to note that there is a risk of damaging healthy uterine tissue while removing the scar tissue.

Hormonal treatments, such as estrogen, may be combined with a small intrauterine catheter that remains in the uterus for a few days following the hysteroscopy. This approach helps reduce the risk of the scar tissue re-forming after the procedure. Estrogen promotes the healing of the endometrium (the inner lining of the uterus). At the same time, the catheter acts as a physical barrier between the anterior and posterior uterine walls, preventing them from sticking together during the initial healing phase. In addition, antibiotics will be administered when inserting the intrauterine catheter to avoid potential infections.

Can Asherman’s syndrome be prevented?

The scar tissue of Asherman's syndrome is a potential complication of several other medical procedures. Frequently, this cannot be avoided because sometimes the procedure is necessary. Still, you should discuss with your doctor all possible risks of medical intervention before doing so as early as possible in such situations. Your doctor may schedule follow-up appointments after a procedure.

These visits will help check for scar tissue and watch for the potential development of Asherman's syndrome.

Can Asherman’s syndrome be cured?

If treatment for Asherman’s syndrome works, your symptoms should get better. Your healthcare provider will check your condition to ensure no new scar tissue forms.

Can I become pregnant after Asherman's syndrome treatment?

The answer is usually yes, especially in most instances. Infertility can be complex because the cause is not easy to determine at times. If your doctor finds that Asherman's syndrome is causing your infertility, treating it can help you have a successful pregnancy.

Why choose Tender Palm Super-Speciality Hospital for Asherman’s Syndrome treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Asherman’s Syndrome treatment in Lucknow, India, at an affordable cost. We have a team of experienced gynecologists and fertility specialists, known as some of the best doctors for women’s reproductive care. We provide accurate diagnosis with advanced imaging and hysteroscopy, personalized medical care, and uterus-preserving surgical treatment whenever possible. Our Gynecology team has decades of experience in successfully treating Asherman’s Syndrome in Lucknow, India.

To seek an Expert Consultation for Asherman’s Syndrome treatment in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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