Asherman's syndrome consists of the formation of intrauterine adhesions (scar tissue) that characteristically develops after uterine surgery.
It is an acquired pathology, you are not born with it. Its cause is a growth of fibrous tissue on a scar, or in an area where trauma has occurred.
Asherman's syndrome affects approximately 8% of women, and can be found in between 2 and 22% of women with fertility problems.
Women affected by this medical condition present adhesions, or synechiae, inside the uterine or endometrial cavity. These adhesions cause a partial or total obstruction of the cavity, making it narrower or deforming it.
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Depending on the degree of involvement of Asherman syndrome we can find mild, moderate or severe cases. The latter is the one with the worst prognosis, since in this case the uterine walls are fully adhered.
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Causes of Asherman's syndrome
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Although there are various causes for this syndrome, in more than 90% of cases the origin is uterine curettage, after a spontaneous or induced abortion.
However, Asherman's syndrome can also appear due to endometrial infections, IUD use, uterine surgeries, etc.
Asherman's syndrome symptoms
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How to detect this pathology in time? What symptoms do you usually present before female fertility is endangered? We tell you the most common:
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Menstrual disturbances. Reduction or absence of menstruation (amenorrhea), mainly due to the reduction of functional endometrial tissue, and by obstruction of the cervix by adhesions, which make it impossible for menstrual bleeding to come out.
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Pelvic or abdominal pain. Usually caused by this retention of menstrual bleeding.
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endometriosis. The possible menstrual retention can, in a retrograde way, go to the abdominal cavity, facilitating the generation of in susceptible womenendometriotic foci.
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infertility. All these adhesions prevent the correct development of the endometrium, causing a failure of implantation of the embryo. Or, if a pregnancy occurs, the correct development of this, such as miscarriages.
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These symptoms may be related to, and are probably indicative of, Asherman's syndrome if they occur suddenly after a D&C or other uterine surgery.
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Diagnosis of Asherman's syndrome
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Its diagnosis can be suspected by the symptoms y by ultrasound and confirmed with a diagnostic hysteroscopy.
Asherman's syndrome treatment
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Treatment includes surgery to cut and remove adhesions or scar tissue. This is usually done with a hysteroscopy, which uses small instruments and a camera inserted into the uterus through the cervix.
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There is a risk of recurrence of Asherman's syndrome in between 3 and 23% of patients. Fortunately today there is treatment, such as the use of estrogens, to prevent this recurrence, although the results tend to be variable.
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We have extensive experience in this type of hysteroscopic surgery and the most common results are usually the total correction of the problem in two months. In the most complicated cases, menstruation prior to the onset of the Syndrome is recovered and many women achieve pregnancy by solving the problem.
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