Occlusion of some part of the female genital
tract, especially of the vagina. (Dorland, 28th
"A condition where the uterine walls adhere to
one another, usually caused by uterine inflammation."
In most cases, Asherman's is caused by an overly aggressive
procedure called a D&C, which is performed following
a miscarriage, birth or for evaluation of the uterus.
Asherman's can also result from intrauterine surgery
to remove fibroids, uterine structural defects (septum,
bicornuate uterus, large polyps), or at cesarean section
infections related to IUD use (or the placement of any
foreign object within the uterine cavity).
In rare cases, other infections or radium insertion
into the uterus for the treatment of gynecologic cancers
can lead to Asherman's Syndrome.
- No menstrual flow (amenorrhea) or decreased menstrual
- Recurrent miscarriages
These symptoms are more likely to indicate Asherman's
syndrome if they occur suddenly after a D and C or other
A pelvic exam is usually normal. If Asherman's syndrome
is suspected, your doctor may recommend a hysterosalpingogram
(an X-ray test of the uterine cavity) or hysteroscopy
(an outpatient surgical procedure). During hysteroscopy,
a small camera is inserted through the cervix that allows
your doctor to look at the inside of your uterus under
magnification. These tests may reveal scar tissue partially
or completely filling the uterine cavity.
If infertility is a problem, other tests or evaluations
may be recommended and it maybe necessary to consult
an infertility specialist.
Asherman's syndrome should be treated if it is causing
infertility or amenorrhea. Surgical treatment includes
cutting and removing adhesions or scar tissue within
the uterine cavity. This can usually be performed by
hysteroscopy - small instruments and a camera are placed
into the uterus through the cervix.
After scar tissue is removed, the uterine cavity must
be kept open while it heals to prevent recurrence of
the adhesions. Your doctor may place a small balloon
inside the uterus for several days, and may prescribe
estrogen replacement therapy to take for several months
while the uterine lining heals.
If tuberculosis or schistosomiasis infections are detected,
antibiotic treatment will be necessary.
Asherman's syndrome can be cured in most women with
surgery, although sometimes more than one procedure
will be necessary. Approximately 70-80% of women who
are infertile because of Asherman's syndrome will have
a successful pregnancy after treatment.
Complications of hysteroscopic surgery include bleeding,
perforation of the uterus and pelvic infection, although
these are uncommon. In some cases, treatment of Asherman's
syndrome will not cure infertility
Source: SeattleInsider.com / Adam.com, Inc. / Illustrated
Overview of Asherman’s Syndrome
- Asherman’s Overview from National Library of
- Asherman’s Overview – PubMedHealth
- Asherman’s Syndrome: WebMED.
of Asherman's syndrome.
surgery and adhesion prevention. Asherman's syndrome.
treatment of severe Asherman's syndrome and subsequent
syndrome: a review of the literature, and a husband
and wife's 20-year world-wide experience.
following surgery for Asherman's syndrome may improve
- The role of Seprafilm bioresorbable membrane in the
prevention and therapy of endometrial synechiae
- Effectiveness of autocrosslinked hyaluronic acid
gel in the prevention of intrauterine adhesions after
of a polyethylene oxide-sodium carboxymethylcellulose
gel in prevention of intrauterine adhesions after hysteroscopic
- The effectiveness of hysteroscopy in improving pregnancy
rates in subfertile women without other gynaecological
For a compendium of photographs from a Google search
of intrauterine adhesions, click here
- Dr. March - Hysteroscopy: Lysis of Adhesion
Syndrome Specialist, Mr. Lower: Interview
to Related Conditions