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Fertility A-Z: Asherman's syndrome

If your periods have stopped but you’re still getting the symptoms after D&C surgery, you could have Asherman’s syndrome

What is it?


Asherman's Syndrome is a rare condition that’s essentially scar tissue that forms in the uterus or the cervix, usually after miscarriage or an abortion. ‘You have a one to two per cent chance of developing Asherman’s syndrome after a miscarriage,’ says Dr Roger Marwood consultant obstetrician and gynecologist. ‘It’s much less common after c-sections and other procedures, like surgery to remove fibroids.’

After a miscarriage or abortion, doctors surgically remove part of the lining of the uterus by scooping and scraping, otherwise known as dilation and curettage (D&C). Trauma to the lining affects the normal wound-healing process, which causes the damaged areas to fuse together. ‘The walls of your uterus or cervix may stick together, which prevents your periods flowing properly, causing fertility issues,’ says Roger.

What are the symptoms?


For some, there may be no symptoms at all. ‘You may only find out if you have trouble getting pregnant,’ says Roger. Or, you may experience an irregular cycle after a D&C procedure. ‘More commonly, you’ll stop getting periods after surgery, but still experience pain and other menstruating symptoms at the time your period would normally arrive,’ he adds. This indicates that the blood cannot come out of the uterus because the cervix is blocked.

What can you do?


Asherman’s syndrome is treated through surgery. A doctor will cut away any adhesions and separate the walls using a procedure called hysteroscopy, which uses small instruments and a camera placed into the uterus through the cervix. ‘Your surgeon may place a small balloon, or coil, inside the uterus for several days to stop the walls sticking together again,’ says Roger. Plus, there’s a chance you may need surgery more than once as the condition can re-occur. It's important to remember that if you have been diagnosed, it's not your fault and there is support available.

See your GP…


If your period doesn’t return after a gynecologic or obstetrical procedure, but you’re still getting period pain. You should also get help if you’re having trouble getting pregnant after a miscarriage or abortion.

 
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