Asherman’s Syndrome is an excess of tissue inside the uterus that can affect fertility, but many women achieve a successful pregnancy after Asherman’s syndrome treatment. Discovering the stages of this medical condition and understanding the other symptoms early can be significant in the cure for asherman disease.
In this article, we will consider the symptoms, causes, and treatment of this disease in detail. We will also say how couples who suffer from infertility due to this condition can have treatment.
What is Asherman’s syndrome?
Asherman’s Syndrome is a rare uterine disorder caused by scar tissue, sometimes referred to as adhesions or intrauterine adhesions, that accumulates inside the uterus. This excess tissue decreases the space inside your uterus. Imagine a place in the center of a room growing smaller and smaller as the walls become thicker and thicker.
In addition to causing abnormal uterine bleeding and pelvic pain, this disorder may result in problems with conception. Treatment is an option for Asherman’s syndrome, and it frequently alleviates symptoms. For couples seeking advanced reproductive options such as IVF in Iran, ICSI in Iran, or surrogacy in Iran, understanding and managing Asherman disease is crucial since it can impact fertility outcomes.
In medical terms, the buildup of scar tissue is also known as uterine synechiae, which refers to internal uterine adhesions. Understanding Uterine synechiae vs Asherman’s syndrome helps distinguish general uterine adhesions from the more severe scarring pattern seen in Asherman’s syndrome.
How common is Asherman’s syndrome?
Asherman’s syndrome is regarded as an uncommon condition. Because Asherman disease can go undiagnosed, it is difficult to determine the precise number of people suffering from it. It is possible for some people to have no symptoms at all. You might never see a physician if you don’t have any symptoms.
Who gets Asherman’s syndrome?
Since Asherman’s syndrome is an inherited condition, scar tissue typically develops as a result of an event. Asherman’s syndrome can be acquired through a variety of procedures, such as cancer treatments, infections, and surgery.
The following factors may make you more vulnerable to Asherman’s syndrome:
- If you have previously had uterine surgery, such as a complicated dilation and curettage (D&C), a cesarean section (c-section), or an operative hysteroscopy.
- If you have experienced pelvic infections in the past.
- If you have undergone cancer treatment.
Is Asherman’s syndrome genetic?
In many cases, Asherman’s syndrome is not inherited. This indicates that you do not inherit this condition from your family; rather, it develops as a result of an event (such as an infection, surgery, or treatment side effect).
What causes Asherman’s syndrome?
Asherman’s syndrome is caused by adhesions, or scar tissue, that accumulate inside the uterus, constricting its interior space and sometimes blocking the cervix. Although there are a number of reasons why this can occur, uterine or cervical surgery is frequently one of the primary causes.
Asherman’s syndrome may have the following causes:
- Operative hysteroscopy: A procedure in which your doctor inserts a camera into your uterus before using an electric device to cut off and remove fibroids.
- Dilation and curettage (D&C): This type of surgery involves opening your cervix (dilating) and then removing tissue from your uterus. This tissue may come from an abortion or miscarriage, or it may be the endometrium, the lining of your uterus. The excess tissue is scraped away with a tool during the procedure. Unless you have an underlying infection, this usually doesn’t leave scars.
- A cesarean section (c-section) is a surgical procedure used to deliver a baby. A c-section may occasionally result in the formation of scar tissue. This may occur if you had an infection at the time of the procedure and the stitches were used to stop bleeding (hemorrhages) during the C-section. Otherwise, Asherman’s syndrome is extremely uncommon after a C-section.
- Infections: Asherman’s syndrome is usually not caused by infections alone. However, Asherman’s syndrome can occur if you get an infection during uterine surgery, such as a D&C or c-section. Cervicitis and pelvic inflammatory disease (PID) are two infections that may cause Asherman’s syndrome.
- Radiation therapy: Scar tissue could develop in your uterus as a result of a treatment option. Radiation therapy can be used to treat diseases like cervical cancer, but it can also result in adhesions, or scar tissue, which can cause Asherman’s syndrome.
Can an IUD cause Asherman’s syndrome?
Not necessarily. One form of long-term birth control is an intrauterine device (IUD), which is implanted inside your uterus and left there for a while (usually several years). There is a risk of infection and scarring when this device is inserted into your body. However, IUDs are not frequently associated with Asherman’s syndrome, and this is not a known cause of the condition.
Stages of Asherman’s syndrome
The severity of Asherman’s syndrome can vary depending on how much of the uterine cavity is affected. This severity can include severe, mild, and minor stages.
Tiny patches of thin scar tissue and slight menstruation alterations are signs of the mild stage. Partial uterine obstruction and painful or irregular menstruation are symptoms of the intermediate stage. Prolonged scarring in the severe stage can completely obstruct the uterus, often leading to infertility or amenorrhea.
Knowing the stages of Asherman’s syndrome, doctors can decide on the best course of action and possibilities for fertility.
What are the symptoms of Asherman’s syndrome?
Asherman’s syndrome is associated with a wide range of symptoms. These signs may consist of
- Experiencing hypomenorrhea, or extremely light periods.
- Experiencing irregular uterine bleeding or not getting your period (amenorrhea).
- Experiencing excruciating pelvic pain or cramping.
- Having trouble becoming or remaining pregnant.
In some cases, women may experience recurrent miscarriage causes due to uterine adhesions that interfere with implantation or fetal growth. Some patients may also notice Asherman’s syndrome discharge, which is an unusual vaginal issue related to trapped menstrual blood or infection caused by uterine adhesions.
You might not have any Asherman’s syndrome symptoms in certain situations. Additionally, you might still have regular periods. Consult your healthcare provider if you experience any pelvic pain or irregular periods.
How is Asherman’s syndrome diagnosed?
Symptoms such as pelvic pain, irregular menstruation, abnormal uterine bleeding, or difficulty becoming and maintaining pregnancy are commonly used to diagnose Asherman’s syndrome.
Asherman’s syndrome may also be diagnosed based on your medical history. You might be tested for Asherman’s syndrome if you have had radiation therapy, a c-section, a dilation and curettage (D&C) procedure, or a pelvic infection. Asherman’s syndrome can result from any of these treatments and circumstances.
After a physical examination, your doctor will do a sonohysterogram to look for scar tissue inside your uterus. Your doctor uses a tiny catheter to inject a small amount of saline solution into your uterus during a sonohysterogram. Transvaginal ultrasonography is then used to check for tissue obstructing the cervix or cavity.
What tests can be used to diagnose Asherman’s syndrome?
Your healthcare provider can view your internal organs through imaging tests. The level of detail varies depending on the test. These tests can be performed on top of your skin with little to no preparation, or they can be more involved.
The following imaging tests can be used to identify Asherman’s syndrome:
- An ultrasound imaging test that creates an image of your internal organs using sound waves. An Asherman’s syndrome ultrasound can be performed internally using a transvaginal ultrasound or externally on your skin. This version of the test involves inserting a thin wand into the vagina.
- Through a hysteroscopy, your doctor looks inside your uterus using a thin instrument that has a camera attached to it. This passes through your cervix and into your uterus after being placed in your vagina. Your doctor can examine the inside of your uterus in great detail with a hysteroscopy. Asherman’s syndrome can also be treated with it.
- Via the imaging procedure of saline infusion sonography, a clear image of the inside of your uterus is obtained by using ultrasound in conjunction with a saline solution, which is a mixture of salt and water. In order for your healthcare provider to see the specifics of your uterine cavity’s shape and defects, the fluid causes your uterus to enlarge. This allows your doctor to examine your reproductive organs in great detail, both inside and out.
What are the complications of Asherman syndrome?
Asherman syndrome patients may be more susceptible to the following complications:
- Infertility, or the inability to become pregnant
- Frequent miscarriages
- Menstrual irregularities, like irregular or light periods
- Cramps or pelvic pain, occasionally brought on by an obstructed menstrual flow
- Accumulation of menstrual blood that becomes stuck in the uterus due to obstruction or scarring (known as hematometra)
- Obstetric complications include low birth weight, retained placenta (when the placenta does not deliver after childbirth), preterm labor (early delivery), and placenta issues.
- After giving birth, postpartum hemorrhage, or severe bleeding, occurs.
- Scar tissue recurrence following therapy
- Recurring surgical operations are required to remove persistent or new adhesions.
- Rare side effects of surgery include infection or uterine perforation, which is a hole in the uterine wall.
Treatment methods for Asherman syndrome
There are a number of ways to Asherman syndrome cure. It’s important to talk to your healthcare physician about your emotions around this medical condition, including any discomfort you may be experiencing, as well as your future fertility aspirations. Sometimes the best course of action for a woman who isn’t exhibiting symptoms is to do nothing at all.
However, there are treatments that can eliminate the scar tissue if you intend to have more children in the future. If you have pelvic pain or cramps, treatment may also be helpful.
Returning your uterus to its natural size and shape while removing the scar tissue is the major objective of treatment. Asherman syndrome treatment can be helpful:
- Reduce pain.
- Restore your regular periods and menstrual cycle.
- If you’re premenopausal, consider the chance of getting pregnant.
To remove the adhesions in your uterus, your doctor could perform a hysteroscopy. During a hysteroscopy, your doctor looks inside your uterus using a narrow instrument called a hysteroscope. Scar tissue can also be removed with this instrument.
The hysteroscope is passed via your cervix, into your uterus, and into your vagina. This surgery involves the meticulous removal of scar tissue. While eliminating the scar tissue, there is a chance that this operation will harm good tissue inside your uterus.
A tiny intrauterine catheter may be placed into your uterus for a few days following the hysteroscopy in conjunction with hormonal therapy (estrogen). This will lower the possibility that scar tissue will grow again following the Asherman syndrome treatment.
In actuality, estrogen helps your endometrium (the cavity’s inner lining) recover, and the catheter creates a physical barrier between your anterior and posterior uterine walls to prevent adhesions in the days after the scar tissue removal surgery. You will receive medicines to help prevent infections once an intrauterine catheter is placed.
Can Asherman’s syndrome be prevented?
No, because the scar tissue associated with Asherman’s syndrome may result from a number of different medical treatments. So, the condition often cannot be stopped because you need the medical operation.
When possible, it’s important to discuss any potential risks associated with a medical treatment with your healthcare physician in advance. Following a procedure, your doctor could arrange follow-up visits to look for scar tissue and monitor the potential onset of Asherman’s syndrome.
Can Asherman’s syndrome cause infertility?
Yes. Excessive scar tissue inside the uterus can lead to infertility by blocking sperm or embryo implantation and, consequently, be one of the causes of infertility. However, with proper treatment and access to advanced infertility treatment methods, pregnancy may still be possible.
If you have been unable to have a successful pregnancy after Asherman’s syndrome or childbirth after 12 months of trying (or six months if you’re over age 35), your healthcare provider may run many tests to diagnose infertility.
Your doctor may find scar tissue (Asherman’s syndrome) inside your uterus during these tests. Infertility may result from having a lot of scar tissue inside your uterus.
Does Asherman’s syndrome cause miscarriage?
Yes, it could. Although you can get pregnant if you have Asherman’s syndrome, your uterus has less room. Because your uterus must make room for a developing baby, it might lead to issues during pregnancy. During pregnancy, your uterus grows and stretches. For your developing baby’s growth, the placenta’s connection to the uterine wall is also essential.
Women with this condition should consult fertility specialists who are experienced with recurrent miscarriage causes and uterine abnormalities.
Therefore, complications with Asherman’s syndrome can raise your chance of problems during pregnancy, such as placenta previa, stillbirth, or miscarriage. The condition known as placenta previa occurs when the placenta is affixed to the uterine wall in an extremely low position. It might block your cervix, which would prevent your unborn child from leaving your uterus. Heavy bleeding and cesarean delivery are associated with this syndrome.
Conclusion
Asherman’s Syndrome (or asherman disease) can affect fertility, but with the right Asherman syndrome treatment, many women achieve a successful pregnancy after Asherman’s syndrome. Early diagnosis of Asherman’s syndrome ultrasonography along with understanding of the symptoms, is essential for recovery.
For patients who are seeking compassionate, world-class fertility care, TebMedTourism stands as a trusted international healthcare facilitator. By offering access to top Iranian and global specialists and free consultations, we provide comprehensive fertility services. The services include Asherman syndrome treatment, infertility management, and advanced reproductive technologies—all within a supportive and affordable framework.
