Asherman's Syndrome (AS)

Definition - What does Asherman's Syndrome (AS) mean?

Asherman's syndrome is a condition resulting from scar tissue formation in the uterus. Scar tissue formation is most commonly due to uterine surgery and it is difficult to predict prior to surgery who may experience this scar formation. Uterine scarring may cause the menstrual cycle to stop (amenorrhea), repeated miscarriage, or general infertility. Additional surgery to remove the scar tissue may resolve fertility issues.

FertilitySmarts explains Asherman's Syndrome (AS)

In women who undergo uterine surgery, the risk of Asherman's syndrome is a serious complication in regard to future fertility. Trauma to the endometrial lining of the uterus that occurs during surgery may cause scarring or adhesions to form. Dilation and curettage (D&C) procedures after a miscarriage or therapeutic abortion are responsible for 90% of Asherman's syndrome cases. Uterine infections and c-section delivery can also cause scar formation.

The most common symptoms of Asherman's syndrome are amenorrhea, painful menstruation, repeated miscarriage, and difficulty achieving pregnancy. Although there are many potential causes of these symptoms, it is appropriate to consider Asherman's syndrome if these symptoms are experienced after a D&C procedure. Infertility, recurrent miscarriage, intrauterine growth restriction, and placenta accreta are all complications associated with Asherman's syndrome.

Direct visualization of the uterus is necessary to determine the presence of scarring. Hysteroscopy is the most reliable method for diagnosis. Other methods may include sonohysterography and hysterosalpingogram. Additional surgery to remove the scar tissue may resolve fertility issues however, adhesions and scarring have a tendency to reform after surgical removal especially in more severe cases. It is important to use minimally invasive surgical methods keep the uterine cavity open after surgical removal of scarring to prevent reformation.

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