Asherman’s Syndrome

Asherman’s Syndrome Specialist:

Drawing from extensive experience in patient care, Dr. Sikka offers services for women’s health throughout the Washington DC area. She has advanced training in the diagnosis and treatment of Asherman’s Syndrome and other gynecological problems.

What is Asherman’s Syndrome?

Asherman’s syndrome or intrauterine adhesions is a uterine condition in which formation of bands occurs between the upper and the lower walls of the uterine cavity. These bands or adhesions make the top and lower walls of the uterus stick to each other and hence there is limited space in the uterine cavity. When intrauterine adhesions become very severe, the condition is called Asherman’s syndrome.

How does Asherman’s Syndrome cause problems?

Intrauterine adhesions cause infertility (difficulty getting pregnant). It is difficult for the embryo to attach  to the uterus in the presence of the adhesions, hence patients will have infertility or miscarriages. A small proportion of patients may also suffer from irregular bleeding. Sometimes these adhesions can be an incidental finding of ultrasound done on the uterus for a different reason.

How do we diagnose these adhesions?

These adhesions are often diagnosed on a saline sonogram which is a special ultrasound examination. Patients who are trying to get pregnant or have had miscarriages often get this procedure done as part of their workup. Band like adhesions can be seen in the uterus in these patients . These bands are suggestive of Asherman’s syndrome.

What is the treatment of Asherman’s Syndrome?

The treatment of Asherman’s syndrome consists of removing these bands or adhesions. This is very helpful in patients who want to get pregnant. Hysteroscopy is done to help remove these adhesions. The success of pregnancy is very good once these adhesions are successfully removed. This also depends on the extent of adhesions and the duration for which the adhesions have been present. These procedures carry a risk of injury to the uterus and therefore should be performed by physicians who are performing these procedures on a regular basis.

What are the causes of Asherman’s Syndrome?

The formation of these adhesions in many instances occurs after a procedure following pregnancy. In many women, it may occur after a dilation curettage that was performed because of a missed or incomplete miscarriage.

What are the post-surgery effects?

This type of procedure does carry a risk of injury to the uterus and uterine perforation which can be minimized by having this procedure performed by a high volume physician.

Once the uterine cavity is normal, the chances of pregnancy are much higher. Patients recover very well after the procedure with mild bleeding and cramping. Depending on the extent of adhesions you may have a intra uterine catheter placed or may be given hormonal therapy for sometime to prevent adhesion formation.