Asherman’s Syndrome is scarring of the uterus resulting in infertility that occurs after dilation and curettage (D and C) or an operation on the uterus. Asherman’s Syndrome is the cause of sterility in 6.9 percent of infertile women. (8)
Other statistics cited from studies at the International Asherman's Syndrome Association website show the incidence of when Asherman’s may occur:
- Occurred In 2.8 percent of women after caesarean section (9)
- 3.7 percent of women after a post-partum D and C (or 25 percent risk if done early between the second and fourth week after birth)(5-10)
- 6.4 percent of women after a D and C managed early miscarriage (6)
- 30.9 percent of women after a D and C managed late miscarriage (6)
- 35 percent of women after a missed miscarriage (6)
- 13 percent of women after termination of pregnancy by D and C (4)
- Between 5-39 percent of women after recurrent miscarriages all managed by D and C, and up to 40 percent of women with retained products of conception, managed by D and C(7, 12)
In my opinion, the problem of Asherman’s Syndrome and infertility after D and C is more widespread than doctors admit and should certainly receive more publicity than it does.
Asherman’s syndrome has few symptoms so one of the first things women will notice is that their periods have become very light or stopped altogether. A doctor will initially take blood samples to see if the absence of menstruation is caused by factors other than Asherman’s, for instance, hormone disorders that affect ovulation.
An ultrasound scan may be given to check the thickness of the uterine lining and the follicles.
A hysterosalpingogram (HSG) may be given to look at the condition of the uterus and fallopian tubes. This is when dye is injected into the uterus and an X-ray is taken to illuminate any problems with the uterine cavity, growths or blockages to the tubes.
The best diagnostic tool to look for Asherman’s Syndrome is a hysteroscopy. This is when the doctor dilates the cervix and inserts a hysteroscope (a type of telescope) to look inside the womb and see if there is any scarring.