Asherman’s Syndrome

Asherman’s Syndrome, also referred to as intrauterine adhesions or synechiae, is a condition that occurs when scar tissue or adhesions form inside the uterus, leading to partial or complete closure of the uterine cavity. The adhesions develop in the endometrium (the inner lining of the uterus) and can cause a variety of complications, including infertility, miscarriage, and menstrual irregularities. In severe cases, Asherman’s Syndrome can lead to a complete inability to conceive or carry a pregnancy to term.

The condition was first described in 1948 by Dr. Joseph Asherman, a gynecologist who observed the association between uterine surgeries, especially dilation and curettage (D&C), and the formation of these intrauterine adhesions. While the condition is relatively rare, it is important for women to be aware of its potential risks, particularly after any uterine surgery or trauma.

Asherman’s Syndrome is a treatable condition, and with early diagnosis and appropriate intervention, most women can successfully recover and restore normal uterine function. However, timely medical intervention is critical, as untreated adhesions can have long-lasting impacts on a woman’s reproductive health.

Asherman’s Syndrome is most commonly caused by trauma to the uterus, often due to surgical procedures, infections, or other factors that damage the uterine lining. The severity of the condition depends on the location, extent, and depth of the adhesions. The primary causes of Asherman’s Syndrome are outlined below:

Dilation and Curettage (D&C):

The most common cause of Asherman’s Syndrome is a D&C procedure, which involves the dilation of the cervix and the scraping or suctioning of the uterine lining. This procedure is often performed after a miscarriage or for diagnostic purposes (such as abnormal uterine bleeding). However, the mechanical process of scraping the uterine wall can damage the endometrium, leading to the formation of scar tissue and adhesions.

Other types of uterine surgery, such as myomectomy (removal of uterine fibroids) or hysteroscopy, can also result in adhesions. Multiple surgeries increase the risk, particularly if they involve the inner lining of the uterus.

Pelvic infections, particularly endometritis (infection of the uterine lining), can lead to scarring. Infections may occur after childbirth, miscarriage, or surgery. Chronic pelvic inflammatory disease (PID) or untreated sexually transmitted infections (STIs) can also damage the uterine lining and increase the likelihood of Asherman’s Syndrome.