What are adhesions?
Adhesions are bands of scar tissue that form between or inside of the abdominal organs including the uterus, ovaries, fallopian tubes or intestines.
Asherman Syndrome is used to describe adhesions that are in the uterus. Uterine adhesions can obstruct or damage the inside of the uterus, preventing an embryo from developing to full term.
Causes of uterine adhesions
Uterine adhesions can occur following surgical procedures like dilation and curettage (D&C). Post-surgical adhesions are more likely after open surgery rather than laparoscopic surgery.
Adhesions may form in the uterus from endometriosis, pelvic inflammatory disease (a condition primarily caused by an STD) or removal of fibroids.
Symptoms of uterine adhesions
Uterine adhesions may not have any external symptoms. Women may experience menstrual changes such as absent or infrequent, lighter or painful periods, or pelvic pain. Recurrent miscarriages can also be a sign of uterine adhesions in some women.
Treatment for uterine adhesions
After diagnosis (usually from medical imaging), surgical removal of uterine adhesions by hysteroscope is performed under anesthesia.
After treatment, women with mild to moderate adhesions have successful full-term pregnancy rates of about 70-80%. The full-term pregnancy rates drop to 20% in women with severe adhesions.
Women with extensive damage to the uterus even after treatment may not be able to carry a pregnancy to full term. In vitro fertilization using a surrogate to carry the pregnancy to term and adoption are also options.