http://www.ivf.com/faqs/endometrialfactor1.html
Question...Dec 1999, I had a miscarriage at 12 weeks and the consultant performed a D&C which did not totally clean the uterus. Another D & C was performed a week later. Since this time I have not had a period and have been given progesterone hormones to induce one. The consultant has told me that I have intra-uterine adhesions /Asherman's syndrome and that a further intervention is required to clear these. Will this affect my fertility in the future? Emma K.
Answer...Asherman's Syndrome or intrauterine adhesions is a frequent cause of amenorrhea ( absent menses ) occurring after a D&C. The likelihood of this surgical complication is greater if repeated surgery is necessary or an infection develops after D&C.
Diagnosis can be made by saline infusion sonography where a small catheter is placed into the uterine cavity and saline solution is injected during a transvaginal ultrasound examination. The adhesion can be seen as bands of tissue between the front and back endometrial surface inside the uterine cavity. Asherman's syndrome can also be detected by hysterosalpingogram or by hysteroscopy. Hysteroscopy allows surgical excision of the adhesions. High dose estrogen and progesterone can help promote healing. Often the physician will place a catheter or IUD into the uterine cavity to prevent recurrence.
Success is excellent for cases where the adhesions are mild and occupy only a small portion of the uterine cavity. If the adhesions are dense or involve a large portion of the uterine interior, results are less satisfactory and infertility may not be correctable.
Dr. Mark Perloe