Advanced Fertility Center of Chicago ivf

Intrauterine Adhesions, Asherman's Syndrome - Scar Tissue In Uterine Cavity

Page author

What is Asherman's syndrome?

The condition of scarring within the endometrial cavity of the uterus is often referred to as Asherman's Syndrome.

A normal uterine cavity and endometrial lining is necessary in order to conceive and maintain a pregnancy. Scar tissue within the uterine cavity can partially or completely obliterate the normal cavity and can interfere with conception, or increase the risk for miscarriage or other complications later in the pregnancy.


Causes of Asherman's Syndrome

  • It is most commonly caused by the trauma to the lining from a D&C (dilation and curettage)
  • A recently pregnant uterus is much more susceptible to developing Asherman's after D&C compared to a non-pregnant uterus
  • It is sometimes caused by scarring after uterine surgeries such as Cesarean section or myomectomy for fibroid tumors
  • In rare cases it is caused by infection, such as genital tuberculosis (rare in the US)
  • We have seen some women with uterine adhesions that have never had any D&C or other surgery - some cases of Asherman's are of unknown cause

Asherman's is uncommon

  • It has been estimated that about 1% of D&Cs will cause intrauterine scarring
  • Having multiple D&Cs increases the risk for developing scar tissue in the uterus
  • D&C done for retained placental tissue postpartum is much more likely to cause Asherman's.
    • Some studies estimate the risk after postpartum curettage to be as high as 25%


Ashermans' syndome ultrasound
Ultrasound picture showing bright (hyperechoic) uterine lining - scar tissue in uterine cavity


Ultrasound image of a uterus with a normal endometrial lining
For comparison, an ultrasound picture of a uterus with a normal endometrial lining
The endometrium here is 11.2 mm thick (yellow cursors)
A normal endometrial thickness is about 8 to 15 mm


Ultrasound picture with uterus and lining outlined
Same image showing the outer uterine contour outlined in red and the "triple stripe" of 3 layers in the uterine endometrial lining outlined in green. The cervical canal is well visualized at lower right.


Hysterocopic view of uterine adhesions
View of the inside of a scarred uterine cavity using hysteroscopy
Thick white scar tissue is seen (same woman as in ultrasound at top of this page)
White patches are the scarred areas of adhesions, pink is normal tissue, dark red is blood


Scar tissue in uterius on office hysteroscopy

Office hysteroscopy showing 2 bands of scar tissue (at green X's) going from "floor" to "ceiling" in uterine cavity

Uterine cavity after cutting away scar tissue with hysteroscopy

Same view after in-office hysteroscopic resection of the scar tissue

This uterus appeared normal when studied with ultrasound alone

Scarring in uterine cavity at hysteroscopy - Ashermans syndrome

Another photo of scarring of endometrium
Area of left tubal opening at 3 o'clock
Area of right tubal opening at 9 o'clock
Scarred region is in the middle

Normal hysteroscopy picture of cavity

Normal hysteroscopy view for comparison

Intrauterine adhesions can be cut during hysteroscopy to improve chances for embryo implantation (pregnancy) and to reduce the risk of miscarriage.



4920 N. Central Ave
Suite 2C

Chicago, IL 60630

Phone: (773) 794-1818
Fax: (773) 794-1819

30 Tower Court
Suite F
Gurnee, IL 60031

Phone: (847) 662-1818
Fax: (847) 662-3001

820 E. Terra Cotta Ave (Rte 176)
Suite 118
Crystal Lake, IL 60014

Phone: (815) 356-1818
Fax: (815) 356-1866

TESTIMONIALS

profile

I am so grateful for Advanced Fertility Center. I just had my son Leland. I want to thank Dr. Catenacci and all of the nurses that helped us. Especially Ashley in the Crystal Lake office. You made this process easier by being supportive and positive. Thank you very much!

profile

Dr. Sherban and his staff are the most amazing, compassionate, and supportive people. After almost 5 years of trying to conceive, going through numerous tests and meeting with another clinic closer to home, who told me my chances even with IVF were still very low, a good friend recommended advanced fertility center of Chicago. Best decision we ever made! We now have 2 amazing children who are now 5 and 3 years old! I cannot stress enough how amazing this staff is, they make you feel like family!

profile

Our experience was amazing with Dr. Cantanucci and all of the nurses (especially Ashley). After ttc for 4 years and at 41 years of age, we became pregnant after 1 round of IVF, and had our beautiful boy this past October. Can't thank them enough!

profile

2/7/15 our son was born all thanks to the assistance of Dr. Sherbahn and his staff. Everyone was so helpful and here for all our questions, worries, etc. They want this for you just as much as you want this for you! Handled with pure professionalism and care from the very start! Thank you advanced fertility!

testimonial-banner