Infertility after D&C with repeat miscarriage, pain and no periods is Asherman’s Syndrome. It can occur in 30% D&C procedures.
Dilation and curettage (D&C) is a procedure to remove tissue from inside your uterus (retained products of conception). Doctors perform dilation and curettage to diagnose and treat certain uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion. Asherman’s can occur after polyp of fibroid removal.
There is a risk of developing intrauterine scar tissue following any trauma to the uterine cavity. The risk becomes much higher in patients undergoing post-partum D&C for retained placenta or multiple fibroid resections within the uterine cavity. Patients should be warned about this risk. Most often they are not.
Uterine curettage, especially repeated curettage, leaves traces which have far reaching consequences. Performing a D&C on a uterus that has recently experienced birth is almost always a precursor for developing Asherman’s. The uterus is boggy and soft. The metal instruments damage the uterine walls, which leads to scarring and an Asherman’s diagnosis.
A boggy uterus is where the uterus is more flaccid than would be expected. This type of uterus is often seen in postpartum females due to uterine atony. A boggy uterus may also be seen in adenomyosis. Uterine atony is the loss of tone in the uterine musculature. Thus it is at a higher risk of damage caused by D&C and resulting in Asherman’s.
The cause of monthly cramping and pain but a lack of menstrual periods is often undiagnosed. Not all women have no bleeding. Some have spotting. Many women have swollen stomachs. For several days each month women are in great discomfort, unable to even walk or sit properly without being in great pain.
They are just not the ‘normal’ periods that occurred, for them, before the D&C. The adhesions at the lower portion of the uterus near the cervix can ‘close’ the cervix. Thus monthly menstruation cannot be expelled from the body. It causes immense pain.
When a woman who has undergone a D&C has cyclic symptoms such as pain without vaginal bleeding, Asherman’s syndrome should be the first diagnosis to consider.
Recurrent pregnancy loss may lead to a diagnosis of Asherman’s. The scarring which develops after an initial miscarriage or procedure contributes to later miscarriage. Insufficiency of the endometrium might be a possible reason for implantation failure, failure and the need for repeat D&Cs.
The build-up of scar tissue prevents the pregnancy embedding in the wall of the uterus. There is a risk of various placental complications or having an incompetent or weakened cervix. This is caused by the repeated cervical dilations which leads to second trimester loss of premature delivery.
A combination of delayed childbearing, multiple losses, and a delay in establishing a diagnosis of Ashermans often results in post-Asherman’s pregnancies occuring in women who are somewhat older and may have hormonal deficiencies. Losing a baby in pregnancy through miscarriage is still a taboo subject. It is devastating every single time.
If you think you may have a claim for Infertility after D&C then call us in confidence to discuss your issue. We are happy to talk through what has happened and advise you on a potential claim. Call us for FREE on 0800 470 2009 or email Dr Victoria Handley at firstname.lastname@example.org