Infertility Cause
A major infertility cause are adhesions within the uterus. They develop after a D&C when the lining is removed.
It has been reported that 88% of AS cases occur after a D&C is performed on a recently pregnant uterus, following a missed or incomplete miscarriage, birth, or during an elective termination (abortion) to remove retained products of conception.
Pelvic adhesions (scar tissue) can cause the uterus, fallopian tubes and ovaries to stick together. Adhesions often prevent the reproductive organs from functioning normally, leading to pelvic pain and infertility. It prevents an embryo from embedding in the wall of the uterus.
Some women with pelvic adhesions experience no symptoms at all. Others have significant pelvic pain, reduced menstrual bleeding, pain with intercourse or painful ovulation.
In some cases, adhesions may be suspected based on the symptoms, an ultrasound or a hysterosalpingogram. However, the best way is a laparoscopy. This procedure allows a surgeon to determine the location and appearance of adhesions. They then assess how they may be affecting the function of the pelvic organs (particularly the tubes and ovaries).
Treatment
Adhesions can be difficult to treat, but for women with pelvic pain and infertility, specialised surgical removal of this scar tissue can have a positive impact on quality of life and fertility.
Pelvic adhesions are treated primarily with laparoscopic surgery. The standard method of removing adhesions involves cutting the scar tissue using laparoscopic scissors or a cautery device. These methods, while commonplace, result in a high risk of the scar tissue returning, since they cause so much trauma to pelvic tissues that scarring returns.
Asherman’s Syndrome
Although the first case of intrauterine adhesion was published in 1894 by Heinrich Fritsch, it was only after 54 years that a full description of Asherman syndrome was carried out by Joseph Asherman.
Other terms used to describe the condition include: uterine/cervical atresia, traumatic uterine atrophy, sclerotic endometrium, and endometrial sclerosis.
Before having a D&C women should be warned about the risk of this complication occurring. As part of the consent process there should be a full and frank discussion to aid understanding and choices of treatment.
Call us today
If you’re ready to discuss your situation or have any questions please contact Dr Victoria Handley today. Don’t suffer in silence. Call FREE on 0800 470 2009 or email vhandley@handleylaw.co.uk