Which are the causes of Asherman's Syndrome?

TL;DR: Asherman's Syndrome is primarily caused by trauma to the basal layer of the endometrium, most commonly resulting from uterine surgeries such as dilation and curettage (D&C). This trauma leads to the formation of intrauterine adhesions or scar tissue, which can partially or completely fuse the walls of the uterus.

What are the primary causes of Asherman's Syndrome?

The fundamental mechanism behind Asherman's Syndrome is mechanical injury to the uterine lining. When the delicate basal layer of the endometrium is damaged, the body’s natural healing process can go awry, causing the opposing walls of the uterus to stick together. While uterine surgery is the most frequent trigger, other factors can contribute to the development of Asherman's Syndrome.

What are the known risk factors for developing Asherman's Syndrome?

While a "cause" is the direct trigger, "risk factors" are circumstances that increase the likelihood of the condition occurring. Common risk factors associated with Asherman's Syndrome include:

• Dilation and Curettage (D&C): Especially when performed after a miscarriage or childbirth (postpartum hemorrhage).


• Uterine Infections: Chronic endometritis can exacerbate the risk of adhesions forming after surgery.


• Cesarean Sections: While less common, surgical complications during C-sections can lead to scarring.


• Other Procedures: Myomectomies (removal of fibroids) or hysteroscopic surgeries.

Is Asherman's Syndrome a genetic condition?

Current medical literature confirms that Asherman's Syndrome is not an inherited or genetic disorder. There are no specific genes, chromosomal abnormalities, or mutations known to cause Asherman's Syndrome. It is strictly an acquired condition resulting from physical trauma or inflammatory processes within the uterine cavity.

Is the etiology of Asherman's Syndrome fully understood?

While the link between trauma and adhesion formation is well-established, researchers are still investigating why some individuals develop severe Asherman's Syndrome after minor trauma while others do not. Current research focuses on individual variations in healing, such as the role of inflammatory cytokines and stem cell activity in the endometrium. At DiseaseMaps.org, 39 people with Asherman's Syndrome have shared their experiences, helping to provide real-world data that complements ongoing clinical studies into better preventative techniques during gynecological procedures.

Next steps

• Consult a reproductive endocrinologist or a gynecologic surgeon specializing in hysteroscopy.


• Request a diagnostic hysteroscopy, which is considered the "gold standard" for visualizing adhesions.


• Join the DiseaseMaps.org community to connect with others who have been diagnosed with Asherman's Syndrome.

Medical disclaimer: This content is for informational purposes only and does not constitute professional medical advice, diagnosis, or treatment.

References

• NIH Genetic and Rare Diseases Information Center (GARD)


• Orphanet: Portal for rare diseases and orphan drugs


• AAGL (American Association of Gynecologic Laparoscopists) guidelines on intrauterine adhesions


• PubMed: Clinical studies on endometrial regeneration and adhesion prevention