What is Asherman's Syndrome

Asherman's Syndrome is a rare acquired uterine condition characterized by the formation of intrauterine adhesions (scar tissue) or fibrous bands that develop within the uterine cavity, often following gynecological procedures. These adhesions can cause the walls of the uterus to stick together, potentially leading to menstrual irregularities, infertility, or recurrent pregnancy loss.

What causes Asherman's Syndrome?

The primary mechanism behind Asherman's Syndrome is trauma to the basal layer of the endometrium, the lining of the uterus. This most commonly occurs after dilation and curettage (D&C) procedures, particularly when performed shortly after childbirth or following a miscarriage. When the endometrium is damaged, the body’s healing process may result in the formation of scar tissue rather than healthy lining regeneration. On the DiseaseMaps.org platform, 39 people with Asherman's Syndrome have connected to share their experiences with these often-challenging symptoms.

How is Asherman's Syndrome classified?

Clinical classification is typically based on the severity and extent of the adhesions found during a hysteroscopy. Specialists use the American Fertility Society (AFS) classification system to categorize the condition:

• Mild: Thin, filmy adhesions with a central location.


• Moderate: Multiple adhesions with partial occlusion of the uterine cavity.


• Severe: Dense, thick bands causing significant obliteration of the cavity or tubal ostia.

Who is affected by Asherman's Syndrome?

Asherman's Syndrome affects individuals of reproductive age, as it is intrinsically linked to uterine surgery and pregnancy-related events. While the exact prevalence is difficult to determine because many cases remain undiagnosed, it is estimated to occur in up to 19% of women who undergo a D&C following a miscarriage. Unlike genetic conditions, Asherman's Syndrome is not inherited; it is an acquired condition that can affect anyone who has undergone uterine trauma.

What differentiates this condition?

Unlike other causes of infertility such as hormonal imbalances or tubal blockage, Asherman's Syndrome is specifically anatomical. It is distinct because the primary issue is the physical obstruction of the uterine cavity, which prevents the endometrium from thickening properly, thereby hindering embryo implantation.

Next steps

• Consult a reproductive endocrinologist or a gynecological surgeon specializing in hysteroscopic adhesiolysis.


• Request a transvaginal ultrasound or a saline infusion sonohysterogram (SIS) to visualize the uterine cavity.


• Connect with the 39 community members on DiseaseMaps.org to share experiences and find emotional support.


• Discuss with your physician whether a diagnostic hysteroscopy is the right gold-standard approach for your specific symptoms.

Medical disclaimer: This information is for educational purposes only and does not replace professional medical advice, diagnosis, or treatment.

References

• NIH Genetic and Rare Diseases Information Center (GARD): Asherman Syndrome.


• Orphanet: Intrauterine adhesions (Orpha:99955).


• American Society for Reproductive Medicine (ASRM) patient fact sheets.