Asherman Syndrome: How Does It Affect Fertility?

Asherman Syndrome is a rare but serious condition that affects the uterus and can lead to fertility problems in women. It occurs when scar tissue forms inside the uterine cavity, causing the walls of the uterus to stick together. This can interfere with a woman’s menstrual cycle, the implantation of an embryo, and the ability to carry a pregnancy to term. Understanding this condition, its causes, symptoms, and treatment options is essential for anyone facing unexplained infertility or menstrual irregularities.

What is Asherman Syndrome?

Asherman Syndrome is a condition characterized by the formation of adhesions or scar tissue inside the uterus. These adhesions can range from thin, web-like bands to thick, dense scars that partially or completely block the uterine cavity. As a result, the normal shape and function of the uterus are disrupted, making it difficult for an embryo to implant and grow.

This condition most often develops after surgery or injury to the uterus, especially following procedures like dilation and curettage (D&C) performed after a miscarriage, abortion, or delivery. Infections of the uterus or pelvic area, as well as cesarean sections or other uterine surgeries, can also contribute to the formation of intrauterine adhesions.

What Causes Asherman Syndrome?

The most common cause of Asherman Syndrome is trauma to the uterine lining. When the inner layer of the uterus, called the endometrium, is damaged, scar tissue can develop as it heals. This scar tissue may connect different areas of the uterine wall, leading to a partial or complete blockage of the cavity.

Some of the major causes include:

• Repeated or aggressive D&C procedures after miscarriage or abortion
• Infections like tuberculosis or pelvic inflammatory disease
• Uterine surgeries such as myomectomy or cesarean section
• Radiation therapy or intrauterine devices that cause injury

Not all women who undergo these procedures will develop Asherman Syndrome, but the risk increases with repeated uterine trauma or infection.

What Are the Symptoms of Asherman Syndrome?

The symptoms of Asherman Syndrome can vary from mild to severe, depending on the extent of scar tissue formation. Common signs include:

• Light or absent menstrual periods
• Pain during menstruation without much bleeding
• Repeated miscarriages
• Difficulty conceiving
• Pelvic pain or discomfort

In some women, menstruation may stop completely, a condition known as amenorrhea. Others may have cycles that are regular but with very light flow. These symptoms can make diagnosis challenging unless a woman is actively trying to conceive or undergoing fertility evaluation.

How Does Asherman Syndrome Affect Fertility?

Fertility is often the most affected aspect of Asherman Syndrome. The scar tissue inside the uterus prevents proper implantation of a fertilized egg, making it difficult to achieve pregnancy. Even if conception occurs, the risk of miscarriage or complications like placenta previa, preterm delivery, and abnormal placental attachment is higher.

In severe cases, the uterine cavity may be so blocked that sperm and egg cannot meet, or an embryo cannot implant at all. Without treatment, Asherman Syndrome can lead to long-term infertility or recurrent pregnancy loss.

How is Asherman Syndrome Diagnosed?

Diagnosis typically begins with a detailed medical history and physical examination. If a woman reports irregular or absent periods, or infertility following uterine surgery, doctors may recommend imaging tests such as:

Hysterosalpingography (HSG): A special X-ray that shows the shape and size of the uterine cavity.

Sonohysterography: An ultrasound test performed after saline is introduced into the uterus to visualize adhesions.

Hysteroscopy: The most accurate diagnostic tool for Asherman Syndrome, where a small camera is inserted into the uterus to directly view scar tissue and evaluate its extent.

What Are the Treatment Options?

Treatment for Asherman Syndrome focuses on removing the scar tissue and restoring normal uterine function. The main treatment is hysteroscopic adhesiolysis, a minimally invasive procedure where a specialist uses a hysteroscope to carefully cut and remove the adhesions.

After surgery, doctors may insert a small balloon or intrauterine device temporarily to prevent the walls of the uterus from sticking together again during healing. Hormone therapy with estrogen is often prescribed to promote the regrowth of healthy endometrial tissue.

Regular follow-up through imaging tests or repeat hysteroscopy is essential to ensure that the uterus heals properly and that no new adhesions form.

Can Fertility Be Restored?

Many women regain their fertility after treatment for Asherman Syndrome, especially when the condition is diagnosed early and treated by an experienced specialist. However, the chances of conception depend on the severity of the adhesions and the success of the surgical procedure. Women who have mild adhesions often have excellent outcomes, while those with extensive scarring may need advanced fertility treatments like in vitro fertilization (IVF).

Living With Asherman Syndrome

While Asherman Syndrome can be emotionally challenging, especially for women trying to conceive, advances in diagnostic imaging and minimally invasive surgery have made recovery and fertility restoration more achievable than ever. Early detection and treatment greatly improve the chances of a successful pregnancy.

If you have missed periods, pelvic pain, or trouble conceiving after a uterine procedure, it is important to consult a specialist promptly. Addressing the condition early prevents complications and increases the likelihood of successful treatment.

Why Choose Continental Hospitals for Asherman Syndrome Treatment?

Continental Hospitals in Hyderabad is one of India’s most trusted multispecialty healthcare centers, offering comprehensive women’s health and fertility care. The hospital is accredited by JCI (Joint Commission International) and NABH (National Accreditation Board for Hospitals & Healthcare Providers), ensuring the highest standards of safety, quality, and patient care.

Our team of expert gynecologists, reproductive medicine specialists, and minimally invasive surgeons work together to diagnose and treat complex uterine conditions like Asherman Syndrome using advanced technology and personalized treatment plans. With state-of-the-art operating rooms, modern fertility labs, and compassionate care, we ensure patients receive the best possible outcomes.

If You Suffer from Asherman Syndrome

If you are experiencing irregular menstrual cycles, repeated miscarriages, or difficulty conceiving, do not ignore the signs. Early diagnosis and expert care can make a significant difference in restoring your fertility and quality of life.

At Continental Hospitals, Hyderabad, our specialists provide accurate diagnosis, advanced hysteroscopic treatments, and ongoing support to help you achieve a healthy pregnancy.

Conclusion

Asherman Syndrome may be rare, but its impact on fertility can be profound. With timely diagnosis, proper treatment, and expert medical care, most women can recover and go on to have successful pregnancies.

If you are facing symptoms of Asherman Syndrome or infertility, consult the Obstetrics and Gynecology Department at Continental Hospitals, Hyderabad. Our dedicated specialists are committed to helping women overcome reproductive challenges with compassion, precision, and excellence in care.