Some inexperienced doctors may recommend performing a D&C to remove Asherman's adhesions; however, this is the most dangerous treatment for this condition and may irreparably damage the uterus. In addition, doctors should not use anything that conducts heat, such as a laser, to remove the adhesions due to the potential for actually incurring new and permanent damage to the endometrial lining.
The chance of a woman with Asherman's conceiving and carrying a child to full term depends on many factors, including the severity of scarring, the skill of the surgeon who performs the corrective surgery, and the amount of healthy endometrium still remaining in the uterus. In some cases, if the remaining endometrial lining is either extremely thin and/or spotty instead of being continuous, a biological child is impossible. This most often occurs after an aggressive D&C or corrective surgery that removed or damaged basal endometrial cells (the layer of cells responsible for the re-growth of the endometrium each month as part of the menstrual cycle). Currently, there are no treatments available to correct such damage of basal endometrial cells.
According to the International Adhesions Society, approximately 70 to 80 percent of women diagnosed with Asherman's syndrome will go on to have a successful pregnancy after treatment. However, such a pregnancy involves greater risk and should not be attempted until all adhesions have been completely removed. A pregnancy after Asherman's has a higher risk of miscarriage, placenta previa, placenta increta (when the placenta attaches itself deep into the uterine wall), bleeding during pregnancy, and stillbirth.
Some doctors encourage women who are not planning to have children to still have their adhesions removed, due to the increased risk of developing endometriosis. This may happen if the cervix is sealed closed by adhesions, preventing menstrual flow from leaving the body and causing it to flow backwards into the fallopian tubes or abdominal cavity. However, other doctors insist that, unless the woman intends on having children, corrective surgery should not be performed.
If you have been diagnosed with Asherman's Syndrome, a support group may be a helpful way to gain information, advice, and encouragement from others with the condition. Go online to the Asherman's Syndrome Online Community Website which provides information about online and local support groups, or the International Adhesions Society's Website which offers a list of support groups around the world.
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