Removal of Adhesion inside Uterus
What is the Removal of Adhesion inside Uterus?
Intrauterine adhesions that result in an absence of menses or menstrual cycle after curettage were first described in 1894 by Fritsch. Later in 1950, Asherman described the history cases of 29 women with amenorrhea which was secondary to trauma of the uterine cavity, the Asherman’s syndrome (AS).
When the trauma occurs in the basalis layers of the endometrium, Asherman’s Syndrome occurs after that. AS is a medical condition that indicates the presence of intrauterine adhesions or adhesions in the endocervix. It has a consequent risk of hypomenorrhea/amenorrhea, pregnancy loss, reduced fertility, and abnormal placentation.
What is Asherman’s syndrome?
Asherman’s syndrome (AS) is a rare medical condition, which a patient is not born with. It refers to the formation of scar tissue in the uterus or cervix. Due to these scar tissues, the walls of these organs stick together and reduce the size of the uterus. Asherman’s syndrome is also called intrauterine synechiae or uterine synechiae where Synechiae means adhesions. It is also called intrauterine adhesions (IUA).
How common is Asherman’s syndrome?
Asherman’s syndrome is considered a rare disease as it affects very few women. It is hard to know how many women it affects because it is not always diagnosed. Research estimates that IUA happens in nearly 20% of women who have had dilation and curettage (D&C) after pregnancy complications.
What are the symptoms of Asherman’s syndrome?
The symptoms of AS depend upon different women where some women will see no symptoms and other women will have normal periods. Some of the symptoms are:
- Having light periods (hypomenorrhea)
- Having no periods (amenorrhea)
- Having severe cramping or pain.
- Being unable to get or stay pregnant
What causes Asherman’s syndrome?
There are some causes of AS. Some of them are:
- Scar tissue caused by uterine surgery like dilation and curettage (D&C). (This causes over 90% of IUA.)
- Scar tissue after a Cesarean section or from sutures used to stop hemorrhages during normal delivery.
- Infections in the reproductive organs
- Radiation treatment
What tests are used to diagnose Asherman’s syndrome?
Your doctor will take your medical history and will do a physical examination. It is to be noted that such Adhesions can not be diagnosed by any physical examination. In this case, a cervical blockage might be indicated if an instrument cannot enter the cervix.
Your doctor might do hormone tests to rule out any endocrine problems, or he or she might use hormones to induce bleeding if you have any menstrual disturbances.
Another option to diagnose Asherman’s syndrome is saline infusion sonography (SIS), also called sonohysterosonography, or ultrasound of the uterus. SIS uses a saline solution that flows into the uterus to make imaging of the uterine cavity clearer even on a 2D scanning.
The best way to diagnose this syndrome is hysteroscopy. During this procedure, the doctor puts a telescopic-camera into the uterus to see the whole uterine cavity. Hysterosalpingography combines an X-ray and radio-opaque material or a dye that is put into the fallopian tubes and the uterus to indicate any growths or blockages. Filling defects in the uterine cavity may suggest intrauterine synechiae.
How is Asherman’s syndrome treated?
The goal of treating this syndrome is to help the uterus regain its normal shape and size. In addition to diagnosis, hysteroscopy is a procedure that can also treat IUA by cutting the adhesions with small scissors, lasers, or other types of instruments that use hooks or electrodes. You might have to have more than one procedure to get the desired results. After the procedure, your doctor may prescribe some hormones to let the uterine lining grow back correctly. This way you will have normal periods again.
Can Asherman’s syndrome be prevented?
According to some researchers, a woman who underwent uterine surgery or injuries to the uterus should also take hormone therapy or go for mechanical separation of uterine walls to prevent IUA. This way a stent is left in the uterus for some time in order to stop the development of intrauterine adhesions. Women who have had uterine surgeries may require imaging tests before trying to get pregnant to see if there are any adhesions.
Some researches have shown that the timing of D&Cs can influence the formation of adhesion. For example, adhesion is more likely to happen if the postpartum D&C is done two to four weeks after the delivery. The uterus that was recently pregnant, can be susceptible to the trauma of the basal layer of the endometrium, which can develop into intrauterine adhesions. An estimation shows that more than 90% of adhesion cases occur after pregnancy-related curettage.
What is the outlook/ prognosis for Asherman’s syndrome?
After the right treatment, when the uterus goes back to its normal shape and size, problems with menstruation will be resolved. This should help a woman to become pregnant if she wants.
In the last 20 years, most women with asherman’s syndrome returned to normal menstruation cycle and there is about 60% percent of women who conceived again.
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Had a great experience with Dr. Gunjan. We visited the clinic as we had some queries regarding the conception process. Dr. Gunjan listened to the queries and answered all those with patience. And we had good news at the next consultation itself. Dr. Gunjan is very experienced, is soft-spoken, and very diligent with the process. Highly recommended!
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A team of Specialists working together as a team with a single Goal: Patient Satisfaction
Dr. Gunjan Gupta Govil
MRCOG(UK), MD(Gynae) – Founder & CEO
She is a Gynaecologist with specialization in IVF, Infertility & Laparoscopy specialist doctor and has close to 2 decades of experience in treating Infertility, performing Gynae Laparoscopy (Keyhole Surgeries) & Handing high-risk Pregnancies. She is a noted speaker in National and International level conferences and has also chaired various sessions on Infertility
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Dr. Pradyot Kumar
Dr. Pradyot Kumar is the founder and CEO of Gunjan IVF World. He is a Neurosurgeon with specialization
(20+ years of experience)
Mr. Gaurav Singhai
Co-Founder & COO
He has 15 years of Managerial Experience from various National & International Organizations like TCS, Fiserv & Sopra Steria. He has lived and worked with various MNCs in the US, UK, France & The Netherlands and gained immense experience and skills which he now contributes to Gunjan’s IVF World assiduously.
Dr. Abhishek Parihar
He is a dedicated & experienced Gynaecologist offering comprehensive fertility practice oriented towards fertility treatment. He has vast experience in dealing with infertile couples and providing health care assistance to them during course of their treatment.
He is a highly experienced and successful Embryologist with more than 10 years of experience in IVF. He has done M.Sc. in Biotechnology from MIMS, Jaipur. He has done more than 4000 IVFs and 3000+ ICSI cases till date.)
Dr. Arshi khan
She is another proud member of our medical team & while serving as a RMO for the past few years, she assists Dr. Gunjan during her session with various patients. Moreover, She is a graduate in BUMS and aspire to achieve greater heights in her career in the future.
Ms. Nivedita Rai
She is the Head Counselor at Gunjan IVF world who counsels and coordinates with our patients during the course of their treatment. Patients hold a very high regard for her. She has pursued her MBA from IMT Ghaziabad & been a part of our Gunjan IVF world Family since past many years.
We not just treat our patient, we also guide them throughout all medical terms and their problems
Do you know the success rate of pregnancy with the IUI procedures ranges from 15% to 20% per cycle? Yes, this is true. IUI, which is Intrauterine insemination, is a kind of artificial insemination that helps in treating infertility issues. This a quick process in which the pre-selected sperm is directly injected into your uterus or womb.
IUI or Intrauterine insemination is a less invasive procedure when compared to IVF or In vitro fertilization. Couples get many benefits from this procedure as the chances of pregnancy increase a lot because of IUI.
The reasons for an unsuccessful implantation are very uncommon and rare as well. Blastocyst provides a greater chance of becoming pregnant therefore the procedure is handled properly as well.
Before jumping to the immediate question first let’s have a small brief of what is blastocyst transfer. Blastocyst transfer is the transfer of embryos that have achieved a higher stage of development.
Normally in natural pregnancy, when a period cycle starts, an egg gets matured in the ovaries. When it becomes 18-20 mm then it is released at that time. After a physical relationship between a couple, the sperms fertilize this mature egg in the fallopian tube. Once the fertilization occurs, this fertilized egg converts into an embryo and sticks to the uterus that causes pregnancy.
If we talk about the term “Secondary Infertility” it generally refers to a situation when a woman is going through certain infertility issues even after carrying a baby already in her life. Moreover, this type of Infertility results in almost 50 percent of total infertility cases in women around the world. This is most common in couples who think of having a baby in their late 30s and 40s.
Egg freezing, medically known as human oocyte cryopreservation. It is an effective procedure allows the woman to go against the biological clock. It enables women to postpone pregnancy to a later date. In this phenomenon, eggs extracted, frozen and stored. The success rate of the procedure depends on the age of the woman and ranges from approximately 14% to 30%.