What Causes Asherman’s Syndrome?

What Causes Asherman’s Syndrome?

Asherman’s Syndrome, also referred to as intrauterine adhesions (IUA), is a condition that occurs when scar tissue forms on the lining of the uterus, often resulting in infertility.  There isn’t any one cause of Asherman’s Syndrome, but it is expected that 90% of the cases are caused by a surgical procedure, and especially D&Cs.  The main reasons for having a D&C are:

  • after a miscarriage to reduce the risk of a serious infection;
  • after childbirth to remove a retained placenta;
  • to stop excessive bleeding at birth; and
  • after termination of a pregnancy.

Thinking about this, it seems odd that a surgical procedure, which is supposed to help you, causes you further trouble… So, why is this?

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Getting to Grips with Asherman’s Syndrome

Getting to Grips with Asherman’s Syndrome

A month ago, I left hospital after surgery feeling quite positive despite having a punctured uterus (the hole-in-the-wall) and a stitched-up tummy.  Morphine does wonders to your mental health – I can see the benefits of being a junkie!
I thought I simply had to take the oestrogen tablets (progynoba) that I had been prescribed for six weeks, recover from surgery and then move to IVF early June… Bam!
BUT, what I learnt since leaving hospital is that:
  1. Asherman‘s Syndrome is not a straight-forward condition (in fact, it is quite a rare one so awareness about the condition is low — even among the medical profession)
  2. most women need the same operation several times to clear all the scarring; and
  3. a pregnancy with Asherman‘s can lead to all sorts of complications – including, increased risk of miscarriage and stillbirth because there isn’t enough space in the uterus for the baby to grow.  SCARY SHIT.

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Asherman’s Syndrome – Diagnosis and My Very Own Hole-in-the-wall

I had my hysteroscopy scheduled for 18 April 2017, the Tuesday after the Easter weekend.  I walked to hospital in the sunshine and remember feeling very positive.  I was almost skipping down the street – in hindsight this might seem like odd behaviour for someone who was heading to hospital to be put to sleep…. who doesn’t love a daytime nap?!
I figured I wold be under for 5-10 minutes – after all this was just a quick check that everything was as it should be in my uterus.  I thought I’d be out for a few minutes, wake up, recover and then skip out of the hospital into that beautiful, sunny spring day.  I met the anaesthetist, the surgeon and signed the usual consent forms.  All set.  “See you in a little bit”, I said to H and then casually strolled into the theatre in my [sexy] hospital nightie (you know the one with an open back where you’re showing your bottom to everyone else on the ward).
I woke up hours later in a daze and in a lot of pain – and I could hear H saying “can I take a picture of the records” followed by “is that negligence?”. I  was wheeled into the gynecology ward where they wanted to monitor me over night. I remember feeling confused: (a) why was I on the ward; and (b) why was I in so much pain?

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My Stubborn Bean

My Stubborn Bean

Fast-forward six weeks to mid-November 2016.  I was feeling a little better following the miscarriage.  We had had a lovely week in Dubai to load up on vitamin D ahead of the winter, so things seemed brighter.  My period had returned (somewhat normal – I can’t remember to be honest) at the right time, so I felt hopeful.  My body was back to normal!

I went for an ultrasound scan with the guy I had been to see previously on Harley Street to track my ovulation (I wanted to make sure I was ovulating regularly again). The good news was that I was ovlulating, but the bad news was that the scan showed that part of the foetus was still in my uterus.  WTF?!!

It turned out that the little foetus, my bean, was more stubborn than its mother (what comes around…) and would not give in.  Sobbing loudly I walked back to the Early Pregnancy Unit (EPU) (again) at the London Hospital and asked to be seen.  The lady at the desk asked if I had had my period.  Yes, I replied, but I KNOW there is still a piece of the foetus inside me.   She didn’t believe me until I managed to get the private ultrasound report sent over.

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Dear Beautiful Bean – a Letter to my Angel

Dear Beautiful Bean – a Letter to my Angel

Dear Beautiful Bean,

Today, Thursday 13 October 2016, is a very hard day. Yesterday they removed you from me. Tomorrow you would have been 11 weeks and while this may seem like nothing in real time, it felt like a long time to me. I had gotten used to having you in my tummy, and your daddy was used to stroking my tummy. In fact, sometimes I’d wake up in the middle of the night finding him holding me and my tummy, protecting you little Bean, in his sleep. It was really sweet.

I had gotten used to the idea of having you around next summer. I’d, perhaps foolishly, made cute little plans in my head. I even looked at prams online before going to the appointment on Monday…

The days and weeks felt so long, waiting, waiting, waiting… and I was finally at the point of relaxing a little. I’m a facts and numbers junkie.  The stats showed that by this point we were down to 3-4% risk of miscarriage after the scan at 7 weeks showed a heartbeat and all being well.  That’s 96-97% chance of a healthy baby.  So, it feels so unfair and unlucky that you were in that 3-4% group.  FFS, that’s really, really bloody unlucky! Last Friday I proudly said to your daddy that (my pregnancy app told me) you’d graduated from embryo to foetus – in truth you never made graduation.  Your little heart had stopped before then.

I know this is nature’s way of making sure you weren’t born with defects. I know it’s nature’s way of telling us you weren’t meant to be. But, nature is cruel sometimes because I so badly wanted you little beautiful Bean to grow into a beautiful baby.  I’m sure you would have been a little boy, but I’ll just never know now.

One of the hardest things in all this is seeing your daddy so upset. I’ve seen him sad, stressed and angry, but never this sad. He’s lost his spark. He misses you too, very much so.

I know we will go on to make another one, but I will never ever forget this moment or you. The tears are rolling down my cheeks as I write this.  You’ll always have a piece of my heart.

Love,

Mamma ❤️❤️❤️