Asherman's Syndrome: Commutable to pregnancy

Asherman's Syndrome is an acquired uterine condition, characterized by the formation of adhesions or scar tissue inside the uterus and/or the cervix. Patients usually present with infertility, recurrent pregnancy loss, menstrual irregularities and cyclic pelvic pain.

The cause of intrauterine adhesions is mostly iatrogenic (40%) as in dilatation and curettage (D&C) for a miscarriage, abortion, or retained products of conception. Other causes include pelvic infection and pelvic tuberculosis.

Here we present a 30yrs old woman with history of one D&C for incomplete abortion, who was anxious to conceive. On hysteroscopy she was diagnosed with moderate Asherman's syndrome. Hysteroscopic adhesiolysis was done and an intrauterine device was inserted. Second look hysteroscopy was done after one month which showed a well formed cavity. Now, 8 months after surgery she has conceived and successfully achieved 18 weeks gestation.

The authors present this case to show that hysteroscopy aids and provides a real-time view of the cavity, enabling accurate diagnosis, grading and concurrent treatment of intra uterine adhesions, hence improving the chances of pregnancy.