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Asherman Syndrome

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Asherman syndrome (AS) is the term used to describe infertility or secondary amenorrhea associated with intrauterine adhesions (IUAs) or development of scar tissue within the endomet...

DIAGNOSIS

HISTORY

  • History of uterine instrumentation

  • Infertility

  • Menstrual irregularities

  • Recurrent pregnancy loss

  • Cyclic pelvic pain

  • Rule out systemic endocrine disorders (eating disorders, excess exercisi...

TREATMENT

Operative hysteroscopy is the mainstay of treatment. 

GENERAL MEASURES

Expectant management is a reasonable option in women with asymptomatic and mild AS: 
  • 78% regain menses in 1 to 7 years.

  • 45....

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Uterine cavity should be reexamined before patient attempts conception.

  • HSG or SHG can be done 2 to 3 months after hysteroscopic adhesiolysis to assess if normal u...

REFERENCES

Schenker JG, Margalioth EJ. Intrauterine adhesions: an updated appraisal. Fertil Steril.  1982;37(5):593–610.  [View Abstract]
Schenker JG. Etiology of and therapeutic approach to syn...

ADDITIONAL READING

Myers EM, Hurst BS. Comprehensive management of severe Asherman syndrome and amenorrhea. Fertil Steril.  2012;97(1):160–164. 

CODES

ICD10

N85.6 Intrauterine synechiae 

ICD9

621.5 Intrauterine synechiae 

SNOMED

  • 48236007 Asherman syndrome (disorder)

  • 361115000 Intrauterine adhesions (disorder)

CLINICAL PEARLS

  • 90% of AS cases are associated with curettage for pregnancy complications.

  • Highest risk for development is trauma to endometrium, occurring within first 4 weeks postpartum or postaborti...

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