need help re: hysteroscopy following aggressive D&C

[Anonymous]

A month ago, I had a miscarriage at 14 weeks with an emergency D&C that required vigorous scrapping because the placenta had adhered to the uterine wall. It was my second miscarriage but first D&C. Because I'm 39, I want to check as soon as possible to see if there was damage (i.e., Ashermans).

Although I lived in the DC area for a long time (former Reiter Hill patient), I am currently living overseas in a country with not-so-hot medical care (also got the D&C done in the not-so-hot medical care country). I will be in DC very briefly this summer and will have one day (1 day!) to see someone to check it out. Because of my limited time, I don't think I want to mess around with the HSG. I want to go straight to the hysteroscopy.

Who can you recommend? Also, has anyone had a similar experience - rather aggressive D&C following incomplete miscarriage - and have done a hysteroscopy?

Thanks!

[Anonymous]

Do you mean an operative hysteroscopy or just the kind where they look around? I had the latter done in-office at CCRM but I don't know if any local REs have that capability. I had an operative hysteroscopy with Women's Health Specialists, but that doesn't sound like what you're looking for.

[Anonymous]

7:51 again. Forgot to say that I'm sorry for your loss.

[Anonymous]

I don't know if they'll do it but I had an HSG and a lap/hysteroscopy with Shady Grove. Maybe calm them to explain and ask how you cam proceed? Good luck and sorry for your loss.

[Anonymous]

OP, I'm so sorry.

I don't have any relevant personal experience, but I could wholeheartedly recommend Dr. Rafat Abassi at Columbia Fertility as a resource. I'm sure she would be willing to talk with you by phone to discuss your clinical options. CFA has a fairly full service clinic in DC but I don't know the limits of their capabilities. She is smart and direct and responsive by email/phone (when necessary) so might help at least point you in the right direction.

Good luck.

[Anonymous]

OP, I'm sorry for your loss. It's good that you're being proactive about potential scar tissue. Many doctors will do the "looking" hysteroscopy and then do removal in the moment if it seems feasible. For that reason, I'd start with the best.

I thought I might need removal, but the tissue ended up magically resolving itself, so I didn't actually use these guys, but when I did research about 6 months ago, Robinson at GW had the best reputation locally. Out of town, Keith Isaacson in the Boston area has a reputation as a miracle worker.

[Anonymous]

I hear dr.robinson is good for asherman's patients

[Anonymous]

Anonymous wrote:I hear dr.robinson is good for asherman's patients

This is the go to guy for Ashermans. Went to see him before spending more money on another cycle. Very nice. He's at GW/Sibley.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I hear dr.robinson is good for asherman's patients

This is the go to guy for Ashermans. Went to see him before spending more money on another cycle. Very nice. He's at GW/Sibley.

Third recommendation for Dr. Robinson. He removed my scar tissue, and I got pregnant on the next cycle. They usually do an exploratory hysteroscopy first, then reschedule the surgery to be done under anesthesia. You may as well call in advance and see what they can do, though it may be tricky since they aren't going to want to put you under unless they know you need scar tissue removal.

FWIW, the idea that aggressive scraping is what causes Asherman's is no longer considered to be true. Some people are just prone to scarring after any kind of irritation to the uterus, and other's aren't I developed it after a very routine D&C for a 6 week MMC (D&C was at 8 weeks).