Post here if you've battled Asherman's/uterine scarring

[Anonymous]

Anonymous wrote:Hi All,

How is Asherman's officially dx? I had a dnc after a loss in 07, then a c-section in 10, then another loss, then another c-section in 12. With my last pregnancy, placenta attached to some scar tissue and I had a big bleed at 30 weeks that put me in the hospital. While in the hospital, got a bladder infection that led to my baby being delivered early. The Dr said I had so much scar tissue in there that she recommends that I do not have another baby (we wanted one more). For other reasons I am no longer with her and don't totally trust her medical advice. She never mentioned Asherman's but said the scarring was pretty bad. If safe and possible, I would like to get pregnant again in another two years but need a Dr that has experience in this kind of thing.

Scar tissue is Asherman's (though I don't think it's unusual that your OB did not use the word). It is possible to do surgery to remove scar tissue, though if it's extensive the surgery may not clear it all out. In the area I recommend Dr. Robinson at GW, though yours sounds severe enough that you may also want to look out of town (I don't have experience doing so).

[Anonymous]

Can scarring usually be picked up by HSG or is hysteroscopy the usual source for diagnosis? I am having first HSG at WashRad. in a few weeks for possible scar tissue issues - 2 csections, including second that was due to pre-term birth as a result of chorioamnionitis. More cramping and strange pain (like a tugging/pulling sensation) in my uterine area that comes and goes during my entire cycle (although I am getting my period, fairly heavy), coupled with no BFP after numerous cycles has me suspect that there might be an issue there.

[Anonymous]

Anonymous wrote:Can scarring usually be picked up by HSG or is hysteroscopy the usual source for diagnosis? I am having first HSG at WashRad. in a few weeks for possible scar tissue issues - 2 csections, including second that was due to pre-term birth as a result of chorioamnionitis. More cramping and strange pain (like a tugging/pulling sensation) in my uterine area that comes and goes during my entire cycle (although I am getting my period, fairly heavy), coupled with no BFP after numerous cycles has me suspect that there might be an issue there.

HSG more or less only tells you if the "pipes are open" so to speak. They check if dye can get through to the fallopian tube. If the scarring completely covers an opening, HSG will likely pick it up. In my case, my scarring mostly but not completely covered my cervix, so dye got through and my HSG was "normal". But the scarring was enough to affect transfer and implantation. I believe that hysteroscopy is the "gold standard" for diagnosing scarring...that's how mine was ultimately diagnosed. Got pregnant with first IVF post surgery to remove scarring.

[Anonymous]

0745 here - thanks. So if the HSG is normal, do we keep trying for a few more cycles before requesting a hysteroscopy? or do doctors sometimes order it as a matter of course to rule this issue completely out? Much appreciate your help.

[Anonymous]

Anonymous wrote:0745 here - thanks. So if the HSG is normal, do we keep trying for a few more cycles before requesting a hysteroscopy? or do doctors sometimes order it as a matter of course to rule this issue completely out? Much appreciate your help.

It depends on your doctor. My doc did not order a hysteroscopy which was a big mistake since there was already an indication that something was wrong in my case. I did not get one and a proper diagnosis until I switched RE's (I also didn't know that HSG was not definitive). If it were me, I would push for a hsyteroscopy. Since you are worried that scarring is due to c-section, it seems less likely to me (not a doctor) that the scarring will be on the uterine wall and not necessarily blocking a passageway. In this case, though, the scarring could still be impacting implantation. If your symptoms haven't changed and the HSG is normal, I would push for a hysteroscopy (or really just ask for it at the outset). It depends on your sense of urgency though.