ASHERMAN'S SYNDROME - problems conceiving after ERPC

[FifiOK]

Does anyone have any experience of this ? Or if you too are having problems after an ERPC then have a read of this. www.timesonline.co.uk/tol/life_and_style/health/features/article3025016.ece

I'm off to see my GP this Friday so would really appreciate any advice.

Thank you.

Hi
I'm sorry to bother you, but I'm going through a bit of a rough patch and I'm hoping you can give us some hope. I'll take you to the beginning.
My name is Charlene Thompson I am 29 years old and in good health.
In 2012 I gave birth to my beautiful daughter now nearly 4 year's old and perfect. After her birthday I had a retained placenta. I had a manual removal under local anesthetic. It was completely adhered to the uterine wall. It took 3 hours for the procedure and they almost had to do a historectomy.
At the time I was just relieved that they had managed. I breast fed my daughter for 2 years.
I had no periods at all for the first 6 months but I put that down to breastfeeding.
Once I started having periods they were regular and seemed normal.
We weren't using any contraception at that point as I was unable to bare having sex as it was very painful, simular to that as when you are crowning. This pain resolved after a year so I started taking the mini pill. This completely stopped my periods which I thought was great. Until I'd been on it for about 8 months then I bled all of the time so decided to stop taking it and my cycle returned to normal.
I then had a merina coil which again stopped my periods, great.
I had this removed in November 2015
To try for another baby.
Fell pregnant found out 2nd Feb 2016
Had a add small bleed on 5th March scan on 7th confirmed that baby had died at 8 weeks. I should have been 11 weeks. We were devastated. After the options being explained a d and c sounded like the best option. It was made to sound almost risk free. Scaring was mentioned but made to sound negligible. And I didn't want to become unwell while looking after my daughter.
I had the procedure at RVI Newcastle. It was completed under general anesthetic with no complications and I went home later same day on 8th March.
After this I had the expected bleeding for 2 weeks it was never heavy infact it was significantly lighter than a period. After that I had almost daily spotting for 4 weeks sometimes with pain like period cramps sometimes not. Then it reduced to every few days some times up to 7 days in-between spotting episodes. Often so little that it is only noticed on wiping.
But it's 13 weeks since now and still no period.
We have been trying to conceive again all pregnancy tests have been negative.
I am growing increasingly worried about my future fertility. And I doubt we have the money to go private. I don't even know if we would qualify for treatment as we already have a child.
I have just had a blood test at gp to check hormone levels awaiting results.
And awaiting date for ultrasound scan.
I am worried about Ashermans syndrome.
Is there any specialist in North East England.
Also how much would it cost to have private treatment if necessary
Please help any advice welcome.

Regards
Charlene Thompson

Hi Charlene,

Have you had any results from your gp or had your scan?

Xx

Afaik, you need a hystero-salpingogram to diagnose Asherman's syndrome. Mine never showed up on ultrasound scans of the pregnancies, which all miscarried and it took up 50% of my uterus.

We went to see Robert Winston after 3 miscarriages. He found it during a full infertility investigation. He divided the adhesion, and the next pregnancy went to term. As Asherman's syndrome can cause painful periods, I Would have thought you could get any surgery on the NHS.

CHarlene, Adrian Lower at Nuada Medical on Queen Anne Street London is an expert on Ashermans. also look at the International Ashermans Association

I have had no periods since an ERPC in March. My second ERPC in 18 months plus I had manual removal of placenta after the birth of my twins so quite a lot of uterine surgery. I too get pain around the time I would expect periods and also my abdomen is bloated pretty much all the time but sometimes it gets worse. I look about 6 months pregnant. Periods were completely normal prior to last ERPC despite being older. Currently undergoing second set blood tests to see if I have become menopausal but timing seems too conincidental. Has anyone else had this swollen abdomen problem?

Hi Ladies,

I wandered if this thread was still going?

Hi @Lizjulie1234. I'm awaiting investigations for Asherman's also. Had an EMCS with my DD almost 4 years ago, followed by a bad uterine infection. Since then I have had very light periods- previously pretty heavy. I've now had 3 miscarriages (2 before 6 weeks, currently in the middle of a MMC- having medical management to avoid ERPC if at all possible, although it obviously might be needed). The EPU consultant I've been seeing thinks he can see lower uterine adhesions- hopefully not too severe as I'm conceiving ok.

Hi all.
I was diagnosed recently with adhesions, probably severe ashermans as absence of period the last 5 months. I had very little flow after an ERPC about 5 years ago. I knew it was asherman's but just managed to get a diagnose.
The consultan I saw said that the success of an operation in severe cases is 30%.
Can anyone suggest a specialist on adhesions in the UK ? In the past I read that there are probaply 2 specialist in UK that have a great experience and can operate with a better chances of success...

@Jackmou hi I am also suspecting that I have Ashermans as no periods after my d and c which was 10 weeks ago. I have a small piece of retained tissue but Hcg is zero and negative pregnancy test. I am not sure it’s whether the retained tissue or Ashermans. I am so confused because in my last scan they saw that I ovulated and has given me three more weeks to wait for my periods. Did you manage to get your treatment sorted ?

So sorry you're suffering. My ashermans diagnosis felt like the end of the world. I ended up with ashermans after an ERPC. Luckily I stumbled across an article about it and after hounding my GP for a referral ended up going to see a specialist privately. If you're in or around London Mr Adrian Lower is the one to seek advice from.

He worked wonders and I had a very successful pregnancy post op! There's hope!

Hello, I know this thread is a bit old, but maybe someone will see this.

I had an ERPC for a MMC about 5w ago and my periods are yet to return. I know 4-6w post-MC event is 'normal' but I'm concerned as I've been getting weird crampy pains in my tummy lately, and also every time I have exercised since the op I get a bit of pink discharge that comes to nothing. I'm scared that there is some sort of blockage/interuterine adhesion that is preventing things from coming out.

I am booking an appointment with Mr Lower early next month (the soonest he is available) but just curious if anyone else was in this situation and how it worked out for them? I am keen to have a scan and either get reassurance or a diagnosis.

I'm so sorry about your MC. Such a difficult time.

I was in a similar situation. I saw Mr Lower. That man is my hero! I have 2 healthy, happy boys now.

He can work wonders if you are suffering though stress can cause a lot too. Easier said than done but try not to panic until you know what you're dealing with. For now be kind to yourself. It sounds like you've been through a lot!

@whathappenedtosleep Thank you for your kind words.

I was so excited yesterday evening as I started to get really bad cramps and when I went to the toilet there was the smallest hint of pink when I wiped, so I thought perhaps I might get some relief, but sadly nothing has come out overnight apart from two tiny streaks of brown. The bad cramps from yesterday are gone now this morning.

I had a private u/s on 2 May where they said that everything looked OK and I was about to ovulate, but I know normal u/s can't detect Asherman's and tomorrow will be 3w from the scan which is now well overdue for a period... I'm mainly worried that something has happened to my cervix and is preventing the blood from coming out, as that might explain why I get spotting when I exercise (i.e. the physical agitation is allowing a few drops to come out).

The loss was my first ever pregnancy and so I have never experienced what it's like trying to get periods back after an MC; I was lucky enough to be very regular before, and so blithely thought it would be the same afterwards. I am also frustratingly still seeing a shadow on a 10mIU test which seems ridiculous to still have HCG in my system at 5w post-op. I am 100% not pregnant. as with all of this happening my desire for intimacy has gone down the drain.

I am very confused as to where I am in my cycle now, and am feeling very stressed. I am trying to just remain calm until I can get some more information in June, but it's very hard as I want nothing more than to be back to normal again.

Hello, I hope you don't mind me jumping on... I know this is an old thread but can I ask please what were your first symptoms of Ashermans? I had an MVA for an mmc 9 weeks ago. I didn't get a negative pregnancy test until 6 weeks after the procedure and then ovulated about 3 days after the negative. 2 weeks after I ovulated I started getting period pains and I had spotting for three days - dark brown/black blood with some small clots but the flow was very light and more like spotting than a proper period. This has made me worry as I was expecting a heavy period first cycle after mc. I have read about Ashermans and am wondering whether to book in for some private tests. I had an internal ultrasound 3 weeks after the procedure to check for retained tissue (none could be seen) and was told all looked normal but I know it's rarely detected on ultrasound.

@whathappenedtosleep What was the outcome of your tests if you don't mind me asking? Hope you are doing okay xx

@Northernsoul90 I had a hysteroscopy for this yesterday. I haven't had a period since my second ERPC on 31st March although I was having period pains (not bad at all but more than I would normally have had ).

I saw the GP twice, was asked to wait the first time as perhaps my body 'just needed more time' and then sent for a scan after the second appointment. The scan didn't show any problems but did identify that I had just ovulated.

I made another appointment with my GP who couldn't understand what the problem was or why I had contacted them because the scan was fine......she called a gynaecologist who was apparently confused because I shouldn't be ovulating with no period and a normal hormone profile and she wanted me to keep waiting. The fertility team I had been in contact with before the pregnancy thought the lack of period could just be stress...... I gave up and went through my work BUPA. The consultant could see it wasn't right within about 5 seconds of looking at his scan.

@Northernsoul90 I will say though that after my first ERPC my periods were REALLY light - I'm talking lasted 1 -2 days and I barely need a liner. I had that investigated and there was no evidence of scarring (an unusual filmy tissue?? which was removed) and I got pregnant again very quickly after that.

@zoomies1
Hope you feel better soon and they cleared it all up for you.

@Northernsoul90 I had no bleed at all after my ERPC, terrible cramps and increased temperature but with no bleed for months. My doctor responded so similarly to @zoomies1 and after being dismissed I went privately and got diagnosed by a specialist in minutes. There are some amazing people out there who can help if needed. Best of luck!