Asherman's Syndrome and Miscarriages

Woman with cramps

Asherman's syndrome, or scarring and adhesions in the uterus, can sometimes be a contributing factor in recurrent miscarriages and infertility. But what causes Asherman's syndrome, how can you tell if you have it, and more importantly, what can be done about it?


Asherman's syndrome often causes no symptoms aside from trouble conceiving and/or maintaining a pregnancy. Some women may have extremely light periods or no periods at all.

Painful periods can also be a sign in some women.


The gold standard for confirming or ruling out Asherman's syndrome is to perform a hysteroscopy. Doctors may also use transvaginal ultrasound and endometrial biopsy as a part of evaluating the severity of the condition and planning treatment.


Asherman's syndrome can be a complication of having a D & C; this is the most common cause of the disorder, although the general risk of developing Asherman's syndrome after a D & C is low. Another possible cause is severe pelvic infection, although this is more rare.

Association with Miscarriages:

It is possible that scarring or adhesions in the uterus could prevent a pregnancy from receiving adequate nourishment from the uterine lining. Women with uterine adhesions have a 40% to 80% risk of miscarriage and around a 25% risk of giving birth prematurely, assuming they are able to get pregnant in the first place (infertility is common in women with Asherman's syndrome).

Treating Asherman's Syndrome:

Having surgery to remove the adhesions can improve the odds of having a successful pregnancy. The surgery usually involves hysteroscopy and may sometimes be performed at the same time as the hysteroscopy to confirm the diagnosis, especially if the doctor strongly suspects you have Asherman's syndrome.

After the initial hysteroscopic surgery, some doctors may also recommend a repeat hysteroscopy, placement of an intrauterine balloon, or oral estrogen to reduce the odds that the scar tissue will return. Exact protocols differ among practitioners, and evidence has not yet shown one method to be superior to others in preventing the return of the scar tissue.


Asherman's Syndrome. Newton-Wellesley Hospital. Accessed: Apr. 16, 2009.

Speroff, Leon and Marc A. Fritz. Clinical gynecologic endocrinology and infertility. Lippincott Williams & Wilkins, 2004. Page 1081.

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