Ashermans syndrome? What is going on?

[tabegle]

I went to Dr. Google and I shouldn’t have.

Maybe you remember my saga from earlier this year where I had weird pregnancy stuff, but it all ended in a missed miscarriage. I elected for a d&c, done early July. Since then, I had a period in mid August (first period post d&c was such an emotional drain), a chemical pregnancy in September, regular period last month, and now another chemical pregnancy.

I didn’t call the doctor after the chemical in September because I didn’t see the point; they never knew about the pregnancy and a lot of people have chemical pregnancies. I did call this month when I got my positive, but will call again on Monday since I started my period.

But seriously, I had three wonderful, great pregnancies. And now, FOUR losses in six months?! Two of those are post D&C (confirmed with multiple home pregnancy tests each). I know I’m getting up there in age, but I was only 36 by the time my third child was born. I didn’t think I’d have issues since I had successful pregnancies prior to age 35.

So, Dr google came up with Ashermans. Symptoms: recurrent miscarriage, much lighter or no periods.
My symptoms: 2 chemical pregnancies and periods that pre d&c were 7 days, post d&c are 4 days.

Ashermans.org states that D&Cs may also lead to Asherman's Syndrome in 30.9% of procedures for missed miscarriages. That’s a huge percent!

Am I reading too much into this? Could it be something else? Could it be nothing? What likely is it?

Any advice or words of wisdom are welcome. I’ll be calling the dr on Monday and would love to have a list of questions to be prepared with.

Thank you all!

[essnce629]

My best friend had her DS1 when she was 26 and her DS2 at 28 years. No miscarriages during that time. Then in July 2014, at 33 years old, she had a missed miscarriage at 12 weeks and a D&C. It took her 7 months to get pregnant again after the D&C and it ended in an early miscarriage at 5 weeks. Four months later she was pregnant again. It also ended in an early miscarriage at 5 weeks (so 3 miscarriages in a year). After the third miscarriage she saw an RE and her DH had a sperm analysis as well (he was perfectly fine). The RE ended up doing a hysteroscopy which is when they go in and visually look inside the uterus with a scope. The RE told my friend she had a ton of inflammation and adhesions, most likely from the D&C a year earlier! She put her on a strong course of antibiotics (doxycycline) and also manually broke up the adhesions during the hysteroscopy (which my friend said was extremely painful). The following cycle after the antibiotics and hysteroscopy, my friend got pregnant again. She is now 18 weeks pregnant with a girl and everything is going great! So yes, Asherman's was most likely causing all the issues. With all the inflammation and adhesions the embryo couldn't implant properly.

I'd highly suggest that you also see an RE. Ask them to test you for the MTHFR mutation as well which also causes repeat miscarriage and would mean you need to be on blood thinners to sustain a pregnancy. After my miscarriage last year I found out I am homozygous for MTHFR. I never had any previous problems with my pregnancies, but my doctor said I'd need to start baby aspirin asap if I ever get pregnant again. Others have told me that I need to be on baby aspirin before then because it is necessary to thin the blood to allow for implantation to even occur. I am on baby aspirin 3 days a week now (daily was causing bruising).

[Philly Mom]

My SIL had three easy pregnancies and then had a similar history to what you described. They went to an IVF doctor. Still no luck. Once they gave up hope and started planning without, she got pregnant. She is due soon. Everything has been great for her in this pregnancy.


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[tabegle]

My best friend had her DS1 when she was 26 and her DS2 at 28 years. No miscarriages during that time. Then in July 2014, at 33 years old, she had a missed miscarriage at 12 weeks and a D&C. It took her 7 months to get pregnant again after the D&C and it ended in an early miscarriage at 5 weeks. Four months later she was pregnant again. It also ended in an early miscarriage at 5 weeks (so 3 miscarriages in a year). After the third miscarriage she saw an RE and her DH had a sperm analysis as well (he was perfectly fine). The RE ended up doing a hysteroscopy which is when they go in and visually look inside the uterus with a scope. The RE told my friend she had a ton of inflammation and adhesions, most likely from the D&C a year earlier! She put her on a strong course of antibiotics (doxycycline) and also manually broke up the adhesions during the hysteroscopy (which my friend said was extremely painful). The following cycle after the antibiotics and hysteroscopy, my friend got pregnant again. She is now 18 weeks pregnant with a girl and everything is going great! So yes, Asherman's was most likely causing all the issues. With all the inflammation and adhesions the embryo couldn't implant properly.

I'd highly suggest that you also see an RE. Ask them to test you for the MTHFR mutation as well which also causes repeat miscarriage and would mean you need to be on blood thinners to sustain a pregnancy. After my miscarriage last year I found out I am homozygous for MTHFR. I never had any previous problems with my pregnancies, but my doctor said I'd need to start baby aspirin asap if I ever get pregnant again. Others have told me that I need to be on baby aspirin before then because it is necessary to thin the blood to allow for implantation to even occur. I am on baby aspirin 3 days a week now (daily was causing bruising).

Thanks Essence. I will definitely ask for the MTHFR mutation. If the ob doesn't do it, I do see an Endo for my thyroid and she's good about running tests.

[tabegle]

Thanks ladies. This gives me hope. :-)

[tabegle]

I went to the dr yesterday and she seemed to be at a loss for what is going on, refusing to admit a possibility of Ashermans or MTHFR based on 1) not having ever seen ashermans in her life and 2) I've had successful pregnancies. She's blaming it on age, but I pointed out it shouldn't be age yet since I've already had kids. She was in the camp of just keep trying. So I asked, what do I do when I get another positive, just wait and see (because at this point I pretty much expect another loss honestly). She gave me the name of two RE that she recommends and is running a couple of blood tests. I really hope this is a simple easy fix. I want my children to be close in age and if this doesn't happen soon, we are going to close that door. :-(

In other news, I told a few people and it's irritating. "Just be happy with the ones you have." Whatever. There is nothing wrong with working towards what you want in life. In nearly every other aspect of life people say if you don't like it, change it.

[essnce629]

So sorry about people's irritating comments! Wanting another baby or feeling upset about all your losses doesn't mean you're not happy with your current children. I got similar comments and it sucks.

I'd definitely see the RE. It was a great decision for my best friend and truly just a simple fix.

[MSWR0319]

I had a D&C a week after having DS1 because of hemorrhaging. The on call dr that did it told me to be aware of Asherman's as time goes on due to the D&C so early after pregnancy. About a year later I started having very light periods every two weeks or so. They really thought it was just my birth control (which wouldn't be an issue for you) but given the D&C she did a procedure where they put some type of dye into my uterus and let it go throughout to see what type of damage,etc there was. This would check for any Asherman's syndrome. They found nothing other than one of my tubes was probably blocked! She said they wouldn't worry about that until I had trouble getting pregnant if we wanted to again. It couldn't hurt to get checked just to rule it out. I have a friend who had a similar problem to you, where she had successful pregnancies and then once she hit 35 had many miscarriages. It just ended up being an age issue of her. Everything checked out fine. She did go on to have a successful pregnancy.

ETA: Wanted to add that my OB told me if it did turn out to be Asherman's there were ways to have a successful pregnancy and she wasn't worried about that at all.
ETA2: This is the test I had: hysterosalpingogram (HSG)

[tabegle]

Thanks for sharing your story! I had an initial consult with the RE and they have a list of things for me to do. They are running all kinds of blood work, then they'll check a bunch of stuff on day 2 of my cycle through both more blood work and an ultrasound. On day 10, I'll have a Saline Sonohystogram <- this is an ultrasound with saline inserted into my uterus and will show if there is scar tissue or polyps preventing a good implantation.

And to be honest, my post D&C 2 day cycles are also the first cycles I've had since my dd2 was born in July 2014. I got pregnant the first time I ovulated after giving birth so the change in the length of my period could have been from giving birth not the D&C. Who knows. Hopefully I'll have some answers within the next month.