Lara's Success Story

In 2003, I delivered my first child, a healthy baby girl, from my first pregnancy. For this I am unbelievably grateful. It was an uncomplicated pregnancy and delivery (though I did develop a significant amount of scar tissue in my pelvic floor from slight tearing and two stitches). My daughter is now 4 years old.

I got pregnant for the second time in September 2005. I miscarried at 12 weeks, 3 weeks after we saw a strong heartbeat. We have no idea why, and never will know. I then had two D&Cs, one just a few days after we learned that there was no longer a heartbeat, and one six weeks later. I had the second one because even 6 weeks after the first D&C, I was still experiencing severe cramping, heavy bleeding, had a thickened endometrial lining and elevated HCG levels and was passing retained tissue/clots. I had to move on physically and emotionally from the miscarriage, and I felt that continuing to bleed and experience pain was getting in the way of that. I wanted to get “back to normal” so I could try to conceive again, and I was concerned that if I retained products of conception for too long, I could develop an intrauterine infection. So I had the second D&C, but if I could do it all over again, I would not have agreed to that, at least not without a second opinion (the RE I saw for some of my AS treatment said that if I had been his patient at the time, he would have monitored me closely to make sure my HCG levels were dropping appropriately, and would have kept me on antibiotics, but would not have done that second D&C).

Two months after the second D&C, I still had not had a regular menstrual period. On a monthly basis, I felt cramping and soreness just as I typically felt when I was menstruating normally, but no bleeding. I spoke with a good friend who had Asherman’s herself two years prior (another member of this group), and she explained that I should not try to get pregnant until I was menstruating normally, and told me to make an appointment with a local RE that she knew and respected. Her advice was great, and I am happy to recommend him to anyone in the Washington, D.C. area who needs help diagnosing Asherman’s or with any infertility or RE issues. He is a wonderful person and an excellent physician with a brilliant mind; I really can’t recommend him highly enough.

The RE did bloodwork to rule out other possible reasons for my lack of menstruation. He confirmed that my hormone levels were normal and that I was ovulating. His colleague did an HSG. She had no trouble getting into my cervix, but when she injected the dye it went only into my cervix and could not get into my uterus. The dye was spilling out of me because it could not get any further. It seemed to stop at the end/top of the cervix (this was easy to see in the pictures), and flowed back from there. The RE tried many different angles and was convinced that it was not a technique issue. It appeared that my uterus was blocked, though it was not clear whether it was blocked from stenosis at the top of the cervix, or whether there was scarring at the bottom of -- or throughout -- the uterine cavity causing the walls of my uterus to stick together.

I immediately became a member of this listserv, and started reading whatever I could on the subject of Asherman’s Syndrome. I corresponded by email with one of the A-listers recommended by this group, asking for his opinion, and we spoke on the phone briefly, which was quite helpful. I then decided to schedule a consultation with another A-lister located closer to D.C., with whom I was able to get an appointment relatively easily, and who came highly recommended by my good friend (whose successful surgery he had done) and by others in the medical community (including my local RE, who at the time was not doing hysteroscopic surgeries himself because of a neck injury he had suffered).

The surgeon did an SHG (sonohysterography) in his office and was able to break through some of the scarring in my cervix with the tubing. He then sent me to his radiologist to get another HSG. This time the HSG worked; the dye was able to get in and we could see the scarring. Interestingly, at first the dye did not enter my tubes and we were concerned that perhaps they were both scarred shut, but then the radiologist, who was very experienced doing HSGs, told me that sometimes it helps to open up the tubes if the patient takes some deep breaths, so I did some deep breathing to relax, and sure enough both of my tubes filled up completely with the dye (so neither of them were closed).

The surgeon looked at the films and told me it looked like a moderate case of Asherman’s, about 50% of my uterus was scarred. We scheduled a hysteroscopy for late June 2006 (about a month to six weeks away from our conversation as I recall), and the surgery went fine. I had the RE in D.C. do my follow-up work (taking out the balloon stent after 7 days, doing a follow-up HSG, etc.).

I was lucky to learn in August 2006 that the surgery had been successful and the HSG showed no remaining scarring. After that great news, the RE gave me the green light to TTC. Getting pregnant turned out not to be quite so easy for me this time around, because even though my period did start again, my cycles were so irregular. But after 6 months of trying to conceive using ovulation predictor kits, etc., I took one dose of Clomid and got pregnant that cycle (with the help of the RE and his staff and their bloodwork, ultrasounds, etc.). The RE monitored me very closely for the first 6 weeks or so, until I started to see a regular OB. Thankfully, my pregnancy was uneventful and just over a month ago (at 39 weeks) I delivered a healthy baby boy! Needless to say we are thrilled and are so grateful.

Thank you so much to Poly for this website, which was the source of a tremendous amount of support and information for me (and has been a great source of support for many others, including the friend who helped me identify the problem and guided me through the diagnosis, treatment, follow-up, etc.)!

I wish the very best of luck to those who are trying to overcome AS. My thoughts and prayers are with all of you!

Lara in Washington D.C.

International Ashermans Association

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