Do you experience or have a history of any of the following?

• Menstrual changes: sudden reduction in menstrual flow or absence of menstruation, a lot more brown blood/less red blood. Note: a few sufferers don't notice menstrual changes.
• Pain or cramping at the time of menstruation with little or no blood (pain resulting from outflow obstruction)
• Endometriosis: this could result from backflow of blood caused by AS.
• Unexplained infertility (primary or secondary)
• Repeated miscarriage which is unexplained.
• Invasive placenta (eg. Placenta accreta, placenta percreta, placenta increta) in a past pregnancy could possibly indicate AS.

Do you have a past history of uterine surgery?

Examples:

• D&C (in the presence or absence of infection) for any reason including:
  • miscarriage (missed or incomplete)
  • retained postpartum placenta
  • postpartum hemorrhaging
  • elective abortion/termination of pregnancy
  • endometrial biopsy
  • fibroid removal
  • treatment of excessive uterine bleeding
• Hysteroscopic myomectomy
• C-section
• Uterine artery embolization
• Endometrial ablation (This is the intentional creation of Asherman's Syndrome to treat excessive uterine bleeding.)

Have you ever had the following?

• Manual removal of placenta
• Uterine packing (filling the uterus with gauze; sometimes used to control postpartum hemorrhaging)
• Pelvic irradiation (cancer treatment)
• Caustic abortifacients (douching with a corrosive chemical to induce an abortion)
• Endometrial tuberculosis

Have you tested the following?

• Blood tests: Estrogen, LH, progesterone, FSH, thyroid, prolactin to rule out hormonal problems affecting ovulation. Some women may not want to jump into hysteroscopy or HSG, which are not without some risks.
• Imaging:
  • Ultrasound to measure endometrial thickness at ovulation and to check normal follicle development
  • Sonohysterography (SHG) or hysterosalpingogram (HSG (these procedures are not as accurate as hysteroscopy, but will confirm patency of tubes if infertility is a problem)
• Other: Some doctors suggest a hormone challenge test but this can be a waste of time if blood tests are normal. It just gives pain for women whose periods are blocked by Asherman’s Syndrome.
• Gold standard for diagnosis: diagnostic hysteroscopy