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
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