What the heck is Asherman’s?

It was two months after my second surgery that I realized something was wrong. I hadn’t had a period, or anything resembling a period. I rang BEP (my obstetrician) and asked what might be causing this. He advised that it could be what I would later term “stubborn cervix syndrome” in that the cervix had reacted badly to the surgical procedure and remained tightly shut, or it could be hormonal, or there may be a few other explanations. He asked me to have a pelvic scan to rule out anything untoward, like Asherman’s Syndrome. I didn’t ask what Asherman’s Syndrome was.

The sonographer was pregnant I noticed. She was pleasant enough, and advised that she wanted to discuss what she had seen with the resident gynecologist. I waited for a few minutes and was then ushered into a separate room. They asked me to sit down. “We don’t really know what the situation is in your uterus, there are a few lumps that could be clots, and a lot of liquid that should be coming out but isn’t.” They seemed deliberately vague. It was a Friday afternoon, and my obstetrician rang and asked if I could please see him first thing on the Monday morning. Alarm bells were ringing. Once again I cried.

Don’t ever Google Asherman’s Syndrome. When I did it produced the most horrible results. Essentially, what was primarily discussed was a risk of the uterus scarring or even fusing together post-surgery, leading to a build up of blood inside the uterus and infertility. I totally flipped out when I read this.

BEP was great. He clearly saw the worry on my face. We read through the sonographer’s report line by line and he explained to me every aspect of it. “Asherman’s Sydrome covers such a broad range of conditions, from extreme to minor, that the term is effectively redundant,” he explained. “Thank God,” I thought, “hopefully we might fall into the minor category”. He suggested that he perform a procedure to dilate my cervix, and in the event that blood came out over the next few days and months that would indicate that there was no lasting issue, but rather a case of “stubborn cervix syndrome”.

It was certainly not glamorous and involved old-fashioned stirrups, but I didn’t care. The procedure appeared to be a success. A small amount of blood came out immediately. He prescribed me a contraceptive pill for a few months to “get things back on track”.

At my follow up scan, a different sonographer spent some time taking a variety of images. She advised that she wanted to discuss what she had seen with the resident gynecologist. I waited for a few minutes with my son, anxious as anything. The same gynecologist came into the room and said, “well it’s a different story today”. I didn’t know whether that was positive or not. “Is that a good thing or a bad thing?” I asked. “Good! Definitely good.” I think I had been holding my breath until that moment. What a massive relief. “There’s some blood remaining in your uterus but if I didn’t know your history I wouldn’t have thought twice about it. Compared to last time when it DEFINITELY WAS NOT NORMAL!” She mentioned something about “products of conception”. I was a bit taken aback at her forthrightness now that everything was seemingly OK. And this was the first time that anyone had suggested that perhaps some “products of conception” remained, that is, that the surgery had not been fully successful. I felt relieved, and confused, and sad.

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