Asherman Foundation

About Asherman Syndrome

The formation of intrauterine adhesions (also referred to as Asherman Syndrome) occurs when scar tissue forms inside the uterus. This can narrow or partially block the space, making it harder for normal menstruation or pregnancy to occur. It often follows surgical procedures such as dilation and curettage (D&C), cesarean section, fibroid removal, or, less commonly, infections or radiation. 

Symptoms to pay attention to

• Very light periods or no periods at all
• Pelvic discomfort or cramping
• Difficulty conceiving or repeated pregnancy loss

Because the symptoms can be subtle or mistaken for other issues, it’s important to bring them up alongside your medical history with your healthcare provider.

Key diagnostic tools

Hysteroscopy:
This is considered the most accurate test. A thin camera is gently inserted through the cervix to view and assess any scar tissue directly 

Imaging tests, such as:

• Hysterosalpingogram (HSG)—an X-ray with dye that outlines the uterine cavity
• Saline infusion sonohysterogram (SHG)—ultrasound with fluid for clearer views
• Transvaginal ultrasound, which can measure the endometrial lining and hint at adhesions 

These tools help your clinician understand whether adhesive bands are present and how extensive they might be.

Treatments

To successfully restore the uterus to its normal function, your specialist might suggest a mix of different treatments. This will depend on the severity of your adhesions and your medical history. Treatments may therefore vary, and there is no one-size-fits-all. However, here’s a breakdown of the most common ones, so you can go into the conversation prepared.

Removing the adhesions

Hysteroscopic Adhesiolysis
This is the most widely used, effective first step. A special scope is used to gently remove scar tissue while preserving healthy uterine lining In more complex cases, laparoscopy may assist to protect against uterine perforation 

Preventing adhesions from returning

To avoid the adhesions from reforming, several supportive measures might be used after removal to support the uterus’ healing process.

Mechanical barriers
such as balloons, stents, or bioresorbable gels (like hyaluronic acid-based barriers: Hyalobarrier®, Seprafilm®) help keep the uterine walls apart during healing 

Hormone therapy
typically estrogen (sometimes followed by progesterone), encourages the growth of healthy endometrium and reduces adhesion risk 

Follow-up hysteroscopy
or imaging about 1–2 months later ensures that any new adhesions are detected early, so they can be addressed promptly 

Regenerative therapies 

Research is into restoring the uterus microbiome and cells balance on a deeper level is still ongoing. For patients who’ve had multiple unsuccessful treatments with recurring adhesions, the following regenerative therapies might bring hope:

Stem cell therapy, using regenerative cells to rebuild endometrial tissue 
Platelet-rich plasma (PRP), another potential regenerative tool, though data are still evolving 

While hopeful, these approaches aren’t yet considered standard care due to limited evidence — but they may become part of future treatment options. If you’re interested in participating in a clinical trial, do not hesitate to contact Asherman Therapy, part of Carlos Simon Foundation. 

Recovery

Symptom Relief

Many women notice their periods become more regular and that cramping or pain improves after treatment. Recovery looks a little different for everyone — it depends on how extensive the adhesions were and which treatments were used.

Some women may feel mild cramping or pressure in the uterus in the days after surgery. If hormone therapy is part of your care, you may notice temporary side effects, and if an intrauterine device (IUD) or small balloon was placed to protect healing, it can feel a bit uncomfortable. These are usually removed at your follow-up hysteroscopy. Most women are able to return to daily routines quite quickly.

Fertility Outlook

When adhesions are mild to moderate, many women are able to conceive successfully after treatment. In more severe cases, additional procedures may be needed. Doctors generally recommend waiting a few months before trying for pregnancy, giving the uterus time to heal and the lining a chance to restore itself. This waiting period is an important step in supporting both fertility and a healthy pregnancy.

Because pregnancies after treatment carry some risks — like placenta abnormalities or preterm labor — thoughtful prenatal care and monitoring are essential 

Steps to take from diagnosis to recovery

1. Symptom awareness
Notice changes in your cycle or comfort, and trust your observations.

2. Specialist referral
Seek a gynecologist with experience in uterine adhesions or reproductive concerns.

3. Accurate diagnosis
Ask about a hysteroscopy, possibly preceded or supplemented by imaging like SHG or HSG.

4. Surgical and supportive care
If adhesions are found, talk about adhesiolysis followed by estrogen and barrier measures.

5. Follow-up
Schedule imaging or evaluation a few weeks later to monitor healing.

6. Planning ahead
If fertility is your goal, discuss timing, monitoring, and potential next steps — including IVF if needed.

To summarize

With thoughtful care, Asherman’s syndrome can be managed effectively. Hysteroscopic removal of adhesions, supported by hormone therapy and barriers, offers real hope. If you feel uncertain or overwhelmed, you’re not alone — compassionate, expert help is available, and with the right team, clarity and healing are within reach.