Amps, while it is so crucial to have the cervix open to conceive (and have a successful transfer!), it is also encouraging that there didn't seem to be any scarring in the uterine cavity itself That usually bodes well for a future pregnancy. Hopefully now the cervix is open the lining will pick up. I can't remember, did you end up having and MRI while you were in Sydney to check on the vascularisation of your uterus?
How did your teleconference go? Good luck with your decision on choosing a treating Dr. It is so important when you have Asherman's to be in the hands of someone who understands the difficulties uterine scarring can present (and the possibility of them returning). I'm yours is now done and dusted and the next transfer will be a successful one
I am having one last go at having a transfer in a couple of months. My AF is still pretty messed up between the hormones from the cancelled FET and my last surgery so hopefully some time out will give it some time to sort itself out.
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27-08-2012 08:13 #21
05-09-2012 06:54 #22Senior Member
- Join Date
- Dec 2011
- Far North Qld
Starf1sh: No Prof V didn't reccommend an MRI, there was no evidence at all to suggest the need for one apparently. The teleconference was a nogo. Their server crashed and they have no other times available. I'm waiting to see him in person on the 26th Spet. Not happy about having to wait even more but I guess it could be worse. I'm day 5 of this cycle and my flow was the what I would call "normal", still kicked the crap out of me for the first day and a half. All good otherwise. I am always thinking of you and pray that your hopes and dreams come true. Good luck!
10-09-2012 17:20 #23Senior Member
- Join Date
- Feb 2012
I've just had a hysteroscopy today along with a lipoidol flush, my specialist (Dr Warren DeAmbrosis) diagnosed Asherman's Syndrome. It's seems to be on the right side of my uterus as the left was completely clear. He removed all the adhesions, and that there is only a small amount of residual scar tissue with no blood supply. The before and after photos from the scope are very different. We are going straight into my next antagonist cycle, but he's also said that he'd happy to refer me to a specialist in Sydney (i'm guessing that it's the specialist you're all discussing). I asked if he felt that we should do that now before trying again, but he said that 75-80% of my uterus was clear and that i have a decent chance of falling pregnant. I trust Warren implicitly and know that if he felt that we had little chance of it working, he'd not go through with a cycle and that if treatment with the doctor in Sydney was the only way to go, i'd be referred immediately. He'll take a look at my lining during the cycle and i'm guessing that if it's not good, we'll look at other options.
I had a D&C when i was 21 and have had laparoscopies since then, but no hysteroscopy - i'm guessing that this was the cause of this condition. I know that Asherman's is not a great diagnosis, but i am so relieved that i finally have a definitive reason for not being able to conceive a)naturally, and b) 2 BFN IVF cycles. Our embryos aren't the best quality, but up until today they had little to no chance of implantation. I'm really hoping that by removing the adhesions this will give me a better chance at having a baby.
11-09-2012 17:57 #24
Know the risks of D&C's - Asherman's Syndrome
It sounds like you have already decided on the course of action you will take. I know there are women who have successfully been treated by their FS for Asherman's (although I am not one of them). In these cases it seems the FS followed the 'gold standard' practice which an Asherman's specialist would suggest including not using an energy source to remove adhesions, using a barrier such as spray gel or a stent and estrogen therapy post surgery to prevent their return.
In my case my FS did none of these things (apart from cut them out) and the adhesions returned (possibly worse than before) within 3 months of my surgery and I ended up needing more surgeries with a specialist in this field.
Prof Vancaillie is the only A list Asherman's surgeon in Australia (which means he is considered by the International Asherman's Association to be experienced in treating AS). In my case he recommended that the uterine cavity be 100% free of adhesions before attempting further transfers as the presence of scarring can inhibit endometrial growth. I would strongly suggest you check out their website www.ashermans.org or join the yahoo group (details in previous posts).
Having only half of your uterus affected is a good sign but receiving the right treatment is IMO crucial for future success. I wish you all the best and happy to discuss further if that would be helpful.
20-10-2012 08:38 #25
Starfish - Thank you so much for starting this thread and bringing awareness to Ashermans Syndrome.
I have a question. Can Ashermans Syndrome be caused from a endrometrial biopsy? I had a hysteroscopy and endrometrial biopsy in mid August and I haven't had my AF since. My doctor put me on provera to correct my cycles and still no sign of AF.
I compeleted 10 days on provera and the day after the last pill I had AF type pains so I was convinced it was on it's way. There was no blood flow whatsoever. I have short cycles and always ovulate around day 8 and I definately ovulated yesterday as I had the ov pain and I did an ovulation test and there were two lines.
I'm aware that once you stop Provera AF can come within 2 weeks but I definately ovulated so it makes me think that AF did come but there's some sort of blockage. I hope I'm wrong.
I have to wait until Thursday as that's two weeks after stopping Provera and then will call the Doctor for answers.
20-10-2012 08:44 #26Senior Member
- Join Date
- Aug 2012
Re: Know the risks of D&C's - Asherman's Syndrome
I had a d & c july 4th 2009,
I was not informed of a risk anything like this,
My d& c was needed though as i was bleeding so badly & doctors couldn't stop ut
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20-10-2012 09:31 #27
I am definitely not the AS expert, but from my research (predominantly from www.ashermans.org) and discussions about my own situation with Prof Vancaillie any kind of uterine surgery can potentially cause scarring. Makes sense right if there is any kind of trauma to the environment and particularly if cuts are made into the lower levels of the endometrium? However, I would've assumed a biopsy would be at quite a superficial level.
Hopefully to ease your mind a little, prior to acquiring AS I had a lap and NK cell biopsy in 2010 and my AF never returned. Think I waited about 60 days.... It was all a bit of a mystery but it definitely had nothing to do with AS. As it turned out my hormones were all over the place after the lap and I ended up starting a new cycle when my bloods were all at baseline.
If it doesn't turn up after a couple of cycles some further investigations would be a good idea and Prof Vancaillie would be able to give you a definitive answer quite quickly. Hope it turns out to be just 'one of those things'
Kirbystar, there are definitely circumstances where D&C's are needed and most women who have them will not end up with scarring in their uterus. But about 16% of us will from a single procedure (and that number goes up the more procedures you have). Like you, I was never informed of the potential risks, nor the alternatives available to dealing with pregnancy loss.
Last edited by Starf1sh; 21-10-2012 at 10:15.
20-10-2012 21:45 #28
Starfish - Thank you so much for your response. I figured you wouldn't mind me asking you your opinion as I had no idea where to turn too. I'm so worried that my hysteroscopy (which involved a curette) and endrometrial biopsy has caused some damage.
After the provera challenge and no sign of AF I have one of three things:
Hypothalamic hypoestrogenism (low estrogen levels)
Compromised outflow tract - either Asherman's syndrome (adhesions) or cervical stenosis (scarring)
Premature ovarian failure
I know for sure that I ovulated yesterday which leads me to believe AF came but I had NO FLOW. Either that or the provera regulated my cycles and my estrogen was too low for the provera to work and build a lining to shed. But how could I get ovulation without AF first? I'm confused.
Your message did give me some comfort and maybe my hormones are just all over the place after the procedure and hopefully in two weeks (from ovulation) my AF will surface.
I hope you are going well and keeping everything crossed for your next transfer
21-10-2012 13:07 #29
Helen, I think they are all well considered thoughts about potential causes and better to be armed with information and a few good theories to methodically explore than to blindly follow the doctors 'best guess'.
My FS blamed POF for my thin lining for about a year (in the absence of any clear evidence other than low AMH). Then when AF ceased all together this was finally the impetus for me to really push hard for further investigations. It turned out my cervix was completely scarred shut and I had significant scarring in my uterus, so I guess what I'm saying is I think it's good that you are considering a number of avenues early on, but I'm still hoping your hormones are simply righting themselves and your usual AF will be along directly!
Hope you get some answers soon that see you swiftly on your way to your next transfer
P.S my scarring has not returned after a number of surgeries this year to address it and after a couple of false starts due to thin lining issues I am in the 2WW as we speak
Last edited by Starf1sh; 21-10-2012 at 17:45. Reason: add info
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22-10-2012 08:36 #30
Starfish - Thanks for your response. I'll be praying for you and keeping absolutely everything crossed. After everything you have been through it's just has to be a BFP!! I had a look at your other thread and it's very comforting to know the hatching blast is of such wonderful quality and that your in for a very good chance!!
I'm just curious in regards to your surgery's did you have splint or balloon in your uterus for the post operation healing phase?
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