Re: NEW MEMBER Amy

[Guest guest]

Dear Amy,

Welcome to our group. Your story sounds so similar to many of ours. The one thing I want to say before anything else is to switch doctors immediately! The fact that your doctor thinks that Ashermans is rare is wrong and tells me he/she cannot treat you. Don't be alarmed, many of us heard the same thing from their doctor and have been treated the same way as you. This makes us so mad...what we have learned is that Ashermans is caused from post partum and post miscarriage D & C's in up to 40% of cases. It is not so rare, what is rare unfortunately is the appropriate diagnosis and treatement of Ashermans. We have also learned in this group that reproductive endocrinologists REs (fertility clinic docs) are very knowledgeable about Ashermans...they get all the women who can't get pregnant show up in their offices. But they aren't necessarily the best surgeons for moderate to severe Ashermans. We also have learned that typicial OB/GYNs don't know much about Ashermans. The best doctors to treat Ashermans are GYN's that specialize in hysteroscopic surgeries that get all the cases of Ashermans from OB/GYNs and RE's. The best doctors are highly skilled hysterosocpic surgeons that have lots and lots of cases of Ashermans. On our homepage we have a list of the best doctors in the world for Ashermans, we call them our A list doctors. The list unfortunately is very small. Where do you live?

Amy, I am afraid to say that you probably do have Ashermans. But, you will need to have a test to diagnose it 100%. Either an HSG, a diagnostic hysteroscopy or a sonohystogram. Please read the Primer that was just sent out by Poly. These tests are explained here. It also sounds as if you have enough scar tissue to completely block your cervix and that is why no blood comes out. Or you may have your uetrus completely filled with scar tissue. However, if you are having cyclic pain every month, this is a good sign. You may have enough endometrium in your uterus to cause the lining to thicken and to shed. This is very good. But where is the blood going? Either back out your tubes into your abdomen or it gets reabsorbed.

My story. I had years of infertility and finally solved the problem with IVF. We had a child and then I hemorrhaged 4 weeks later. I went to emergency and they did a D & C. I felt great after the D & C. But, noone ever mentioned that Ashermans is a possible side effect. 9 Months later I stopped nursing and my periods never returned except for a light spot. No cramping like I usually have. I went to my RE to start another round of IVF for child number two and i told him about my hemorrhage and lack of menses. He immediately suspected Ashermans and injected sterile saline into my uetrus to see the cavity under ultrasound. The saline wouldn't go in...my uterus was completely filled up with scar tissue. My RE said that Ashermans is a fairly common side effect of post partum and post miscarriage D & C's because a recently pregnant uterus is softer and more fragile. And many docs don't know how to perform gentle non aggressive D & Cs. My RE and another OB/GYN tried to operate on me only to find the densest most vascularized scar tisssue they have ever seen. The were so blind that they punctured my uterus and decided to discontinue the operation.. My RE told me to find a surrogate or go to one of thebest surgeons for Ashermans. I did. This expert surgeon (my savior) fixed me in 1 surgery and my uterus and cavity were completely restored. We did IVF and I got pregnant, but like you the baby's heart stopped at 7.5 weeks. I had to have another dreaded D & C. But I had it done with the super surgeon and within 5 weeks I was in IVF again. I am now 13 weeks pregnant.

Moral of the story. RE's are wonderful in diagnosing. If you have moderate to severe scar tissue then go to the best doc around for the operative hysteroscopy. When the scar tissue is this dense, an expert can usually remove it all in fewer surgeries and without damaging your endometrial lining in the process. Ashermans surgery is a very delicate and very precise surgery and should only be done by the best (if you have a moderate to severe case). If you have a severe case then if it's done by an inexperienced or less skilled surgeon then they can cut into the muscle layer of the uterus or take away too much of the endometrial lining. Once this happens, the lining will not come back. If you have poor lining or it is not continuous then the embryo will not implant properly and you will have failed attemps at implantation or early miscarriages. My lining was damaged from the origianl D & C. thanks to my ER doc, he reduced my lining of 9 mm to 6 mm. I lost 3 mm of lining that will never grow back. Fortunately for me, I still have been able to get pregnant. But, I am on strict bedrest now and may be for the remainder of my pregnancy because the placenta is pulling away at one spot. I don't know what is causing this and we will never know. But, at least I am pregnant...something I never thought would happen again as of last November.

So let us know where you live and hopefully you live near an A list doc. If not, then we will work with you to try to find a good docotor to get a diagnsis before you make your next move. Good luck and let us know. Again, so soryy that you are here, but your are in the best hands.