Asherman’s Syndrome, Hysterescopy, and TTC

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When the doctor told me that the surgery will not do much to improve my chances of conception, that it would just be to remove SOME of my adhesions, I ran. Who wants to hear that kind of news abeg?”

And it is true; no TTC woman would like to hear the kind of news that the doctor was telling Nofisat.  They were going to perform surgery merely to reduce the adhesions, but it will not automatically boost her conception chances, which was the real reason behind her volunteering to go under the knife again, or should I say strobe in this case.

Due to adhesions, she’d had both laparoscopic and open surgeries, but it had not cleared up enough to enable her have a baby. As it stands, the last two doctors she has seen have been pushing for her to try surrogacy, in order to become a mom.

Both times, she left the doctor’s office crying. Surrogacy takes some getting used to. More so for a young lady like Nofisat.

While Nofisat is faced with the choice of surrogacy, what she would actually like is Tolulope’s victory report…but we are all not the same.

For a long time too, Tolulope had to deal with the anxiety of knowing a hysteroscopy might not work for her, but one day, she gathered courage and decided to have the procedure done, while keeping fingers crossed for a beautiful result.

The first good news was when the doctor told her after the procedure that they were able to get out most of the adhesions out, and that after a month of hormone treatment and healing, she should be able to conceive.

It was literally from his lips to the ears of God, as Tolulope indeed got pregnant less than six months after the surgery.

Another miracle happened; she conceived her second child less than six months after the birth of the first one.  It was totally unexpected but absolutely welcome, after the long wait to start having babies.

The only answer the doctors had for her second conception was that her womb was in prime condition for conceiving, and it just did it’s job without any consultation, and there Tolulope was, still thinking it wouldl take some time for her to conceive the second time.

It’s a disheartening one for Adenike, who knew even before her doctor knew, that she had Asherman’s syndrome.  In her lifetime, she has suffered two miscarriages and had a D&C after each loss. Both times, her period stopped. Her period didn’t come even when it was induced, but there were always monthly signs that her menstrual period was trying to come but that its passage was blocked.

Adenike finally convinced her doctor to consider her Asherman’s syndrome hypothesis. It turned out to be true. Her womb was massively scarred.  There were layers of thickness in her womb, her cervix was also blocked thanks to adhesion.

This literally stunned her doctor, who confessed that she hadn’t seen that kind of scarring before.  It was a really bad case, as far as she was concerned, but she was also more conscious of the need to get Adenike to go through a hysteroscopy.

Adenike has undergone a hysteroscopy twice already, with plenty of adhesions still in situ. With no other alternative for now, she is open to trying the procedure again, just to see how much of the adhesions she can get out, in order to boost her chances of conception.

When I mentioned surrogacy, her expression was priceless, so I guess she is not ready to process going down that path yet.

For yet another TTC mom, Tammy, she has moved on from the stage of putting her hopes solely in the hysteroscopy. It is now a case of what next to do, and that next step for her to is IVF. Having dealt with Asherman’s syndrome for two years, done some hysterescopy, with not much success, she is currently of the mindset of getting out as much of her eggs out as possible. And not just that, she is harvesting her eggs, fertilising them and keeping them frozen, for the perfect time when they will be needed.

Age was also another factor she considered.  So, while she tries to sort out her womb lining and get it conducive for an embryo to implant, Tammy has embryos in waiting.

According to ObGyn.net, a hysteroscopy is a form of minimally invasive surgery. The surgeon inserts a tiny telescope (hysteroscope) through the cervix into the uterus. The hysteroscope allows the surgeon to visualize the inside of the uterine cavity on a video monitor. The uterine cavity is then inspected for any abnormality. The surgeon examines the shape of the uterus, the lining of the uterus and looks for any evidence of intrauterine pathology (fibroids or polyps). The surgeon also attempts to visualize the openings to the fallopian tubes (tubal ostia).

Many gynecologists will use the hysteroscope to inspect the lining of the uterus and look for intrauterine pathology such as fibroids or polyps that may be causing irregular or heavy menstrual bleeding. Assessment of the cavity is also performed for women having difficulty becoming pregnant.

Other conditions suitable for hysteroscopy include:

  • Removal of endometrial or cervical polyps
  • Removal of fibroids
  • Biopsy of the endometrial lining
  • Cannulation (opening) of the fallopian tubes
  • Removal of intrauterine adhesions (scarring)
  • Removal of a lost IUCD (intrauterine contraceptive device)

 

The main benefit of hysteroscopy is usually that the recovery time is very quick. Almost all the patients go home the same day following hysteroscopic surgery. There is no abdominal wound, so the postoperative pain is minimal and there are no wound infections.

Even though there is a lot of awareness on the Asherman’s syndrome condition, there are still a lot of women who fall through the cracks, not knowing they have the condition, and merely living with the aftereffects.

Also, even as much as hysteroscopy is widely used now, there is still a lot to be desired of the procedure. Like other fertility procedures, it comes with no guarantees.  The doctors can only try, the healing comes from God.

Lastly, it is not always a dreary case with Asherman’s syndrome, but it can definitely test a woman’s resolve to get pregnant.

Baby dust to you mamas.

 

 

Join the conversation with any of our TTC and Pregnancy Groups here

Photo credits:

1. http://www.fertility-ivf.eu/

2. http://www.bonati.com/

3. http://diagnostinfo.ru/

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