Asherman’s syndrome is an uncommon condition, but it shouldn’t be overlooked.
Without treatment, the condition can make it difficult to get pregnant. For some people, it causes multiple miscarriages, but they may not know they have it.
“Asherman’s syndrome can often go undiagnosed, as it’s not always picked up in routine examinations or scans,” explains a TFP consultant.
At TFP Fertility UK, our approach is to go beyond a simple ultrasound scan.
“First, we have to find out if Asherman’s syndrome is a factor, and if the womb is in good condition to carry a baby.”
Asherman’s syndrome is a fertility condition affecting the uterus, where scar tissue builds up inside the womb. It’s usually caused by an operation for a miscarriage or an abortion. It can reduce or stop your periods, and cause infertility or miscarriages.
When Audra and Josh first arrived at TFP Fertility UK, they'd been through a challenging fertility journey.
“It was clear that Audra knew her body, and knew something wasn’t right,” the consultant recalls.
It started when Audra had a surgical procedure to remove a miscarriage. Her periods had reduced, and the couple were struggling to get pregnant again. Then a second pregnancy was ectopic, leading to the removal of her second fallopian tube.
The tests at their local hospital came back inconclusive.
Although Audra fell pregnant again, the pregnancy was ectopic and had to be removed along with her fallopian tube.
“The hospital told us that IVF was unlikely to work, and we may be better thinking about surrogacy or adoption instead,” says Audra.
Looking for answers, Audra went online and saw that all her symptoms were pointing towards Asherman’s syndrome.
“They had done their research and wanted to be heard and understood – which was quite right,” the consultant agrees.
Although a simple ultrasound scan can point towards Asherman’s syndrome, specialist scans are needed to see what’s really going on. A hysteroscopy, or saline scan, allows us to fully visualise the uterus and create a detailed treatment plan.
After Audra and Josh attended an open evening at TFP Oxford Fertility Clinic, they met with their consultant to take the next steps.
Together, they agreed that before jumping into in vitro fertilisation (IVF), they needed to know whether Asherman’s syndrome could be behind their fertility challenges.
“We explained it was also possible that Audra had a bicornate uterus – a heart-shaped womb, which can impact fertility,” says the consultant.
To get the answers they needed, the couple were referred to TFP’s Harley Street clinic where Audra and Josh were treated by Mr Trew, an expert consultant on the diagnosis and treatment of Asherman’s syndrome.
The first step was to use an advanced scan called a hysterosalpingogram (HSG), where a coloured dye helps to create a map of the womb.
“This lets us see where the scar tissue is growing,” the consultant explains.
The clinicians found that up to 50% of Audra’s womb was affected by scar tissue, giving a diagnosis of Asherman’s syndrome at long last.
“The scar tissue could be pulling the womb downwards, which would explain earlier clinical observations about a ‘heart-shaped’ womb.”
The scan showed that the scar tissue could be removed with surgery to give Audra and Josh a better chance of successful pregnancy.
“The positive news was that the scar tissue was the ‘good sort’. It was growing vertically and so was easier to remove.”
After a successful surgery to remove the scar tissue, the couple secured NHS funding for IVF with TFP Oxford Fertility.
Audra said: “Looking back, it feels as if it all happened quickly. I had the surgery for Asherman’s syndrome early in June and started IVF at the end of July.”
Although the couple had been nervous about how many eggs could be retrieved, it went smoothly.
We were able to retrieve nine eggs and fertilise six of them using an intracytoplasmic sperm injection (ICSI). After five days, one blastocyst was ready to transfer.
“There was a lot of pressure on that little embryo,” said Audra.
Like many people with Asherman’s syndrome, Audra and Josh’s pregnancy story is full of highs and lows.
“Your hopes are up, and you’re excited, but you’re automatically thinking about what happens next,” shares Audra’s partner, Josh.
For this couple, there was good news ahead.
Their pregnancy was successful and beautiful baby Martha arrived nine months later.
“I’m happy that our in-house experts were able to diagnose and treat Audra and that this enabled the arrival of baby Martha,” says our consultant.
“Achieving this, against the odds, was an incredible experience,”
Reflecting on their journey Audra says: “You must never accept the first diagnosis. You have to keep persisting and be determined."
“We particularly appreciated the contact with the team and TFP Fertility as it gave us more control, with all our information and resources being available on the patient portal.
“Having been told there was no way of having our own child and then achieving this against the odds, was an incredible experience.
“You hear people say your heart is immediately full of love and it sounds cheesy but when this tiny thing arrives that you’ve wanted for so long, it is perfect.
It does feel like a miracle,” said Audra.
If you would like advice about your fertility options or a second opinion, reach out to us today for a free, confidential chat. Simply fill out our form and we’ll get back to you within 48 hours. Our friendly support team can answer your questions or book an appointment if you’re ready.