Which are the causes of Asherman's Syndrome?

Asherman's Syndrome is a condition that affects the uterus and is characterized by the formation of scar tissue inside the uterine cavity. This scar tissue, also known as intrauterine adhesions, can lead to various reproductive problems, including infertility, menstrual irregularities, and recurrent miscarriages. While the exact cause of Asherman's Syndrome is not always clear, there are several factors that have been identified as potential contributors to the development of this condition.

1. Uterine Surgery: One of the most common causes of Asherman's Syndrome is previous uterine surgery, particularly procedures that involve scraping or removing tissue from the uterine lining. These surgeries can cause trauma to the uterine walls, leading to the formation of scar tissue during the healing process. Examples of uterine surgeries that may increase the risk of Asherman's Syndrome include dilation and curettage (D&C) for miscarriage or abortion, removal of uterine fibroids, and treatment of uterine adhesions.

2. Infections: Infections of the uterine lining, such as endometritis, can also contribute to the development of Asherman's Syndrome. Inflammation caused by these infections can lead to the formation of scar tissue as the body tries to repair the damaged tissue. In some cases, severe or recurrent infections can result in extensive scarring and adhesion formation.

3. Radiation Therapy: Women who have undergone radiation therapy for the treatment of uterine or cervical cancer may be at an increased risk of developing Asherman's Syndrome. Radiation can damage the uterine lining and impair its ability to regenerate properly, leading to the formation of scar tissue.

4. Trauma or Injury: Any trauma or injury to the uterus, such as a severe infection, uterine rupture during childbirth, or a complication during a surgical procedure, can increase the risk of developing Asherman's Syndrome. The body's natural response to injury is to form scar tissue, and if the uterine lining is affected, adhesions may develop.

5. Miscarriage or Pregnancy Complications: Women who have experienced multiple miscarriages or complications during pregnancy, such as retained placenta or postpartum hemorrhage, may be more susceptible to developing Asherman's Syndrome. These events can cause damage to the uterine lining, leading to the formation of scar tissue.

6. Hormonal Factors: Hormonal imbalances, particularly low estrogen levels, can impair the regrowth of the uterine lining after injury or surgery. This can increase the risk of adhesion formation and the development of Asherman's Syndrome.

It is important to note that not all women who experience the above factors will develop Asherman's Syndrome, and the severity of the condition can vary. Diagnosis of Asherman's Syndrome typically involves a thorough evaluation of a woman's medical history, symptoms, and imaging tests, such as hysteroscopy or ultrasound. Treatment options may include hysteroscopic surgery to remove the scar tissue and restore the normal uterine cavity, hormonal therapy to promote regrowth of the uterine lining, and assisted reproductive techniques for women experiencing infertility.