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Scarring after ERPC

Hi ladies,
I went for an HSG last week and have really bad news.
Not only do I have either a bicornuate uterus or a septum uterus (only a laparoscopy would define for sure) but I have also got extensive scarring to the lower two thirds of my uterus from the ERPC that I had back in February for my mmc.
The gynae said that the scarring would prevent a foetus from implanting in that part of the uterus.
I have been given the option to have a laparoscopy (to check out the bicornuate/septum uterus) and if its a septum to have surgery to 'split' it, which would involve having 2 coils inserted and hormone treatment for a month. Also to have a hysteroscopy to have surgery to 'smooth' out the scarring that the consultant did during the ERPC.
As you can imagine I am feeling extremely low and shocked about what has happened. I'm also angry that I had not been told that an ERPC can cause scarring if the consultant removes too much tissue.
Has anyone else had scarring from an ERPC or D&C and had surgery to smooth it?
I fear that more surgery may cause more scarring.
I suppose it goes someway to explain why I haven't managed to get pregnant over the last six months (despite having fallend pregnant very quickly twice before).
Can anyone help?


  • Hi Koi,
    Welcome to the horrible world of Asherman's Syndrome... It totally sucks and I'm really sorry that you're having to go through this.
    I got Asherman's syndrome (intrauterine adhesions) after my ERPC for mmc in Feb too. I had really light periods afterwards, kept getting fobbed off by the GP, eventually demanded private gynae appointment and she did hysteroscopy and found the adhesions. Mine were in the lower part of my uterus too. She divided them quite easily (thank you gynae!) and I now have a coil in. She didn't give me hormones, but most people do have them.
    Now scarring is actually quite common. They didn't consent me for it either, they don't to most people - we've made a formal complaint about this. I could go on about the rules of consent for a while... and many doctors don't know that it exists or believe that ERPC's cause it. According to one bit of research, the chances of getting scarring are 30% for an ERPC for mmc. Would be nice if they'd told us, huh?
    You now, sadly, have to get well-informed and pushy to get the right treatment. It is VITAL that you DO NOT let anyone do a D&C or ERPC on you ever again as this will only make the situation worse. I would ask exactly what your consultant intends to do during the hysteroscopy as if the intend to use cautery at all, or do a further D&C (same as ERPC) then walk away - they are wrong. This will only make the situation worse. the fact that they mentioned "smoothing out the scarring" concerns me - adhesions should be divided, very very carefully, by someone who knows what they're doing. Always a consultant, and always someone experienced in doing it - it is very delicate surgery. Who are you seeing? Where do you live? There are some Asherman's experts in the UK, am happy to give you their names, just email me.
    The scarring basically stops implantation, but the other problem with Asherman's is that the endometrium is often too thin, even after the scarring has been removed. It can be "plumped up" with hormones, also acupuncture and chinese meds (which I am having) help. It also means that if you do conceive again, any pregnancy should be treated as high risk. You will have a greater chance of cervical incompetence, placenta accreta, and joy of all joys, miscarriage.
    With regards to the bicornuate uterus - it may be that this appearance is due to scarring. This has happened to other Asherman's women I know.
    So you need to:
    1) Read up about Ashermans - go to and make sure you're well-informed
    2) Make sure you're seeing the right dr, and they're doing the right procedure
    3) Look after yourself!

    Seriously, I know that this is a devastating diagnosis. I know you're feeling angry and awful and down about it, it's completely normal. I wish so much that this didn't happen to any woman, its horrible. I'm sorry if this message has been depressing/ a bit of a lecture, but I don't want you to go through further heartache, and i want you to give yourself the best possible chance of getting pregnant again. Keep in mind that it IS possible to have a baby after Ashermans, lots of women do it with a thin lining, lots of women manage it who have previously had their whole uterine cavity scarred up. I know it's hard, but try and retain some hope.
    If you have any questions or want more info at all, please email me.
    Mary xxx
  • Sorry - in case it's not clear: scarring is the same as adhesions. Any scarring or adhesions in the uterus is called Asherman's Syndrome.
    And forgot to say - the lower part of your uterus is the best place to get them (if there is a "best place"!) as the foetus usually implants at the top.
    Am so sorry that the above post was depressing - i hate this condition!
  • Mary - thank you so so much for your response. I will definitely do much more research now I know what I have to try and deal with. Its so kind of you to take the time with such an indepth response and if you don't mind I will take you up on the offer to e-mail direct.
    Thanks again.
  • No problem. As you can probably tell I've had to become quite quickly well-informed too!
    Look forward to hearing from you
    Mary xxx
  • Hey hun,
    Just wanted to check you're OK?
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