Intrauterine Adhesions (Asherman's Syndrome)

By RRM Academy Reviewed by Dr. Naomi Whittaker, MD, Board-Certified OBGYN, MIGS, NFPMC, FCI Updated May 14, 2026

Intrauterine adhesions (Asherman's syndrome) are bands of scar tissue that form inside the uterine cavity, binding the walls together and disrupting the endometrial lining. They develop after uterine trauma: most commonly a dilation and curettage (D&C), uterine surgery, or severe intrauterine infection. Severity ranges from thin, filmy adhesions across a small segment of the cavity to dense fibrotic obliteration of most or all of it.¹²

The most common symptoms are amenorrhea or markedly reduced menstrual flow following a uterine procedure, cyclic pelvic pain without outward menstrual flow, and infertility or recurrent pregnancy loss. Some women have no symptoms at all despite clinically significant adhesions.

Hysteroscopy is the gold standard for diagnosis and staging. Saline infusion sonohysterography and HSG can suggest adhesions but cannot grade them precisely. Diagnostic hysteroscopy reveals the extent, location, and density of adhesions under direct visualization.

Operative hysteroscopy with adhesiolysis is the restorative treatment. The surgeon divides and removes the adhesions under direct vision, re-establishing cavity architecture. Post-surgical hormonal support to promote endometrial regrowth and follow-up office hysteroscopy are standard components of the restorative approach.³

Asherman's syndrome is a correctable structural cause of infertility and pregnancy loss. Recurrent pregnancy loss evaluation should include uterine cavity assessment, particularly in women with prior uterine procedures. Related structural conditions, including uterine septum and isthmocele, may coexist and warrant evaluation in the same workup.

This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.