The Challenges of Asherman’s Syndrome: a clinical view

Abstract

This thesis focused on enhancing the care for women with Ashermans Syndrome (AS) from various perspectives. For a long time, AS was considered a relatively simple disease with a simple cure, namely adhesions which were resolved by adhesiolysis. We show, however, that despite a high rate of successful (chapter 2) and safe (chapter 3) adhesiolyses in our center, rates to get pregnant are not as high as in the normal population (chapter 5) and that the use of adjuvant estrogen is to be debated (chapter 4). Even after achieving a successful pregnancy, the risk of adverse events was not over, as many women suffer from pregnancy and post-partum complications (chapters 6 & 7). We also showed that we were not able to distinguish those with a high risk of adverse events from those with a low risk (chapter 8). This results in a very high rate of women suffering from depression and anxiety disorders (chapter 9).