Signs and symptoms
It is often characterized by a decrease in flow and duration of bleeding (absence of menstrual bleeding, little menstrual bleeding, or infrequent menstrual bleeding) and infertility. Menstrual anomalies are often but not always correlated with severity: adhesions restricted to only the cervix or lower uterus may block menstruation. Pain during menstruation and ovulation is sometimes experienced and can be attributed to blockages. It has been reported that 88% of AS cases occur after a D&C is performed on a recently pregnant uterus, following a missed or incomplete miscarriage, birth, or during an elective termination (abortion) to remove retained products of conception. Causes
The cavity of the uterus is lined by the endometrium. This lining is composed of two layers, the functional layer (adjacent to the uterine cavity) which is shed during menstruation and an underlying basal layer (adjacent to the myometrium), which is necessary for regenerating the functional layer. Trauma to the basal layer, typically after a dilation and curettage (D&C) performed after a miscarriage, or delivery, or abortion, can lead to the development of intrauterine scars resulting in adhesions that can obliterate the cavity to varying degrees. In the extreme, the whole cavity can be scarred and occluded. Even with relatively few scars, the endometrium may fail to respond to estrogen.Ashermans syndrome affects women of all races and ages equally, suggesting no underlying genetic predisposition for its development.
Epidemiology
AS has a reported incidence of 25% of D&Cs performed 1–4 weeks post-partum, up to 30.9% of D&Cs performed for missed miscarriages and 6.4% of D&Cs performed for incomplete miscarriages. In another study, 40% of patients who underwent repeated D&C for retained products of conception after missed miscarriage or retained placenta developed AS.In the case of missed miscarriages, the time period between fetal demise and curettage may increase the likelihood of adhesion formation due to fibroblastic activity of the remaining tissue.The risk of AS also increases with the number of procedures: one study estimated the risk to be 16% after one D&C and 32% after three or more D&Cs. However, a single curettage often underlies the condition. In an attempts to estimate the prevalence of AS in the general population, it was found in 1.5% of women undergoing hysterosalpingography HSG, and between 5 and 39% of women with recurrent miscarriage.After miscarriage, a review estimated the prevalence of AS to be approximately 20% (95% confidence interval: 13% to 28%). References
External links

"The secret syndrome leaving women infertile". Daily Mirror. UK. 29 April 2010. Sophie Blake talks about being diagnosed with Ashermans syndrome. Bruton C (10 December 2007). "The hidden threat to fertility". Times Online. Archived from the original on 27 July 2008. Perloe M (20 July 2001) [17 August 1998]. "Ashermans Syndrome Overview". iVillage. Archived from the original on 25 December 2005. "How Ashermans syndrome causes infertility or miscarriages". Blog: Ashermans Syndrome Watch. 19 February 2010. (awareness, education, prevention)
"What are intrauterine adhesions?". How to treat intrauterine adhesions. womedtech.com.