Adhesions and Infertility
Adhesions are areas of scar tissue that form between organs or between organs and the abdominal wall. Adhesions are often located on and around the female reproductive organs, including the uterus, fallopian tubes, and fimbriae. Adhesions in the uterus are known as Asherman’s Syndrome or uterine synechiae.
What Causes Adhesions?
Pelvic adhesions result from inflammation, so anything that triggers inflammation can in turn cause adhesions. This includes infections (such as pelvic inflammatory disease), endometriosis, and the food we eat, but they are most often the result of gynecological pelvic surgeries including:
- myomectomy (surgery to remove fibroids)
- tubal surgery (to remove an ectopic pregnancy)
- surgery on the ovary (to remove cysts)
- surgery for endometriosis
- even surgeries to remove adhesions can lead to the formation of new adhesions
Pelvic Adhesion Symptoms:
Many people who have pelvic adhesions do not have any symptoms. Others may experience:
- Abdominal cramping/pelvic pain
- Bowel obstruction
How Do Adhesions Cause Infertility?
Infertility is caused when the adhesions interrupt gamete (sperm or egg) transport and prevent them from meeting or implanting or distort the reproductive organs. The fimbria (finger-like projections of the fallopian tube) have difficulty receiving the oocyte (egg) after ovulation if adhesions block the entry point or pull the fallopian tube too far away from the ovary. Asherman’s syndrome or uterine adhesions cause infertility by preventing implantation. They are also linked to recurrent miscarriage.
Women who have adhesions are at greater risk for having infertility, recurrent pregnancy loss, and ectopic pregnancy.
How are Pelvic Adhesions Diagnosed?
Pelvic adhesions can be diagnosed via:
- Hysterosalpingogram (HSG): A test in which the uterus is visualized via x-ray as dye is introduced into the uterus through the cervix and passed through the fallopian tubes.
- Hysteroscopy: A miniature camera is inserted into the vagina to examine the cervix and inside of the uterus.
- Laparoscopy: A miniature camera is inserted through a small incision in the abdominal wall to view the abdominal organs.
How are Pelvic Adhesions Treated?
Surgical repair may be possible via an operative Laparoscopy Hysteroscopy depending on the severity and location. IVF is another successful form of treatment for women suffering from infertility due to pelvic adhesions.
Through out-patient procedures, CNY Fertility‘s skilled surgeons are able to detect and remove adhesions, thus improving fertility and reducing discomfort.
For more information, contact us.