obsessing about risk of Asherman's syndrome

[Nimyra]

Because missing my baby isn't bad enough now I am finding myself obsessively searching the internet and terrified out of my mind that I will develop uterine scarring or Asherman's syndrome because of my decision to have the D&C (and repeat D&C for retained tissues).

I don't know how to make myself stop worrying about this. Some people quote the risk as quite high but my dr. indicated that it was actually quite low based on how they do the procedure, but I didn't really get a chance to quiz the dr. who performed the second procedure.

I'm second guessing myself now and so scared that I won't be able to have another baby.

Hoping for some encouragement or reassurance.

 

[LuckyW]

I can't tell you anything technical, scientific or statistical about your chances of scarring. Only that they tend to use a suction type of procedure these days, as opposed to manual/mechanical, so that it's reportedly become extremely safe and routine. And although I tend to have great mistrust of the medical establishment, I think one thing they do not f around with is someone's chances at fertility, if only in order to avoid lawsuits and charges of malpractice.

But I do know too well what it's like to second guess and start obsessing over a worry that doesn't warrant that level of worry. I've actually wondered if pregnancy hormones might chemically promote anxiousness. Anyway, you're probably already aware of this, but maybe it will help to have someone else say: Your current fear isn't very rational. It's extremely unlikely you've compromised your fertility in any way.

Furthermore, in the very remote chance you do develop scarring/ adhesions as a consequence, there are procedures which can clear these sorts of complications. But cross that road when you come to it, and only if you must.

 

[Nimyra]

Thank you. And yes, you are probably right, my hormones are affecting my anxiety (although to be fair, I had an anxiety disorder to begin with!)

Thank you for the reassurance. I found reading Wobbles Facts and Myths sticky reassuring. Based on that I didn't really have much choice for the first D&C because my body wasn't handling the MMC very well and I was too far along to take the meds to help miscarriage happen. I didn't know that and it helps to recognize.

 

[george83]

I think pretty much everybody ends up second guessing something and becomes fixated in one aspect or another, I'm now obsessed with the fact that my husbands old drug problem has caused lasting damage or that fact I had to have an extra anti-d injection after the birth of my son because there was a problem with my blood has caused my mmc and now I'm terrified that even if we fall pregnant again the exact same thing will happen again, I think it's nature's way of punishing us even more

 

[GaiaSN]

I agree with everything LuckyW said above (esp. the part about suction), and would like to add this: I had my D&C done last week. I was as nervous about Asherman's as you are. My awesome doctor said, she had only seen it once in the 12 years she worked at this hospital. I hope this makes you feel a little better. I know how hard this time is.

 

[Nimyra]

Thank you ladies. For the record and for all others who may someday stumble across this thread:

I called my OBGYN today and she called me back fairly quickly. She said the following:
- The research on the internet is EXTREMELY out of date. She has no clue where they get outrageous numbers like 15-25% from. She says that is NOT accurate.
- She says that scarring is most likely to result when there is already an infection going on. Infected tissue is swollen and injures more easily. She said that for most women undergoing non-emergency D&Cs this is simply not the situation.
- Further, she says a repeat D&C within a few days is not as traumatic as a repeat D&C weeks or months later due to infection. She said I would not be injured by the fact that I opted for the repeat procedure and further that my cervix was already still soft from the previous D&C so I shouldn't expect any cervical issues either.
- She also said that my second D&C there was actually very little tissue that still had to come out, so they didn't have to do much in there anyway.
- I asked her to give me numbers. 1 in a 100, 1 in 1000? She said 1 in a 1000 or less. She says she almost never sees scarring. So .1% risk for scar tissue for someone having a D&C under similar (first trimester MMC, no infection) situations.

My mind is considerably at ease. I believe I made the right choice in trusting my doctor. I hope this information can help others.

 

[GaiaSN]

Nimyra, thanks for posting this! Of course I had to start researching this on the internet after responding here. There are a lot of scary websites out there about Asherman's, but as you already said, they seem to cite mostly older research, and the numbers are presented in a way that makes you think Asherman's occurs quite a bit more often than it actually does in women who had a D&C. The usual numbers you see make you think that 30% of all women who had a D&C get Asherman's, when in reality it's 30% of all women with Asherman's that had a D&C. Hard numbers on how many women get Asherman's after a D&C seem to be extremely hard to come by, but numbers I have seen were also less than 1%. So yes, the risk exists, and is not 0, but also not as big as some of these sites make it out to be.

My doctor said the same thing after I told her about mu concerns: "It's a risk, but it's very rare. Don't have too many." She told me she has seen one case in the 12 years she has been at our hospital.