Irresponsive endometrium after Lupron

Answer

• Asherman Syndrome is a medical condition characterized by severe intrauterine adhesions, also known as synechiae. These adhesions can cause significant damage to the basal layer of the endometrium, the part of the uterus responsible for developing the uterine lining (endometrium) under the influence of hormones like estrogen and progesterone. When the basal endometrium is severely affected, it can lead to  a reduction in menstrual flow (hypomenorrhea) or complete cessation of menstruation (amenorrhea), and infertility.

  Causes of Asherman Syndrome

  The most common cause of Asherman Syndrome is inflammation of the uterine lining, a condition called endometritis. This inflammation often occurs after childbirth (post-partum) , after an incomplete miscarriage or post-abortal. However, it can also result from uterine surgeries, such as the removal of fibroid tumors (myomectomy) that encroach upon or penetrate the uterine cavity.

  Treatment for Asherman Syndrome

  The primary treatment for Asherman Syndrome involves a procedure called hysteroscopic resection. During this procedure, a telescope-like instrument is introduced through the vagina and cervix into the uterine cavity. This allows surgeons to directly remove as much scar tissue as possible and free any adhesions that have fused the walls of the uterine cavity together. The goal is to uncover viable basal endometrium and promote its growth to cover the surface of the uterine cavity. In some cases, a small balloon may be placed in the uterine cavity for a short period to prevent adhesion recurrence. Women undergoing this treatment typically receive supplemental estrogen to encourage endometrial growth.

  Fertility Complications

  Asherman Syndrome can lead to scarring and blockage of the uterine entrance to the fallopian tubes. This blockage often affects the ability of the uterus to support embryo implantation. In rare cases, pregnancy can occur in the fallopian tubes, leading to an ectopic pregnancy. Ectopic pregnancies are dangerous and require early diagnosis and treatment to prevent severe intra-abdominal bleeding.

  A Glimmer of Hope: Viagra Suppositories

  Recent research has explored the use of Viagra vaginal suppositories to improve blood flow and enhance the delivery of estrogen to the endometrium. This innovative approach has shown promise in improving endometrial development, especially in cases where traditional treatments have failed. Approximately 75% of women who struggled with poor endometrial development, often after multiple failed IVF attempts, experienced positive results with this treatment. Some of these women successfully conceived and went on to deliver healthy babies, providing renewed hope for those facing infertility challenges.

  Challenges and Considerations

  However, for women with extensive damage to the basal endometrium due to Asherman Syndrome, improving blood flow with Viagra may not be sufficient in achieving the necessary endometrial development. In such cases, it’s essential for women to consider alternative options, including adoption or gestational surrogacy, to fulfill their dreams of parenthood.

  In conclusion, Asherman Syndrome is a complex condition that can have a profound impact on a woman’s reproductive health. While treatments like hysteroscopic resection and innovative approaches with Viagra offer some hope, the severity of the condition may necessitate exploring alternative paths to parenthood. It’s crucial for individuals facing this challenge to consult with their healthcare providers to determine the best course of action for their unique circumstances.

• Geoff Sher
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Herewith are  online links to 2  E-books recently  co-authored with  my partner at SFS-NY  (Drew Tortoriello MD)……. for your reading pleasure:

1. From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS) ; https://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf

1. Recurrent Pregnancy Loss and Unexplained IVF Failure: The Immunologic Link ;https://drive.google.com/file/d/1iYKz-EkAjMqwMa1ZcufIloRdxnAfDH8L/view

If you are interested in having an online consultation with me, please contact my assistant, Patti Converse at 702-533-2691 or email her at concierge@sherivf.com\