QuestionI am 24 and have never been pregnant. In July 2007, I had a d&C because of thickened endometrial lining (supposedly due to changing from depo-provera to ortho tri-cyclen). I had a fever for 2 days afterwards. I have not had a period regardless of the fact that I was on the birth control pill. My dr. tried Provera 10mg for 10 days twice with no withdrawl bleed. My dr. also check my prolactin and thyroid (both normal). I am scheduled for a hysteroscopy with possible laparoscopy. Asherman's is suspected. How common is Asherman's in women who have never been pregnant? Do my symptoms point to anything else? Any help would be greatly appeciated. Thanks.
AnswerDear Katie
I wish you could give me some idea about the pattern of your cycle before you started the depo-provera.
Anyway; if you had a normal cycle and average menses before going on depoprovera, 3 possibilities exist:
-First is the occurence of pregnancy, even if you are on the pill, which can be excluded easily by a pregnancy test or pelvic ultrasound.
-Second is the occurence of post pill amenorrhea which occur in some women for a period of 6 months or less after stopping the pill. According to the description you gave, you do not belong to this category.
-Third is a possibility of Asherman's syndrome ( intrauterine synechiae or adhesions). Actually the postoperative fever which followed your D&C points to some sort of infection potentiated by the fact of absent withdrawal bleeding and the normal prolcatin and thyroid levels. All 3 together point to possible Asherman.
At this stage, hysteroscopy seems to be the best possible approach to diagnose your case.
I hope that these information are of help to you.
Best of luck.
