This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Disorders in Menstruation, Subject name: Gynaecology & Obstetrics
A young female presents with the history of spontaneous abortions and secondary amenorrhea since then. FSH 6 ILI/mL. What is the most probably cause of amenorrhea? 
Select and explain. 
A. Ovarian failure, B. Pituitary failure, C. Fresh pregnancy, D. Uterine synechiae
D: Uterine synechiae
Answer: D: Uterine synechiae 
Explanation: Ans. D. Uterine synechiaeFSH within normal limit rules out other options. Recurrent spontaneous abortions supports the answer.Asherman Syndrome* Intrauterine synechiae is also known as Asherman syndrome.* This condition occurs due to vigorous uterine curettage in early pregnancy which may lead to scarring that interferes with normal endometrial growth and shedding.* Asherman syndrome is classified as mild, moderate, or severe depending upon the degree and extent of adhesion.* The patients present with secondary amenorrhea, hypomenorrhea, and infertility or habitual abortions.* Hysteroscopy confirms uterine synechiae, type (flimsy or fibrous) and extent of adhesions.Treatment: Reformation of adhesions is prevented by insertion of IUCD for 3 months and giving estrogen cyclically (21 days) for 3 months to developendometrium.