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What do you think, can abortion cause infertility? Not sure about the answer? Well, worry not, today we will clear all your queries.
Abortion is a completely healthy procedure that terminates any unwanted pregnancy or complications like a miscarriage. There are a lot of misconceptions and stigmas regarding the same in the common mass.
Through this article, we will address all the possible misconceptions. One such is, can abortion cause infertility? The short answer is that the procedure itself doesn’t cause infertility, but surgical complications might affect fertility and future pregnancies.
1. What Are the Types of Abortions?
The most important aspect of abortion is the early detection of pregnancy and early decisions, which can be beneficial to your reproductive health and avoid complications affecting future fertility. There are two kinds of abortion: medical abortion and surgical abortion.
What kind of abortion one should opt for depends upon the duration of your pregnancy. If detected early, that is, during the first 9 weeks of being pregnant, one can opt for medical abortion after consulting with their health care professional/gynecologist.
However, if the pregnancy is detected late and has been more than 9 weeks, one should reconsider aborting or consult with their gynecologists’ to get a surgical abortion done.
The same goes for women who went through miscarriages and cases involving ectopic pregnancy. In the latter, the egg is implanted in the fallopian tube outside the uterus or womb. Medical abortion doesn’t work in such cases, and one has to opt for surgical methods.
2. How Abortion Procedures are Performed?
Your healthcare professional will guide you through the prerequisites of abortion, be it medical or surgical. Women going through such major operations are generally well-counseled before the surgery.
You might be asked to reconsider your decision or communicate about your mental state so that it helps you panic less and prepare for the procedure ahead.
Some medical tests are conducted before the process to evaluate the state of your uterus. If it’s a surgical abortion, you would be on anesthetics to avoid the pain felt during the surgery.
2.1. Medical Abortion or Induced Abortion
The health care professional will determine your stage of pregnancy by performing ultrasonography. As scary as the term sounds, it’s not!
The condition of your uterine wall etc. You will be required to lie on a table, and they will monitor your uterus. This will help him determine where exactly is the position of implantation.
If your pregnancy is detected early, the gynecologist will prescribe you 2 pills, a combination of two potent abortion-inducing drugs. Mifepristone and misoprostol. Abortion Pills induce cramping and lower the level of progesterone which in turn lowers the capacity of the uterus to hold a baby.
Bleeding will follow with the shedding of the components attached to the uterine lining. This is a very small medical procedure that can be done at home to avoid pregnancy complications.
Vaginal misoprostol alone can be used before nine weeks of pregnancy. Misoprostol tablet is placed in your vagina and in your buccal cavity between the teeth, which will slowly dissolve and create the effect.
The main function of mifepristone is to block the progesterone hormone, followed by thinning of the uterine lining.
Most of the time, abortion pills work and don’t affect future fertility. However, there are cases where a woman can feel nauseous and dizzy.
She might experience unusual discharges after the medical procedure. Women are advised not to panic and avoid sexual intercourse after the procedure.
Cases where medical abortion cannot be performed:
- When a woman is allergic to the medications
- When she has an intrauterine device installed inside her cervix to prevent pregnancy, IUDs can lead to scar tissue formation as it is long-term birth control.
- When an ectopic pregnancy is suspected the fertilized egg is implanted outside the uterus.
- The gestational age is how long the pregnancy is. If the gestational age is over 20 weeks, abortion is not recommended.
2.1.2. Side Effects of Medical Abortion
There are cases where Induced abortion doesn’t work when after consuming the pills, the bleeding doesn’t happen naturally.
This means that there is continued pregnancy or a case of incomplete abortion. To avoid any abortion complications, one should contact their medical professional immediately.
2.2. Surgical abortions
In a surgical procedure, you are sedated and made to lie on the table while the operation is performed. Your cervix is dilated with the help of stretchers, and a small suction tube is inserted into your uterus.
After cleaning the products of the fetus, a scrapping tool is inserted to remove the remaining placenta gently. Local anesthesia may also be given by injecting numbing agent t=in the cervix walls to prevent pain caused by the dilators. This process is known as dilation and curettage.
Before the procedure, a small urine test may also be performed to examine the state of the uterus. There are few cases when surgical abortions are advised.
2.2.1. Incomplete abortion
Not-so-heavy bleeding after performing medical abortions and continuous lower abdominal pain indicate incomplete abortion. The uterine lining still contains some residual fetal tissue that needs to be passed or cleaned to avoid pregnancy. After your healthcare professional confirms the same, you will be prepared for the surgical abortion.
2.2.2. Failure of medical procedures
There are times when even after 48 hours of consuming pills, bleeding is not observed. This indicates the complete failure of induced abortion. Surgical removal should be opted for in that case where the fetal tissue is pumped out by vacuum aspiration.
2.2.3. Late detection of pregnancy
A pregnancy test confirms if one is pregnant, but it doesn’t confirm how many weeks pregnant. By the time you realize you are pregnant, you may already be in your first trimester. In that case, your healthcare professional will advise you whether to opt for medical or surgical abortion.
2.2.4. Pregnancy complications
Ectopic pregnancy or Miscarriages may require a surgical abortion to ensure no remaining tissue in the uterine lining.
2.2.5. Procedure of Surgery
The surgical removal procedure involves inserting dilators to gently stretch open the cervix and inserting a small suction tube into the uterus to remove the fetal tissue. In medical terms, this procedure is known as vacuum aspiration.
2.2.6. First-trimester abortion
Early pregnancy loss before 20 weeks of pregnancy, a woman can experience miscarriage because of a lack of normal chromosomes in the embryo. Chromosomal abnormalities generally lead to low birth weight, preterm birth, and autoimmune disorders in the fetus.
The chromosomal determination is done during early pregnancy, confirming whether the fetus is healthy. In rare cases, chromosomal abnormalities may cause a miscarriage, or you would need to opt for early abortion to prevent birth.
3. Aftermaths or Risks of Abortion
Abortion has always been a low-risk procedure, but it possesses some potential risks or postoperative complications like any other medical procedure. This may or may not affect future pregnancies.
Listed below are some possible risks that you might need to consider.
3.1. Infection
An infection usually doesn’t occur in medical abortion, but if lower abdominal pain followed by pelvic fever lasts for more than 24 hours, one should contact their healthcare professional. This pain is usually treated with antibiotics, or surgical abortion is prescribed to avoid serious complications.
3.2. Injury to Reproductive Organs
During the surgical abortion, a surgeon might accidentally injure your underlying organs, such as the urinary bladder, but this happens in rare cases
3.3. Asherman’s Syndrome
Asherman’s syndrome is a rare complication that develops after surgical abortion where the injury leads to the formation of scar tissue and can potentially cause future pregnancy complications. The scar tissue usually forms after a surgery that involves dilation and curettage, where a tool is used to scrape away the remaining tissue after a miscarriage
3.4. Heavy bleeding
Experiencing heavy bleeding and cramps is usual after an abortion. If the bleeding is uncontrollable and saturating two pads per hour, one should seek medical attention. In rare cases, blood transfusion is needed according to the situation’s demand.
3.5. Pelvic Inflammatory Disease
Although PIDs are mostly observed in women below 25 years of age, any surgical treatment that involves the opening of the cervix and vagina can cause bacteria to move up and affect the reproductive organs, thereby causing inflammation. PIDs can be treated again by antibiotics injected intravenously.
4. Follow-up Procedure after an Abortion
After a surgical abortion, you must visit your doctor for a follow-up procedure. The doctor might examine you for post-abortion symptoms like foul-smelling vaginal discharge, severe abdominal back pain, fever lasting for more than 2 hours, or heavy bleeding.
It is important to communicate with your health care practitioner regarding whether you saw the embryo sac expulsion and how much bleeding you had in case of medical abortion.
The doctor would again perform an ultrasound to determine the size of your uterus and whether you still feel pregnant after an abortion. He will then declare if you need a surgical abortion if it’s incomplete.
You would most likely be asked to refrain from having sexual intercourse and avoid using tampons for two weeks after the abortion. You may feel a sense of guilt, loss, or sadness after the procedure, which is entirely normal to feel.
5. Getting Pregnant after an Abortion
There is no harm in getting pregnant again after an abortion and trying to conceive. Generally, women are advised to wait for their first menstrual cycle after an abortion before getting pregnant as it reduces the chances of getting a false pregnancy test and accurately determines what will be the next delivery date.
After an abortion, ovulation generally takes up to two weeks to occur. Colleger, if one wants to delay future pregnancies, the American College of Obstetricians and Gynecologists has advised the use of contraception like condoms and the birth control pill.
Abortion does not affect fertility, and one can achieve a healthy pregnancy even after a surgical procedure.
5.1. How Does Abortion Affect a Future Pregnancy?
The short answer to this question is no. Abortion does not affect future fertility, and women can continue to try to get pregnant.
However, it is advised to wait for a month before conceiving as the woman goes through much physical and emotional turmoil after an abortion. She might not be mentally prepared and may have past trauma.
Past abortion doesn’t affect your fertility or pregnancy unless there is a case of multiple abortions where the cervix has been subjected to repeated dilation, and it might have lost its capacity to hold a fetus again.
Surgical abortion may also have imparted injury to the body, resulting in scar tissue formation and womb damage. An infection caused due to surgical procedures can be treated with antibiotics, and a strong stitch around the cervix can treat cervical incompetency to keep it closed.
Medical procedures always possess a certain degree of risk. Past abortions may lead to vaginal bleeding in the first trimester, premature birth, low birth weight, a retained placenta, or even a miscarriage due to chromosomal abnormalities.
5.2. What is a False Pregnancy Test?
Often the pregnancy test shows a false-positive result if you have had a miscarriage or abortion recently. This false-positive test is due to the higher levels of human chorionic gonadotrophin hormone, which determines pregnancy.
Generally, after an abortion, the HCG levels lower within 9 to 35 days. Always make sure not to test for pregnancy during this window as it might show false-positive results.
Another factor where a false test can be witnessed is when a woman takes medicines to induce fertility. The medicines contain HCG hormones that help the follicles mature, triggering false-positive tests.
Medical conditions such as ovarian cysts, urinary tract infections, and pituitary problems can also trigger false results as these conditions tend to inflate the HCG levels in your body.
5.3. Factors Most Likely to Cause Infertility Rather than Abortion
5.3.1. Smoking
Smoking regularly affects your health and the quality of your ovaries. The fallopian tubes and uterus are also affected, which might lead to infertility or blockage in the fallopian tubes.
5.3.2. Polycystic Ovarian Syndrome
Health conditions such as polycystic ovarian syndrome can affect fertility and make it harder to get pregnant. It can cause incomplete ovulation, or ovulation can be completely absent.
5.3.3. Infections
Untreated sexually transmitted infections like chlamydia and gonorrhea can affect your uterus, cervix, and other reproductive organs. This can adversely affect future fertility as the inflammation caused by bacteria is left untreated.
5.3.4. Some Other Health Conditions
Conditions like endometriosis and scarring of internal tissues can also be a factor affecting fertility.
5.3.5. Age
Age is also a factor in pregnancy; as we all know, women experience menopause at 45 -50, which means a complete reproductive shutdown. After a certain age, the quality of ovaries doesn’t remain the same, so even if you choose not to get pregnant after an abortion, it doesn’t guarantee a pregnancy.
6. The Mental Impact of Abortion
Experiencing depression after abortion is common, and the symptoms may include:
- Lack of energy
- Lack of sex drive
- feeling sad
- Loss of interest in activities planned termination prepares a woman’s body, and the emotional changes might be due to the hormones. Still, an unplanned abortion may affect her mental health worse.
- She might feel isolated and exhausted. A pregnancy loss is an interruption in the hormonal cycle which can lead to negative thoughts. There should be proper communication with her partner during this phase and social support.
- This may help her prevent future relationship problems and low self-esteem. Suicidal thoughts may arise during this phase, and it’s important to monitor her health conditions and do checkups if necessary.
7. Summary: Can Abortion Cause Infertility?
Achieving healthy pregnancy and parenthood is a blessing, and abortion does not entirely affect your fertility or chances of getting pregnant. Most postoperative infections can be treated with antibiotics, reducing future pregnancy loss.
Early detection and early abortion cause less exhaustion than a surgical procedure, but the latter is safe if performed with care and professionalism.
After an abortion, if a couple continues having unprotected sexual intercourse, pregnancy can be achieved, and it doesn’t affect your fertility. There are two types of infertility:
- Primary infertility – When a couple has difficulty conceiving for the first time
- Secondary infertility- When a couple cannot conceive after past pregnancies,
Some of the reasons that impact fertility can be poor semen quality, blocked or damaged fallopian tubes, poor ovulation, stress, environmental factors, and other reproductive problems. These can be treated at your local health care center, or if the target is to get pregnant, one can opt for artificial insemination.
Intrauterine semen transfer or surrogacy are also two viable alternate methods. Apart from the risks and rare cases, abortion doesn’t cause infertility, and experts agree. Your decision is always respected, and women should be carefree about conceiving again.
8. Frequently Asked Questions
8.1. Can a miscarriage affect future ovulation?
Yes, women can ovulate after a few weeks after a miscarriage. However, their cycle of ovulation depends on the time of miscarriage.
8.2. What to avoid after abortion?
A woman would most likely be asked to refrain from having sexual intercourse and avoid using tampons for two weeks after the abortion.
8.3. What can be the causes of infertility?
Some of the reasons that impact fertility can be poor semen quality, blocked or damaged fallopian tubes, poor ovulation, stress, environmental factors, unhealthy habits, and other reproductive problems.
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Last Updated on by Aditi Gautam
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