If you are thinking about having an abortion, you may be wondering if your fertility (your ability to have children) will be affected later on. As with any medical procedure, there are risks to consider. About 10% of abortion procedures result in complications that could hurt a woman’s fertility. Read on to learn about the risks involved with abortions and future fertility.
can abortion affect my fertility?
Many women who consider abortion or have experienced abortion in the past have questions about fertility after abortion. For example: Does abortion decrease fertility? Do abortions leave scars? Do abortions cause cervical or uterine scarring? How does scarring affect my future pregnancies? What other fertility risks are associated with surgical abortion? Are there fertility risks associated with medical abortion? If you have questions like these, continue reading to learn more.
Complications from Medical Abortion
Most medical abortions (abortion pill) will not affect future fertility. A medical abortion is completed by taking a series of two pills within the first 10 weeks of pregnancy. The first pill cuts off the flow of Progesterone which is known as the “pregnancy hormone” as it helps to create a stable environment for the newly forming fetus during early pregnancy. The second pill brings on labor-like contractions of the uterus to expel the pregnancy.
After a medical abortion, it is common to experience:
- heavy bleeding, much heavier than your period
- severe cramping
- you may also experience nausea, vomiting, and chills
A medical abortion may take several days to several weeks to complete. A follow-up with your doctor is necessary to assure there is no remaining tissue from the pregnancy.
How well does medical abortion work?
In a small percentage of cases, a surgical procedure is still needed to completely remove the pregnancy from the uterus after a medical abortion (abortion pill).
When performed at 8 weeks or less, the abortion pill is effective 94-98% of the time. When performed at 8-9 weeks, the abortion pill is effective about 94-96% of the time. When performed at 9-10 weeks, the abortion pill is effective about 91-93% of the time. When performed at 10-11 weeks, the abortion pill is effective 87% of the time. An additional dose of medicine can be given at weeks 9-11 to increase the likelihood that the abortion will be effective.
If the medical abortion does not completely expel the pregnancy, it will necessary to have a surgical procedure to complete the termination. What happens in this situation is that tissue from the pregnancy remains in the uterus. If tissue from the pregnancy remains in the uterus, it can lead to scarring or infection. The infection must be treated and tissue may need to be surgically removed which can lead to more scarring and infection. The more often a woman undergoes surgical abortion procedures the greater the risk of uterine scarring from abortion. All of these surgeries from abortion can have an effect on your fertility.
Complications from Surgical Abortions
In most cases, surgical abortions do not keep a woman from having a healthy pregnancy in the future. Surgical abortions are effective about 99% of the time. There are two different types of surgical abortion.
The most common surgical abortion is a Vacuum Aspiration or suction abortion. These are normally performed up to 14-16 weeks and involve using an instrument that suctions the pregnancy out of your uterus.
The second type of surgical abortion is called Dilation and Evacuation (D&E). A doctor performs the surgery by dilating (opening) the cervix. Using suction and a sharp, spoon-shaped tool called a curette, the doctor will scrape the inside of the uterus and remove the pregnancy.
Just like any surgery, there are health risks associated with abortion. Some risks may include heavy bleeding, infection, cervical scarring, uterine scarring, damage to internal organs, sepsis, fertility loss, complications with future pregnancies, and death.
Surgical abortion is the leading cause of Asherman Syndrome. Though rare, Asherman Syndrome is when scar tissue develops in the uterus and/or cervix as a result of surgical procedures. Multiple surgical abortions increase the risk of cervical and uterine scarring from abortion.
Asherman Syndrome
Asherman Syndrome is the development of scar tissue in the uterus and cervix. The scar tissue can prevent a fertilized egg from attaching to the lining of the uterus. In essence, the tissues of the uterine wall will become “sticky” and adhere to each other which reduces the size of the uterus. The main way women develop Asherman Syndrome is through uterine surgery (including surgical abortions). Women who have multiple surgical abortions are at risk of this uterine scarring from abortion. The presence of scar tissue can make it more difficult to become pregnant in the future.
Common symptoms of Asherman’s Syndrome include:
- Having very light periods
- Having no periods
- Having severe cramping or pain
- Being unable to get or stay pregnant
Some women have no symptoms, and some women have normal periods.
Treatment for Asherman Syndrome is surgery to remove the scar tissue within the uterus, which may cause additional scarring.
Pelvic Inflammatory Disease and Fertility
Pelvic Inflammatory Disease (PID) is an infection of the female reproductive system. Although it can have other causes (such as sexually transmitted diseases), PID can be caused by infections that develop after an incomplete medical abortion or as a complication of surgical abortion. In most cases, the infection will be identified and treated before it causes any lasting damage to your fertility. However, if PID is untreated it can cause infertility. Sometimes PID shows no symptoms or only vague symptoms, which makes it more likely to be untreated. In addition to scarring of the uterus and cervix, the fallopian tubes can become infected which will result in scarring and narrowing. If this happens, eggs cannot pass from the ovaries to the uterus. An estimated 1 in 10 women will become infertile because of Pelvic Inflammatory Disease.
Prematurity and Low Birth Weight, pregnancy loss
Some studies have shown that abortion (especially multiple abortions) increases a woman’s chance of having a premature/low-birthweight baby in future pregnancies. This is concerning because premature and low-birthweight infants have a higher mortality rate and are known to have more health concerns throughout life. The link between abortions and premature/low-birthweight babies in future pregnancies can be associated with cervical insufficiency/incompetence. In other words, the cervix doesn’t work the way it should to hold a pregnancy in the uterus.
During a surgical abortion, the cervix is dilated (opened) causing trauma to the cervix. This trauma could make the cervix shorter or weak during future pregnancies – in a sense, not able to hold the pregnancy in the uterus, especially during the second and third trimester. This could lead to premature birth or even pregnancy loss.
A fair percentage of women who choose to have an abortion will not see a major impact on future fertility. However, there are specific risks to consider when thinking about abortion including Pelvic Inflammatory Disease, irreversible uterine scarring, and prematurity/low-birthweight of future babies.
Learn More About How An Abortion Can Affect Your Fertility
If you think you might be pregnant and need to know for sure, Jewel Women’s Center can help you get your questions answered. We offer free, confidential help in a warm, caring environment. Contact Jewel today for an abortion consultation and get the information you need about abortion’s effect on your fertility.