• Dr Peter Chew

Abortion and fertility

I had an abortion when I was a teenager. I am now 27 years and am planning to get married next year. I am worried about whether the abortion would have affected my fertility. What should I do?

A: Abortion, also known as termination of pregnancy, is a surgical procedure usually performed in the first trimester of pregnancy under general anesthesia . In this procedure, the neck of the womb(cervix) is gradually forced open by the gynaecologist using metal dilators of various sizes. After the cervix is dilated to about 6-10 mm, a plastic tube with holes at the tip is inserted into the cavity of the womb and connected to a suction machine. The foetus is then extracted out in pieces. 

In experienced hands, complications following the procedure are few. Occasionally, they may be life threatening or may cause emotional upset  in the patient for a long time. They can be categorized into early and late complications.

· Early complications include

· Pelvic Infection with fever

· Excessive vaginal bleeding

· Perforation (puncturing) of the womb

· Injuries to the lower genital tract (vagina and cervix)

· Injuries to the surrounding organs (urinary bladder and intestines)

· Shock from blood poisoning (septicemic shock) due to severe infection · Complications from general anesthesia

Late complications include

· Loss of blood, leading to anaemia (low red cell count)

· Lower abdominal discomfort from chronic pelvic infection

· Laxity of the cervix, resulting in repeated miscarriages or premature births

· Ectopic pregnancy ( pregnancy outside the womb )

· Infertility

· Psychological trauma,

· Increased risk of breast cancer 

Fertility can be affected:

· if there is excessive damage to the lining of the uterus from overzealous scraping (curettage). This will result in scanty or absence of menstruation (Asherman's syndrome)

· if there is pelvic infection, which lead to blockages of the fallopian tubes · if there is laxity of cervix, which may result in repeated miscarriages or premature births.

You should consult a gynaecologist and have a preconception check to assess your fertility potential.

You can also do a self-test using the fertility index at our website.

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