I had an abortion when I was a teenager. I am now 27 years and plan to get married next year. I am worried whether the abortion will impact on my fertility. what should I do?
A: I presume you had an induced abortion or termination of pregnancy. This is usually done under general anesthesia in the first three months of pregnancy by a procedure called dilatation and curettage (D&C). Metal dilators of various size are introduced through the vagina to force open the cervix (neck of the womb). When the cervix is dilated to about 6-10 mm in diameter, a plastic tube is inserted into the uterus (womb) and connected to a suction pump. Vacuum is then created and the foetus sucked out in pieces. Complications can occur during the procedure and they can be divided into early and late complications
Early complications include;
Infection of the womb with patient having fever,
Excessive Bleeding from injuries to the cervix and the uterus,
Perforation or puncturing of the uterus by the instruments,
Complications from general anesthesia,
Injuries to surrounding organs like urinary bladder and the intestines,
Shock and death from severe infection.
Late complications include;
Anemia, a condition in which there is a lack of blood, resulting in general body weakness,
Chronic pelvic infection with lower abdominal discomfort,
Laxity of cervix causing repeated miscarriages,
Ectopic pregnancy, a life-threatening condition in which the fetus grows outside the uterus, usually in a fallopian tube,
Psychological problems, emotional upset, “anniversary” syndrome,
Link to Breast cancer.
Fertility can be affected if there is excessive damage to the lining of the uterus from overzealous scrapping (curettage). The will cause scanty or absence of menstruation (Asherman's syndrome) if there is pelvic infection causing blockage of fallopian tube if there is laxity of cervix causing repeated mid trimester miscarriages. You should have a preconception check to assess your fertility potential. You can also do a self-test using the fertility index in our website.