The likelihood of infertility after medical abortion

This is the most painful diagnosis for a man and woman who wants to have a baby. And often the cause of infertility is an abortion that a woman once had. Gynecological statistics say that after such an operation, every tenth representative of the weak half of humanity becomes infertile. If the abortion was performed outside a medical institution, by an inexperienced specialist, then the risk of infertility increases several times. So, let's find out why women cannot get pregnant after such an operation and what they should do next to solve the problem.

The danger is not imaginary

Every tenth woman after one artificial termination of pregnancy is faced with a diagnosis of infertility. If the operation was done “handicraft”, using advice or “folk” recipes, not in a certified clinic, then the likelihood of infertility increases.

Termination of pregnancy is most dangerous for very young women carrying a child for the first time.

If the decision is made finally, you should contact a certified medical institution. Before the procedure, you should be thoroughly examined, tested, and prepared.

It is not recommended for women to have abortions:

• never given birth;
• women with Rh-negative blood;
• with a diagnosis of “uterine tumor”;
• in late gestation.

There are three ways to end an unwanted or health-threatening pregnancy, each of which can result in a woman having to undergo fertility treatment several years later.

What is the likelihood of infertility after an abortion?

If an abortion is performed in a specialized medical institution, the probability of infertility after an abortion in a woman who has given birth before is approximately 10%.

Read also The influence of excess weight on the problem of infertility

This figure can increase sharply and reach 40-45% if the intervention took place at home, in non-sterile conditions, if the woman did not follow the advice of the treating gynecologist. The same number of women will face the problem of infertility after their first abortion. The risk is that at a young age, when unwanted pregnancies most often occur, the reproductive system is still in the process of formation, and gross interference in its work causes a sudden failure.

Each subsequent attempt to get rid of an unwanted pregnancy significantly increases the threat of forever losing the opportunity to have children.

Without surgery: medical abortion

Abortion using pills - medicinal - is carried out from the first to the sixth week of gestation inclusive (up to 42 days from the last menstruation). With this type of abortion, the woman takes special medications: they affect the body in such a way that the fetus in the uterus dies. This is followed by a miscarriage.

It is believed that infertility will not occur after medical termination of pregnancy, because this method is carried out without surgical manipulation, but this is not true.

Despite this “gentle regimen,” the procedure is accompanied by unpleasant complications and can lead to infertility. This happens due to:

• intolerance to medications taken;
• severe bleeding that opened;
• disruption of the menstrual cycle, which can become an obstacle to conceiving a desired child and successful pregnancy;
• inflammation of the organs located in the pelvic area due to the remaining unrejected tissues of the already deceased fetus, and the retention of parts of the embryo is a reason for performing a surgical operation;
• formations in the fallopian tubes, through which the fertilized egg moves to the uterus, adhesions;
• occurrence in subsequent pregnancies, if an abortion is performed on a woman with a negative Rh factor, Rh conflict.

Due to these complications, infertility is diagnosed after medical abortion.

What complications can there be after an abortion?

Women who have been unable to get pregnant for a long time and have experienced an abortion in the past periodically wonder whether the operation could really cause infertility. Let's try to figure it out.

Abortion, like any intervention in the human body, can have various, sometimes extremely negative, consequences. The likelihood of their development depends on:

• general health of the woman;
• thorough medical examination before intervention;
• the quality of the abortion (whether parts of the fetus remained in the uterus);
• the period at which the pregnancy is terminated (longer period means higher risk);
• presence of scars on the uterus or cervix;
• number of previous births, abortions and miscarriages;
• doctor's competence and skills.

All types of post-abortion complications can be divided into two groups: early ones, which arise during the procedure or immediately after it, and late ones, which develop after some time.

Early complications after abortion

1. Perforation (perforation) of the uterine wall and nearby organs: bladder, intestines. It occurs with surgical termination of pregnancy, but is also possible with vacuum aspiration. Often the uterus has to be removed.
2. Incomplete extraction of fetal parts occurs with mini-abortion and short-term pharmaceutical abortion. Characterized by abdominal pain and prolonged bleeding. Requires curettage.
3. Progressive pregnancy - the embryo is not damaged and continues to develop. It is more common when performing vacuum aspiration in short periods or during curettage during multiple pregnancies.
4. The most common are inflammatory processes in the uterus and appendages. The reasons may be minor traumatic injuries to organs during manipulation, insufficient compliance with sanitary standards in the operating room, the presence of an infectious process in the woman’s body during an intervention that was not detected during the examination (for example, if an abortion is performed due to thrush). Symptoms of inflammation increase gradually and, without treatment, progress to sepsis.

Long-term complications after abortion

1. Cicatricial changes and adhesions in the uterus and fallopian tubes, thinning of the uterine walls.
2. Amenorrhea, dysmenorrhea and other menstrual irregularities.
3. Muscle weakness and erosion of the cervix, endometriosis appear after the use of dilators and the use of mechanical stress on the cervix and uterine mucosa.
4. Depression requiring drug therapy occurs after an abortion in approximately half of women.
5. Chronic inflammatory diseases affecting the pelvic organs, subsequently leading to recurrent miscarriage, ectopic pregnancy and infertility.

Read also Polycystic ovary syndrome and infertility

"Light" surgery

Termination of pregnancy using vacuum aspiration is considered more traumatic. This surgical procedure is allowed for up to 6-8 weeks. Until recently, most unwanted pregnancies were terminated this way, but today it is used less and less.

Aspiration is the pulling out of the uterine cavity of the fetus that has settled there. The procedure is risky because:

• There is no guarantee that the embryo will separate and come out completely. If tissue particles remain in the uterus, inflammation begins, leading to dangerous blood poisoning.
• Accompanied by hormonal imbalance;
• The tubes and walls of the uterus are damaged, which will lead to the development of inflammation.

Consequences of abortion at home

Abortion, after being carried out at home, becomes the cause of infertility in almost every second case. Despite the widespread availability of technologically advanced medical care, a woman may decide to have an abortion at home. The reasons may be:

• low standard of living;
• illiteracy;
• fear of publicity (especially for young women living in small towns);
• life in the outback (great distance from medical facilities);
• banal fear.

When deciding to take such a step, a woman should understand that the likelihood of serious health problems increases by an order of magnitude. Complications after an abortion outside a hospital can be extremely severe, even fatal, and develop rapidly.

Direct path to infertility: curettage

Surgical abortion is the most common, but also the most dangerous. It is also called “curettage”, because the embryo is scraped out of the uterus with instruments. This serious procedure has a whole list of possible complications, so infertility after curettage is not at all uncommon.

In addition to the appearance of adhesions and scars in the reproductive organs, which will impede the passage of sperm and the movement of the egg, curettage:

• injures the cervix, because during the procedure it is opened “manually”;
• provokes the development of inflammation of the uterus;
• accompanied by recovery therapy, which causes vaginal dysbiosis to develop; this pathology makes it difficult for sperm to enter the uterus;
• leads to endometriosis, tissue growth that will make a new conception impossible;
• negatively affects the vaginal microflora and the reproductive system;
• due to the formation of scars in the uterus, it increases the chances of an ectopic pregnancy;
• leads to bleeding in the uterus, due to which the surgeon may decide to remove the organ.

Is it possible to avoid consequences after an abortion?

Any abortion, no matter how it is performed, is a drastic intervention in the hormonal and reproductive sphere, the consequences of which can be complications, including infertility.

How can you reduce the likelihood of developing complications and protect yourself from them? It is important to remember that for any inflammatory diseases you cannot have an abortion without treatment. The key to good health is strict adherence to all medical recommendations and ultrasound monitoring of the condition of the uterus after the intervention.

Gynecologists recommend that while the recovery process is underway, monitor the temperature, do not overcool, do not take baths and thermal procedures in the first days, and avoid lifting heavy objects and sexual intercourse for at least a couple of weeks. After resuming intimate life, it is better to use barrier contraception for at least a month.

Diagnosis of problems after abortion

If a woman wants to make sure that her reproductive functions are normal, or, on the contrary, have suffered, weeks after termination of pregnancy, then it is necessary to undergo a full examination in a specialized clinic. This is a set of diagnostic and treatment procedures, selected individually by the doctor, which will give a complete picture of the state of women’s health. Such diagnostic methods of infertility can be:

• examination of the female genital organs by a gynecologist;
• blood test for hormone levels;
• screening for infections, including STDs;
• Ultrasound of the uterus, ovaries, appendages, mammary glands;
• study of fallopian tube patency;
• pipel biopsy of the endometrium of the uterus followed by histology;
• colposcopy and hysteroscopy.

Reasons to be concerned about mini-abortions

If the following signs appear, a woman should immediately consult a doctor:

• Bleeding. If a large blood clot comes out, prolonged and intense bleeding lasting more than 12 hours, you should immediately consult a doctor. Moderate bleeding in the first days after an abortion is normal.
• Fever, chills, muscle pain, dizziness are signs of infection in the body.
• Severe pain in the abdominal area that does not go away with painkillers and is not relieved by rest and warming up.
• Fever, hot flashes.
• Vomiting for 4-6 hours.
• Cardiopalmus.
• Sudden bloating.
• Vaginal discharge with an unpleasant odor.
• Redness, swelling and pain in the perineal area.

If some unusual phenomena occur after a mini-abortion, you should also consult a doctor.

Infertility treatment after abortion

Treatment of infertility after an abortion is usually a lengthy process that can last for months. Can be performed on an outpatient basis or in a hospital setting. Treatment methods are often used in a comprehensive manner, depending on the causes of infertility and aimed at eliminating them. This may be taking antibiotics, other medications, hormonal therapy, minimally invasive or abdominal surgeries, psychotherapy, and physiotherapy. Most of the consequences of abortion can be cured with modern medicine. If the changes have become irreversible, then assisted reproductive technologies will come to the aid of the infertile couple.

Happiness or sadness?

The question: “Maybe I’m pregnant?!” - every woman asks. And more than once or twice in my life. It is impossible to describe in words the whole range of feelings at the time it arises. For some this is a long-awaited hope, for others it is unexpected happiness and joy. Some people are confused when looking at a test with two lines. Some people are horrified thinking about the problems that lie ahead.

“I don’t know whether to give birth or not” - this is what many women may say to themselves. Everything seems so easy and simple when a woman is happily expecting a child, because she treats even thoughts about him with great sympathy. These feelings are light and pleasant. Even if the baby “turned out” unexpectedly, the confusion goes away after just a few days, and is replaced by a feeling of boundless peace with a slight admixture of anxiety about whether everything will go well.

But what to do if the thoughts visiting a pregnant woman’s head are joyless and pessimistic? Of course, we cannot blame those women for whom the appearance of a child in their life is a huge problem. Every person has the right to make their own choice, express their opinion and make a decision, no matter how it may seem to others. How to decide whether to give birth or not? Only the woman herself can decide what is important and necessary for her in this period of life. This is a matter of life circumstances and morality.

Possible causes of unplanned pregnancy

So, all women understand that pregnancy can be either planned or unplanned. Every expectant mother has a choice - to keep the child or interrupt its development, to give birth or not. We can talk endlessly about the moral aspect. Yes, every life is given for a reason, and every baby has the right to be born. But is that how his parents see it?

From time to time, the church makes attempts to ban abortions in the country or make them paid. But who will benefit from this? Most often, unplanned pregnancies are terminated precisely because of financial problems. And if the state makes abortions paid, the number of deaths will increase and more women will remain crippled due to home, criminal abortions.

What are the reasons why pregnancy happened suddenly:

1. A woman is breastfeeding her baby and is not menstruating. In this situation, when the first child is still very small, the question no longer arises whether it is easier to give birth to a second one or not. Not every woman will decide to have a second birth so that the age difference between the two children is about a year. An unplanned second pregnancy quite often occurs precisely because young mothers are convinced: as long as there are no periods, pregnancy will not occur. But. Ovulation often precedes the first menstruation. Pregnancy can occur even when a woman considers herself “sterile.” The menstrual cycle can resume even in the first weeks after birth, even if the mother is very actively breastfeeding the baby.
2. Coitus interruptus did not “work.” Because of such arrogance, unplanned pregnancy can occur, especially in young girls. In the same way, douching with water with lemon juice, a solution of soap, and the like will not help. The situation that has happened is the result of one’s own ignorance and lack of knowledge.
3. The woman is sure that menopause has arrived and does not worry about anything. It turns out that if pregnancy occurs after 40 years, it is difficult to call it a rarity, because many women retain their reproductive capacity. But the number of miscarriages at this age is higher. But anyway. Therefore, if a woman does not have her period on time, even if she feels the symptoms of menopause (they may turn out to be early toxicosis of pregnant women), but sexual intercourse has taken place, she needs to take a pregnancy test.
4. Many people are wondering whether to give birth at 35 or not. And after 40, this question is more relevant, because the older the female body, the more difficult pregnancy can be tolerated and the greater the likelihood of having a baby with Down syndrome and similar pathologies.
5. The chemical contraceptive turned out to be ineffective, the condom broke, and I did not take the hormonal contraceptive on time. This can happen to every couple. To prevent an unplanned pregnancy from occurring, you should take a hormonal emergency contraceptive. If a woman accidentally missed the time and did not take a hormonal contraceptive pill, she must strictly follow all the instructions in the instructions in this regard.
6. According to the woman's calculations, there should not be ovulation. But the calendar method is not very accurate, and doctors do not advise relying only on it. It is better to find a more reliable means of contraception. By the way, sexual intercourse two to three days before ovulation can also cause conception: sperm live for several days.

Either yes or no

If a woman decides to keep the child, she needs to register for pregnancy. First, visit a gynecologist who will examine her and, if necessary, refer her for an ultrasound of the uterus. It's better to do this as early as possible. But if the expectant mother is not worried about anything (no stomach pain, no severe manifestations of toxicosis, no bleeding from the vagina), then it is quite possible to wait a couple of weeks.

If the baby is not part of the family’s plans, an abortion should be done as early as possible. The price for it varies, depending on the type and the drugs used. More on this below. The shorter the period, the greater the likelihood that the woman will not have problems with her reproductive health in the future due to this operation.

Until twelve weeks of pregnancy, abortion is carried out at the request of women. It is absolutely not necessary to have medical indications for its implementation. A referral for the procedure is taken from the antenatal clinic at your place of residence. If you have an insurance policy, this operation is performed free of charge. A woman must undergo tests, have an ultrasound, and come to the hospital on the appointed day to terminate her pregnancy. They are usually discharged on the same day, a few hours later, as soon as the woman comes to her senses after anesthesia (if it was administered).