Submitted by Kate Seldman Mon 04/18/2011
Doctor-wearing-mask-in-operating-room.jpg Having a pregnancy terminated doesn’t usually lead to infertility, especially when medical professionals perform the procedure in a safe, clean environment. There’s no evidence to suggest that abortions cause infertility, except in a few rare cases as outlined below. A D and C, or dilation and curettage, is a procedure in which a woman’s pregnancy is terminated by the dilation of her cervix and the cleaning out of her uterine tissue. If a woman has had multiple D and Cs, there’s a small risk of scarring inside her uterus or at the top of her cervix, which could pose problems if she wants to get pregnant again. Doctors can check for this scarring by performing a hysteroscopy: the doctor will insert a small camera into the uterus to scan for any scar tissue, and if he or she finds any, he or she can usually repair it right then and there. Another risk of multiple D and Cs is a weak cervix. The cervix, which has been dilated several times during abortions, may start to dilate prematurely during a pregnancy a woman has decided to carry to term. This isn’t an infertility problem per se, but can endanger the health of a growing fetus who isn’t yet ready to be born. In this case, doctors may place a cerclage, or a stitch to keep the cervix from dilating too soon. Medical abortions are different from D and Cs or vacuum extractions, both of which are known as surgical abortions. Medical abortions involve the patient taking two medications to terminate her pregnancy: the first, mifepristone, blocks progesterone the pregnancy needs in order to stay viable; the second, misoprostol, brings on uterine contractions that will induce a miscarriage. No research has indicated that medical abortions have a negative effect on fertility. Abortions performed in an unsanitary environment can lead to post-operative infection, which can definitely affect fertility, and may even lead to serious illness or death.