Abortion and Infertility

With rising rates of infertility there has been some speculation as to a possible link with damage a woman has experienced with a previous abortion

  • Women with infertility of 1-5 years' duration after an abortion, have had bone fragments discovered on vaginal ultrasound, and conceived after removal.
  • Foetal tissue left in the womb can rot, leading to infection and sterility.
  • Perforation of the uterus can lead to removal of the uterus.
  • Women with previous or existing Pelvic Inflammatory Disease have a decrease in fertility following an abortion.
  • Multiple abortions and delayed childbearing can lead to infertility.
Unlike the experience of the 'baby boom' generation following World War II (1946 - 1964) when infertility was not a problem for most people, many couples today have to deal with the frustration and heartache of infertility. Infertility is defined as the inability to produce a pregnancy after 12 months of trying.

The growing rates of infertility and secondary infertility (infertility after a woman has had one child) can be attributed to many things, but many medical experts and researchers are reluctant to name surgical abortion as a possible causal factor.

Because abortion is such a controversial issue, any expert who speaks up and links abortion with negative side-effects is regarded as a secret "pro-lifer" and is in danger of committing professional "suicide." Such a scientist or researcher risks being shunned by colleagues and ridiculed in the media and professional journals.

Many advocates of abortion deny that there is a link between abortion and future infertility, except when the abortion is illegal. There is usually a qualifer, however, that says legal abortion should not affect future fertility "where there are no complications."

Dr Tiller - world-renowned abortionist
Abortionist Dr George Tiller's website cites the following complications of abortion that can lead to a woman being unable to have children at a later date of her choosing. With first and second trimester abortions:

"Another case series with West African women, involved eleven with secondary infertility lasting 2-15 years' duration. All these women had a previous pregnancy termination performed between 10 and 26 weeks gestation. Diagnosis of retained fetal bone was made with transvaginal ultrasound in all cases. Hysteroscopy was then performed to remove the bone fragments, and eight out of the eleven women subsequently conceived spontaneously." 3

N.B. The best imaging technique for visualising retained foetal bone, is vaginal ultrasound.

Retention of foetal tissue
In a first trimester abortion the doctor sometimes performs what is known as an "incomplete abortion" accidently leaving some tissue in the uterus. When foetal tissue is left behind in the womb it can rot and cause a severe infection that can cause permanent damage to the female reproductive organs. This can result in sterility or miscarriage of future pregnancies.

Infections
While many abortion advocates deny future infertility can be due to an abortion, they do mention that it could have resulted from a sexually transmitted infection/disease that was present at the time of the abortion. It is indeed likely that following an abortion the main risk to fertility is the development of Pelvic Inflammatory Disease (PID), which is an inflammation uterus, fallopian tubes and ovaries. Any use of instruments on the cervix, such as during a D&C, can lead to a greater spread of these organisms and, therefore, the risk of PID.

A Scandinavian study found that women with previous or existing Pelvic Inflammatory Disease had a decrease in fertility following an abortion. Acta/Obstetrics and Gyn. Scandinavia 1979; 58:539-42 4

Multiple abortions
In some cases, multiple dilations and curettages (D&C) may cause some scarring at the top of the cervix or inside the uterus. Any procedure that dilates the cervix, which is a necessary step during most abortions, can weaken it. It can affect the ability of an embryo to implant into the uterus or the ability of your cervix to support a pregnancy.

Women who have had more than one abortion and get pregnant again later on, may find that they have what's known as an incompetent cervix ? a cervix that starts dilating prematurely.

Delaying childbearing
Since the mid-1960s there has been a trend, especially among higher educated women, of delaying childbirth while they established their career goals. In order to put off having a child until she is established in her career, has paid off student loans and, perhaps purchased a house many women use abortion as a back-up for contraceptive failure.

Quite apart from any possible abortion-related cause, she may simply find that her optimum time for conceiving has come and gone without her realising it.

The Estrogen connection
A growing body of scientific evidence suggests that while a number of factors may be to blame for rising infertility rates, one of the greatest could be because of an an excess of estrogen.

An excess of the estrogen hormone can effect ovulation in women and some experts also believe that uterine fibroids, endometriosis, ovarian cysts and infections of the reproductive organs ? all of which can impair fertility in women ? are often the result of estrogen overload.

While many experts would agree that excess estrogen can be a causal factor in infertility, most would avoid all suggestion that abortion may also be a contributing cause because of the 'politics' involved.

By 7 to 8 weeks gestation, a pregnant woman's blood already contains six times more estradiol (an estrogen hormone) than it did at the time of conception, more than twice the highest level attained in the non-pregnant state.

Whereas after pregnancy, many women breastfeed, thus suppressing the production of estrogen, many girls/women may conceive again within 12 months after having an abortion. Having repeat abortions, especially in young females, may well be a reason for future fertility.

References:
  1. Naftolin N. A bone of contention: an unusual case of secondary infertility. Br J Obs Gyn 1999
  2. Latrogenic secondary infertility caused by residual intrauterine fetal bone after midtrimester abortion. Am J Obstet Gynaecol 1997
  3. The ultrasound diagnosis of retained fetal bones in West African patients complaining of infertility. Br J Obstet Gynecol 2000 Source: Fertility and Sterility, Vol 79, Issue 4, April 2003. National Library of Medicine
  4. Acta/Obstetrics and Gyn. Scandinavia 1979; 58:539-42