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Expert Q&A

	By Robert Jansen Fertility Expert

Does a past history of terminating a pregnancy affect your current ability to become pregnant/does it cause infertility? If so, how?

Terminating a pregnancy only rarely causes later problems with fertility. The main reason it sometimes does is if there was an infection immediately afterward, and for terminations done by a trained person in a clinic this is very unlikely (and would mostly have been obvious at the time).

There are some other special circumstances that can be important to preconception planning when a pregnancy is terminated.

First, occasionally, the periods can stop straightaway after the termination. This is usually due to intrauterine adhesions localized to just above the cervix, and is usually easily treated at a hysteroscopy (passing a scope through the cervix into the uterus).

Second, in cases where the cervix has had to be stretched open a lot for the termination without being softened with drugs, the cervix might be structurally weakened, and might start to open during pregnancy (called "cervical incompetence"), resulting in miscarriage. So don't keep terminations a secret from your OB. He or she will want to check on the cervix, especially between 14 and 28 weeks.

Third, don't feel guilty about the termination. If it was the right thing for you at the time, even if you might be having trouble getting pregnant now, you made the best decision you could in difficult circumstances. On the other side of the coin, think very carefully about terminating a pregnancy if it's to the person you love, especially if you're in your thirties and you would be planning a pregnancy in a few years anyway. Sometimes the pregnancy you're about to terminate could be your only chance.

The relevant chapters in my book, Overcoming Infertility (www.jansen.com.au) are:

Ch. 8: Treatment for miscarriages
Ch. 24: Pregnancy"

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