ABORTION and INFERTILITY

Also check out these links:

http://www.pregnancyweekbyweekcalendar.info/abortion/possible-causes-to-show-the-signs-of-
infertility-after-abortion.html

http://www.pregnancyweekbyweekcalendar.info/abortion/possible-causes-to-show-the-signs-of-
infertility-after-abortion.html

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."
Source: http://www.life.org.nz/abortion/abortionkeyissues/futurefertility/

Two sources contain key data:

1. "Roughly 25% of the women who interrupt their first pregnancy have remained
permanently childless." Source: Dr. Bohumil Stipal, Czechoslovakia's Deputy Minister of
Health

2. “ The risk of secondary infertility among women with at least one induced abortion is
3-4 times greater than that among non-aborted women.” (British Journal of OB/GYN,
August, 1976)

One pro-choice resource, in countering this finding, has stated: “ The 25% figure would
presumably include:

1. women who had an abortion and simply have not tried to become pregnant since.
2. women who had decided to not have any children for the foreseeable future,
found themselves pregnant, had an abortion and have remained childless by
choice ever since
3. women who were fertile, had an abortion and are now infertile because of
complications arising from the abortion.

A figure of a risk of 25-30% for infertility may represent the results of two episodes of
PID after an abortion or apart from an abortion. Note: Approximately 10% of women
will develop tubal adhesions leading to infertility after one episode of PID, 30% after two
episodes, and more than 60% after three episodes. – Source: (M. Spence, Sexually
Transmitted Disease Bulletin, John Hopkins University).
The real issue may be the validity of Secondary infertility which “.. is usually defined as
the inability to conceive or carry a pregnancy to term after successfully and naturally
conceiving one or more children. According to a 1995 survey by the National Center for
Health Statistics, 3.3 million American women were experiencing secondary infertility.
This showed an increase from 1988, when 2.7 million women were affected by secondary
infertility.” Source: http://www.fertilityfactor.com/infertility_secondary_infertility.html

Data that leads to a figure of 25-30%: The cumulative effects of one or more abortions
leading to various complications that lead to sterility:

"The relative risk of secondary infertility among women with at least one induced
abortion and no spontaneous miscarriages was 3-4 times that among non-aborted
women." D. Trichopoulos et al., "Induced Abortion & Secondary Infertility," British
Jour. OB/GYN, vol. 83, Aug. 1976, pp. 645-650

Abortion results in cervical damage, which results in permanent weakening of the cervix,
which, in turn, is unable to carry the weight of a later pregnancy. The cervix opens
prematurely..symptoms related to "cervical incompetence" were found among 75% of
women who undergo forced dilation for abortion” Source: A survey by Dr. Ren,
"Cervical Incompetence - Aetiology and Management," Medical Journal of Australia
(December 29, 1993), Volume 60,

In a study performed with 252 women, the investigators concluded that "the occurrence
of either induced or spontaneous abortions independently and significantly increased the
risk of subsequent development of secondary infertility. Source: Study done at Harvard
from the Journal of Epidemiology and Community Health. Feb 1993 issue.

Among women who had aborted their first pregnancy, there was a 500% increase in
subsequent ectopic pregnancies. Chung et al., "Effects of Induced Abortion
Complications on Subsequent Reproductive Function," U. of Hawaii, Honolulu, 1981

Tubal pregnancy increased 30% after one abortion and 160% after two or more abortions.
Am. J. Public Health, 72:253-6, 1982

“Abortion results in cervical damage, which results in permanent weakening of the

cervix, which, in turn, is unable to carry the weight of a later pregnancy. The cervix
opens prematurely. A survey by Dr. Ren, “Cervical Incompetence – Aetiology and
Management,” Medical Journal of Australia (December 29, 1993), Volume 60, reported
that symptoms related to “cervical incompetence” were found among 75% of women
who undergo forced dilation for abortion. (http://www.gargaro.com/healthproblems.html)

In a study performed with 252 women, the investigators concluded that “the occurrence
of either induced or spontaneous abortions independently and significantly increased the
risk of subsequent development of secondary infertility. – Study done at Harvard from
the Journal of Epidemiology and Community Health. Feb 1993 issue.
The Fallopian tube is a fragile organ, if infection injures it, it often seals shut. The typical
infection involving these organs is pelvic inflammatory disease (PID). “Pelvic
Inflammatory Disease is difficult to manage and often leads to infertility, even with
prompt treatment … Approximately 10% of women will develop tubal adhesions leading
to infertility after one episode of PID, 30% after two episodes, and more than 60% after
three episodes. – (M. Spence, Sexually Transmitted Disease Bulletin, John Hopkins
University).

The risk of secondary infertility among women with at least one induced abortion is 3-4
time greater than that among non-aborted women. – (British Journal of OB/GYN,
August, 1976)

“Experienced by 1 in 4 (24.3%). May include excessive bleeding, premature delivery,

cervical damage, and sterility.” Source: Acta/Obstetrics and Gynecology Scandinavia
1979; 58:491-4

“For example, one possible outcome of abortion-related infections is sterility. A large

number of aborted women are left inadvertently sterile as a result of the operation’s latent
morbidity. The risk of sterility is even greater for women who are infected with a
venereal disease at the time of the abortion.” Wren, ‘Cervical Incompetence – Etiology
and Management’, Medical Journal of Australia (December 29, 1973), vol. 60.

“Experienced by 1 in 4 (24.3%). May include excessive bleeding, premature delivery,

cervical damage, and sterility.” Source: Acta/Obstetrics and Gynecology Scandinavia
1979; 58:491

“Miscarriage risk is almost doubled for women with one induced abortion but no prior
deliveries” Source: New England Journal of Medicine, September 1979, pp 677-681

“160% increased risk of tubal pregnancy.” Source: American Journal of Public Health
1982; 72:253-6

“Because an abortion is a surgery there is a risk of damaging the nearby organs (i.e.
Ovaries), but due to the nature of this part of the body there can be serious consequences
to the reproductive future of women. In these types of pregnancies the baby grows in the
fallopian tubes, causing serious risk to the mother, and an almost certain death to the
baby. Women who have their first pregnancy terminated have five times the chance of
having ectopic pregnancies.” Source: (Gentles 1990, 77)

“..overzealous currettage can damage the lining of the uterus and lead to permanent
infertility. Overall, women who have abortions face an increased risk of ectopic (tubal)
pregnancy and a more than doubled risk of future sterility. Perhaps most important of all,
the risk of these sorts of complications, along with risks of future miscarriage, increase
with each subsequent abortion. ” Sources: 94. Danforth, cited above, p. 887, and David
H. Nichols, M.D., Gynecologic and Obstetric Surgery (St. Louis: Mosby-Year Book Inc.,
1993), p. 260, and Leon Speroff, Robert H. Glass, Nathan G. Kase, Clinical
Gynecological Endochrinology & Infertility (Baltimore: Williams & Wilkins, 1983), pp.
156-157. 95. A. Levin, et al, "Ectopic Pregnancy and Prior Induced Abortion," American
Journal of Public Health, Vol. 72, No. 3 (March 1982), pp. 253-256. 96. Anastasia
Tzonou, et al, "Induced abortions, miscarriages, and tobacco smoking as risk factors for
secondary infertility," Journal of Epidemiology and Community Health, Vol. 47 (1993),
p. 36. 97. A. Levin, et al, "Association of induced abortion with subsequent pregnancy
loss," Journal of the American Medical Association, Vol. 243, No. 24 (June 27, 1980),
pp. 2495-2496, 2498-2499.

Concluding thoughts:

The issue of sterility is complicated because of various factors like secondary infertility
(explained herein). It may be best to be conservative and not use a 30% figure (as I may
have in the past) because of these factors.

I myself feel comfortable with the 25% quote of Dr. Bohumil Stipal, Czechoslovakia's
Deputy Minister of Health, but this is argued because some say 'secondary fertility' is no
longer an issue; others, when searched clearly state it as an issue for today. Again,
statistics and studies are muddied by political persuasion.
http://www.life.org.nz/abortion/abortionkeyissues

Additional resources:

Abortion aftermath can cause infertility {Washington Post } - [ The Atlanta

Journal-Constitution: 5/4/03 ]

Unexplained infertility in otherwise healthy women may sometimes be caused by the presence of
fetal bone fragments left embedded in the uterus after a previous abortion, according to a new
report that offers a novel approach to solving the problem. Evidence has been accumulating for
years that small pieces of fetal bone can sometimes get left behind after an abortion, causing a
chronic irritation in the uterus that can interfere with subsequent pregnancies. Sometimes the
bone fragments can be seen with a hysteroscope, a tube with a tiny camera at the end that allows
a doctor to look inside the uterus. But many such cases of infertility go undiagnosed and
unexplained. Now a new case report, published in the April issue of the journal Fertility and
Sterility, helps explain the difficulty in recognizing this problem. Doctors at the University of
Ottawa found that, in some cases, these bone fragments can work their way into the muscular ----
uterine lining, making them invisible even with a hysteroscope.

However, if the abortion is infected or complicated by pre-existing and nontreated STDs, risks of
secondary infertility, ectopic pregnancy, and fetal loss increase. Therefore, it is critically important to
provide prophylactic antibiotics with the surgery to protect against pelvic infection. Source: Sawaya
GF, Grady D, Kerlikowske K et al: Antibiotics at the time of induced abortion: the case for universal
prophylaxis based on a meta-analysis. Obstet Gynecol 87: 884, 1996

Cervical laceration among THE PHYSICAL COMPLICATIONS OF ABORTION

National statistics on abortion show that 10 percent of women undergoing induced abortion suffer from immediate
complications, of which one-fifth (2 percent) were considered major.9,11

Over one hundred potential complications have been associated with induced abortion. “Minor” complications
include: minor infections, bleeding, fevers, chronic abdominal pain, gastro-intestinal disturbances, vomiting, and Rh
sensitization. The nine most common “major” complications which are infection, excessive bleeding, embolism,
ripping or perforation of the uterus, anesthesia complications, convulsions, hemorrhage, cervical injury, and
endotoxic shock.23

In a series of 1,182 abortions which occurred under closely regulated hospital conditions, 27 percent of the
patients acquired post-abortion infection lasting 3 days or longer. 27

While the immediate complications of abortion are usually treatable, these complications frequently lead to long-
term reproductive damage of much more serious nature.

For example, one possible outcome of abortion related infections is sterility. Researchers have reported that 3 to 5
percent of aborted women are left inadvertently sterile as a result of the operation’s latent morbidity.33,23 The risk of
sterility is even greater for women who are infected with a venereal disease at the time of the abortion. 30

In addition to the risk of sterility, women who acquire post-abortal infections are five to eight times more likely to
experience ectopic pregnancies.7,20 Between 1970-1983, the rate of ectopic pregnancies in USA has risen 4-
fold.4 Twelve percent of all maternal deaths due to ectopic pregnancy.2 Other countries which have legalized
abortion have seen the same dramatic increase in ectopic pregnancies. 14,30 Cervical damage is another leading
cause of long term complications following abortion. Normally the cervix is rigid and tightly closed. In order to
perform an abortion, the cervix must be stretched open with a great deal of force. During this forced dilation there
is almost always causes microscopic tearing of the cervix muscles and occasionally severe ripping of the uterine
wall, as well.

According to one hospital study, 12.5 percent of first trimester abortions required stitching for cervical lacerations. 31
Such attention to detail is not normally provided at an outpatient abortion clinics. Another study found that
lacerations occurred in 22 percent of aborted women. 1 Women under 17 have been found to face twice the normal
risk of suffering cervical damage due to the fact that their cervixes are still “green” and developing. 26,28

Whether microscopic or macroscopic in nature, the cervical damage which results during abortion frequently
results in a permanent weakening of the cervix. This weakening may result in an “incompetent cervix” which,
unable to carry the weight of a later “wanted” pregnancy, opens prematurely, resulting in miscarriage or premature
birth. According to one study, symptoms related to cervical incompetence were found among 75 percent of women
who undergo forced dilation for abortion. 32

Cervical damage from previously induced abortions increase the risks of miscarriage, premature birth, and
complications of labor during later pregnancies by 300-500 percent.12,15,19,33 The reproductive risks of abortion are
especially acute for women who abort their first pregnancies. A major study of first pregnancy abortions found that
48 percent of women experienced abortion-related complications in later pregnancies. Women in this group
experienced 2.3 miscarriages for every one live birth. 19 Yet another researcher found that among teenagers who
aborted their first pregnancies, 66 percent subsequently experienced miscarriages or premature birth of their
second, “wanted” pregnancies.25

When the risks of increased pregnancy loss are projected on the population as a whole, it is estimated that aborted
women lose 100,000 “wanted” pregnancies each year because of latent abortion morbidity. 23 In addition,
premature births, complications of labor, and abnormal
development of the placenta, all of which can result from
latent abortion morbidity, are leading causes of handicaps
among newborns.16 Looking at premature deliveries alone,
it is estimated that latent abortion morbidity results in 3,000
cases of acquired cerebral palsy among newborns each
year.23,33 Finally, since these pregnancy problems pose a
threat to the health of the mothers too, women who have
had abortions face a 58 percent greater risk of dying during
a later pregnancy.23
Record based studies in the United States and Finland have shown that the maternal death rate associated with
abortion is significantly higher than for women who give birth, who have miscarriages, or who have not been
pregnant.36

Sources cited above:

9. Frank, et.al., “Induced Abortion Operations and Their Early Sequelae”, Journal of the Royal College of General
Practitioners (April 1985), vol.35,no.73,pp175-180.

10. Friedman,et.al.,”The Decision-Making Process and the Outcome of Therapeutic Abortion”, American Journal of
Psychiatry (December 12, 1974), vol.131,pp1332-1337.

11. Grimes and Cates, “Abortion: Methods and Complications”, Human Reproduction, 2nd ed., 796-813.

12. Harlap and Davies, “Late Sequelae of Induced Abortion: Complications and Outcome of Pregnancy and
Labor”, American Journal of Epidemiology (1975), vol.102,no.3.

13. Heath,”Psychiatry and Abortion”,Canadian Psychiatric Association Journal (1971), vol.16, pp55-63)

14. Hilgers, “The Medical Hazards of Legally Induced Abortion,” in Hilgers and Horan, eds., Abortion and Social
Justice(New York: Sheed and Ward, 1972).

15. Hogue,”Impact of Abortion on Subsequent Fecundity”, Clinics in Obstetrics and Gynaecology (March 1986),
vol.13,no.1.

16. Hogue, Cates and Tietze, “Impact of Vacuum Aspiration Abortion on Future Childbearing: A Review”, Family
Planning Perspectives (May-June 1983),vol.15, no.3.

17. Kent, et al., “Bereavement in Post-Abortive Women: A Clinical Report”, World Journal of Psychosynthesis
(Autumn-Winter 1981), vol.13,nos.3-4.

18. Kent, et.al., “Emotional Sequelae of Therapeutic Abortion: A Comparative Study”, presented at the annual
meeting of the Canadian Psychiatric Association at Saskatoon, Sept. 1977.

19. Lembrych, “Fertility Problems Following Aborted First Pregnancy”,eds.Hilgers, et.al., New Perspectives on
Human Abortion (Frederick, Md.: University Publications of America, 1981).

20. Levin, et.al., “Ectopic Pregnancy and Prior Induced Abortion”, American Journal of Public Health (1982),
vol.72,p253.

21. Mattinson, “The Effects of Abortion on a Marriage”,1985 Abortion: Medical Progress and Social
Implications,(Ciba Foundation Symposium, London: Pitman, 1985).

22. Pare and Raven,”Follow-up of Patients Referred for Termination of Pregnancy”,The Lancet(1970) vol.1,pp635-
638.

23. Reardon, Aborted Women-Silent No More, (Chicago: Loyola University Press, 1987).

24. Reardon,”Criteria for the Identification of High Risk Abortion Patients: Analysis of An In-Depth Survey of 100
Aborted Women”, Presented at the 1987 Paper Session of the Association for Interdisciplinary Research, Denver.

25. Russel, “Sexual Activity and Its Consequences in the Teenager”, Clinics in Ob&Gyn, (Dec. 1974).
vol.1,no.3,pp683-698.

26. Schulz, et.al., “Measures to Prevent Cervical Injury During Suction Curettage Abortion”, The Lancet (May 28,
1983),pp1182-1184.
27. Stallworthy, “Legal Abortion, A Critical Assessment of Its Risks”, The Lancet (December 4, 1971) pp1245-
1249.

28. Wadhera, “Legal Abortion Among Teens, 1974-1978”, Canadian Medical Association Journal (June 1980),
vol.122,pp1386-1389.

29. Wallerstein,et.al., “Psychosocial Sequelae of Therapeutic Abortion in Young Unmarried Women”, Archives of
General Psychiatry (1972) vol.27.

30. Wilke, Abortion: Questions and Answers,(Cincinnati, Hayes Publishing Co., 1985).

31. Wilke, Handbook on Abortion, (Cincinnati, Hayes Publishing Co., 1979).

32. Wren, “Cervical Incompetence–Aetiology and Management”, Medical Journal of Australia (December 29,
1973), vol.60.

33. Wynn and Wynn, “Some Consequences of Induced Abortion to Children Born Subsequently”, British Medical
Journal (March 3, 1973), and Foundation for Education and Research in Child Bearing (London, 1972).

34. United States Supreme Court, Roe v Wade, U.S. Reports, October Term, 1972, 149,163.

35. Zimmerman, Passage Through Abortion (New York: Praeger Publishers, 1977).

36. Reardon, et al., Deaths associated with abortion compared to childbirth: a review of new and old data and the
medical and legal implications (2004).