Expert: Pat G - 8/22/2011

Question
Hi, I had a surgical abortion when I was 15 yrs old and I was 10 weeks when I had it done, after my abortion I went straight on to the implant I had the implant taken out after a year and a half as I seemed to bleed all through out it, from that I went straight onto the injection and I had the same problem again I bleed all the way through so when I went back to my doctors I had a blood test done and they ran some tests but everything came back negative, I have been with my partner 5 years now and I am 20 years old, and we have been using the withdrawl method for nearly 3 years now, so my question is do you think I could now be infertile, I am unsure what to do, I was diognosed with a pelvic infection 6 months ago but it was caught at an early stage I had antibiotics and have been fine since, and it wasn't even caused from a std and I still now don't no what it was caused from. The thought of us now not being able to have a baby is devastating, do you think as we have been using the withdrawel method for nearly 3 years now that I am not going to be given another chance of concieving, please help me on advice I realy don't no if I'm worrying over nothing or if I should be concerned. Thanks.

Answer
Hello, selina,

Your question won't be so easy to answer. You have a number of things in your history, each of which could interfere with your fertility. First, you had a surgical abortion. It is known that about 10% of women who have a surgical abortion will never conceive again. The reason isn't always known. One common reason is that there is scar tissue over the openings to both Fallopian tubes. This can prevent sperm from getting to the egg. If there is a small opening, it can also result in a tubal pregnancy, so if you become pregnant and then begin to feel pain a couple of weeks in, get it checked right away. Tubal pregnancies require emergency surgery. Also, a low grade infection, which results in pelvic inflammatory disease, can prevent conception. A woman who has had an abortion can easily get PID and never know it. Even though you discovered you had a pelvic infection and even though it has been treated, that doesn't mean there isn't a problem. I recommend you take some pro-biotics to get your intestinal flora back up to where they need to be. It is also true that some women will only ever conceive one child for reasons unknown, and if they have an abortion, they will never give birth.

The second problem is that you had long-term contraceptive hormones in your body. This disrupts the hormones, and there is no way to know exactly what effect this might have on fertility in a given woman. For this reason, you should have your hormones tested. I don't think this will necessarily give you the answer, but it is something you may need to have done.

The third possibility may be somewhat remote, but I need to mention it. Babies need parents who are committed to each other. You have been together for five years, but that is not the same as a public commitment. We women also require the security of a real commitment. Just being together is no guarantee things won't go bad later on, if life starts to become challenging. Quite often, conceiving a child is all it takes to cause these problems. We instinctively know this. There are some women who simply don't conceive until they are in that kind of secure relationship. This means marriage. If the two of you aren't married, you simply may not be able to give yourself to pregnancy and a child because of our natural instincts. You really should consider providing that kind of stability before trying to get pregnant. I'm not saying things can't go wrong in marriage; obviously they do, especially since these days, too many people don't take marriage as seriously as they should.

Withdrawal isn't normally a reliable method of preventing conception, but if the man's sperm count is low, I can imagine the possibility that a drop of semen isn't enough. If you really want to conceive, withdrawal is not the way to go.

There are plenty of women who ARE devastated if they cannot conceive again. Be prepared with the thought that you may need some counseling, or be able to benefit from counseling, to deal with the emotions you are experiencing. These emotions can also prevent conception.

There is just no way to know right now why you haven't gotten pregnant. If you start having sex without withdrawing, and especially if you learn how to tell when you are fertile, and you still don't get pregnant, it would be wise to ask a doctor to look into possible causes.

Please take care, and let me know how things go.