Infertility After Abortion? It Might Be Fetal Bones Acting as an IUD

John Peeples Jr

Lime 5 recounts the case of "Margie," who underwent an abortion in January of 1978 at Dr. John D. Peeples Jr's office, aka "Planned Motherhood." Peeples told Margie that he had been unable to complete the abortion and to return on March 2. After this second procedure, Margie continued to suffer bleeding and pain. It continued until July 5, 1983, when she could no longer tolerate it. She went to an emergency room and was diagnosed with an infection, inflammatory cysts, and endometriosis reaching to her cervix and appendix. A surgeon also performed a hysterectomy. A pathology report found bones from the fetus aborted four years ago still in Margie's uterus. ("Two abortions suits heat regulation issue," Memphis Commercial Appeal, February 13, 1985) 

When looking for information about the Fetal Homograph portion of Lime 5, I found similar cases of retained fetal bones.

Of particular interest is a statement in an article from a 1994 Croatian medical journal, with the abstract provided in English. A 49-year-old patient suffered irregular and painful periods since an abortion performed in 1973. In 1977 she sought treatment for infertility but doctors were unable to determine the cause. Finally, 19 years after the abortion. doctors performed a scope of her uterus. They found and removed a 22 mm (0.9 inch) fetal bone. "This bone was most probably functioning as an intrauterine device, the cause of infertility. Thus, the authors' findings strengthen once again the association between abortion and infertility."

An article that bears consideration is in the November, 2022 issue of Sultan Qaboos University Medical Journal describes a literature review of 17 case reports, 7 case series, and a retrospective study. In all, the review looked at reports of 75 total patients who experienced infertility eventually attributed to retained fetal bones after induced abortions. I'd like to draw your attention to this sentence, which you will probably never seen in any politically-savvy Western medical journal: "In conclusion, secondary infertility is a common occurrence after a dilation and curettage procedure partially due to fetal bone retention."

And there's this article from the July - September 2018 Journal of Human Reproductive Sciences, which notes that "Midtrimester surgical abortions often result in retained intrauterine fetal bones and consequent secondary infertility."

Hmm..... Prochoice common knowledge is that abortions in no way limit future fertility. Not a bit. Nothing to worry your pretty little head about. 

Moving right along.

The July, 1982 American Journal of Obstetrics and Gynecology covers the case of a 22-year-old Black woman who went to a doctor to try to find out why she was unable to conceive. After a year of testing, a doctor did a scope of her uterus and found "a white-appearing tubular structure which was similar to the noncopper-bearing portion of an IUD" embedded in the top of the uterus. "Removal was difficult and the removed segments proved to be bone. Results indicated that there were bits of fetal bone partially embedded at the fundal portion of the uterus for six years after an induced abortion." The doctor performed a curettage to remove the remaining bits of fetal bones. 

In the February, 1997 AJOG, Korean authors noted 11 cases from a facility where women suffered infertility caused by retained fetal bones after induced abortions between 16 and 24 weeks of gestation. In ten of those cases the bones appeared to be from fetal skulls that had been crushed for removal from the uterus. The authors suggested that any woman struggling with infertility after an abortion be checked for retained fetal bones.

The 1990 issue of Clinical and Experimental Obstetrics and Gynecology notes the case of a 47-year-old Italian woman who was admitted to a hospital for acute pelvic pain and purulent vaginal discharge. She had been experiencing recurrent abdominal and pelvic pain, pain on urination, nausea and vomiting, headaches, painful and irregular periods and bleeding between periods after an abortion she'd undergone 8 years earlier, in 1979. After other treatments failed, doctors performed a hysterectomy. Her uterus was found to be closely packed with fragments of fetal bones.

The June, 2014 issue of Journal of Medical Case Reports describes the case of a 30-year-old Chinese woman experiencing infertility after a 15-week abortion performed 9 years earlier. After an ultrasound revealed foreign bodies in the uterus, doctors used a scope and found "a large number of intrauterine bony fragments, with clear fetal skeletal outline and intact morphology." The article includes images taken through the scope. The largest piece was about 20 x 10 x 3mm, or 0.8 x 0.4 x 0.12 inches.

The June, 2004 Journal of Clinical Ultrasound notes a case where a woman suffered infertility, excessively heavy periods, and persistent vaginal discharge for 8 years following an abortion. Foreign bodies were visualized on ultrasound. A curettage was performed which removed fetal bone fragments.

A 2014 issue of Journal of Experimental Therapeutics and Oncology describes a case where a 34-year-old woman sought care for abnormal uterine bleeding and infertility. Her only pregnancy had ended in a 15-week abortion eight years earlier. Her doctor found and removed fragments of fetal bones.

The September 3 issue of the International Journal of Reproductive Biomedicine described the case of a 25-year-old Iranian woman who sought care for infertility. After routine workups, doctors discovered that she had fetal bones in her uterus from a previous induced abortion.

The October, 2004 issue of Journal of Reproductive Medicine described the case of a 20-year-old woman with "a history of multiple terminations of pregnancies." She went to a clinic for treatment of chronic pelvic pain. Her doctor found and removed retained fetal bones.

The November 1991 issue of Obstetrics and Genecology describes two cases in which patients suffered infertility, painful periods, and dysfunctional uterine bleeding. One had undergone a D&C abortion 14 months earlier, the other 13 years earlier. Both had to have doctors remove fetal bones left in their bodies after their abortions.

The May 3, 2018 issue of Cureus reports a woman who underwent a 15-week abortion after her baby had been diagnosed with anencephaly. She tried for the next five years to get pregnant again and finally sought medical help. Her doctor removed fetal bones from her uterus. This article also provides images, including one showing the bone fragments that were removed.

The September, 2020 issue of Autopsy and Case Reports describes a case where a woman suffered bleeding and vaginal discharge for two years after an induced abortion. She underwent a hysterotomy. Pathologists found fetal bones in her uterus. The article includes an image of the uterus, cut open by a pathologist, with the bones in place.

This is not a comprehensive list of all of the articles I found. You can follow links in these abstracts to find more.

Watch Sometimes You Find Stuff in Medical Journals on YouTube.