Is anesthesia necessary for painless abortion?

Patient's question:

Third pregnancy within one year, third time, previous treatment and effectiveness: Considering undergoing a painless procedure, but afraid it might affect future fertility. What kind of assistance do you need: I want to know which option will not interfere with the body in the future. The first time I had a painless procedure, and a year later I got pregnant again. The second time I had a procedure without anesthesia, and a year later I got pregnant again. Now I want to do a painless procedure, but I'm afraid it might affect future fertility.

Doctor's answer:

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