I would like to ask how much impact does medication abortion have on future fertility?

Patient's question:

I would like to ask how much impact does medication abortion have on future fertility

Doctor's answer:

Hello:
The medication used for medical abortion, mifepristone, is now administered at a dose of only 1/4 to 1/3 of the initial dose. Therefore, the side effects are not significant, primarily including exacerbation of early pregnancy symptoms and fatigue. The side effects of prostaglandins are mainly gastrointestinal reactions, such as nausea, vomiting, diarrhea, and lower abdominal pain due to uterine contractions. Some individuals may experience fever, dizziness, flushing, or numbness. To prevent or treat gastrointestinal side effects, compound ethinyl estradiol or metoclopramide can be taken before and after medication. For severe abdominal pain, pethidine or atropine-like analgesic and spasmolytic drugs may be administered. However, it is important to avoid the use of anti-prostaglandin medications such as indomethacin, flurbiprofen, or salicylic acid preparations.
A few pregnant women may experience a miscarriage after taking mifepristone. 80% of pregnant women expel the chorionic villi and fetal sac within 6 hours of using prostaglandin drugs; approximately 10% expel them within 1 week of medication. Therefore, it is important to monitor the expelled contents if there is any bleeding. If tissues are expelled at home, they should be brought to the doctor for examination to determine whether they are chorionic villi.
Based on whether the chorionic villi and fetal sac are expelled or not, follow up at the medical institution where the medication was administered within 8 to 15 days after taking the drug, as prescribed by the doctor, to determine the effectiveness of medical abortion. If medical staff determine that the medical abortion has failed or is incomplete, an artificial abortion procedure must be performed to terminate the pregnancy.
Although the chorionic villi and fetal sac may be expelled during medical abortion, the decidua tissue in the uterus is gradually expelled, resulting in a longer bleeding period, with an average duration of 18 to 20 days. Some women may develop anemia or complications such as endometritis or pelvic inflammation due to excessive or prolonged bleeding. Therefore, medication for