A woman’s body undergoes many changes and transitions through stages every single month. Upon reaching menarche (her first period), a woman starts menstruating every month, meaning her uterus sheds tissue lining every month until she reaches menopause. Sometimes, the body needs extra help in removing the tissue from the uterus, and D&C is a simple procedure doctors resort to for this specific purpose. Can it do more than just remove tissue? Can it affect one’s fertility? Read on to find out.
D&C – Dilation and curettage is a small surgical procedure to remove tissues from inside the uterus. It is mainly done as an outpatient procedure under anaesthesia. Doctors opt for D&C to both diagnose and treat certain issues related to the uterus.
The cervix is the narrow part of the uterus. In D&C, the doctor will dilate the cervix using an instrument or a medication. Next, they will insert a surgical instrument known as the curette to remove the tissue from the uterus. The curette can be a sharp instrument or a suction device.
A D&C can be performed to diagnose or treat issues in the uterus.
In cases of unusual bleeding, bleeding after menopause, or the discovery of unusual endometrial cells during a routine examination, the doctor will collect a sample of the endometrial tissue for further analysis. If the test is inconclusive or the health care provider needs more clarity, they may perform a D&C to remove the tissue from inside the uterus and analyse it.
In some cases, doctors can use D&C to diagnose infertility. It can help them identify polyps, fibroids, or collect samples of the uterine lining to determine if it is causing issues with implantation.
After a clear diagnosis, doctors can opt for a D&C to:
● Remove the remaining tissue after a miscarriage or abortion to prevent infections and excess bleeding.
● Remove a molar pregnancy (formation of a tumour instead of a fetus)
● Clear out the placenta, the body does not expel it on its own after a delivery
● Remove benign polyps or formations in the uterus or cervix
● Remove fibroids.
D&C is a simple procedure to clear the contents of the uterus. It does not directly impact one’s fertility unless there are some complications. Like any other surgical procedure, D&C has its own set of risks and complications, such as:
If the D&C was originally performed to remove the uterine contents following a miscarriage, the risk of another miscarriage in the future is high.
Scar tissue formation inside the uterus, after the D&C procedure, increases the risk of infertility and miscarriage. The scar tissue can interfere with the menstrual cycle, thus affecting periods and ovulation. It can also interfere with implantation and placental development, thus leading to miscarriages.
D&C after a miscarriage has higher chances of infections, resulting in scar tissue formation. The scar tissue can form inside the uterus, in the fallopian tubes, or even in the ovaries and makes it very difficult to conceive naturally.
Repeated D&Cs for various reasons can scar and weaken the cervix, thus making it incompetent. This increases the risk of mid-trimester abortions.
The curette is a sharp instrument that can perforate or damage the uterus during the procedure.
Uterine bleeding and reactions to anaesthesia are rare complications that may impact one’s fertility or ability to conceive again.
It is possible to conceive naturally after a D&C. Here are some factors to consider and keep in mind before and while attempting pregnancy after a D&C:
● You need to give your body enough time to recover and recoup after a D&C. If the procedure was performed after a miscarriage or an abortion, your uterus will require some time before it is ready to support another fetus.
● The number of miscarriages in the past and your current health conditions play a significant role in the pregnancy outcome.
● It is necessary to allow time for emotional healing, too, just like physical healing after a D&C before a pregnancy attempt.
● Maintaining a healthy lifestyle, following a nutritious diet, avoiding harmful substances, and engaging in regular exercise can improve overall health and increase the chances of pregnancy following a D&C.
● Some women may require more time than others to conceive naturally following a D&C. Each body is different, and recovery time is also different.
D&C is a routine gynaecological procedure performed for both diagnosis and treatment. It is a simple surgery that helps remove the contents of the uterus. It is mostly very safe and does not cause any complications. However, like any medical procedure, this surgery also carries some risks and can cause complications. Consult your doctor to clarify all your doubts, rather than worrying unnecessarily.
