Hello, Thank you for your query. There are 2 ways to confirm. The first is serial blood values of beta hcg (that is 2 values taken a few days apart to check for decreasing levels). The second is by an ultrasound to check for any retained products. If there is no evidence of active blood supply to the just terminated pregnancy in the ultrasound and there are still products left behind, a repeat scan in a week can show us if it has been completely expelled. As your symptoms are improving, I believe that there is a good chance that the vacuum aspiration was complete. However pregnancy, even a short one and evacuation can lead to anemia and tiredness. Please get your hemoglobin levels checked. Hope this helps. Please let me know if there is anything else I can help you with. Wish you good health