Can Abortion Affect Fertility?

Once you start thinking about getting pregnant, every little thing in your past becomes potential fodder to worry about.

You might hope that none of your past choices, such as who you've had sex with or how long you've waited to conceive, will affect your ability to get pregnant. You may also worry that you might not be able to get pregnant if you had an abortion in the past.

A significant number of people undergoing abortion are in their 20s—in fact, the Centers for Disease Control and Prevention (CDC) reported that nearly 57% of women who received abortions in 2019 were in their 20s.

It stands to reason that some people who receive abortions in their 20s may want to get pregnant again someday. You may be one of them. Or you may be in your 30s or 40s and concerned that having had an abortion will affect your ability to conceive in the future.

You could even already be a parent who's had an abortion, as the Guttmacher Institute notes that 59% of abortions are obtained by people who are already parents. Fortunately, there's good news to be found in the research, but there are a few things to keep in mind, too.

What the Research Shows

Some people worry that an abortion in their past could affect their chances of getting pregnant again. They may worry about an increased risk of miscarriage. Some of their fears may arise out of misinformation and misconceptions that falsely link abortion and future conception woes.

But the research is more reassuring, especially when you consider that many people who get an abortion go on to become parents.

First, a look at the numbers.

According to a 2019 report from the Guttmacher Institute, approximately 862,320 abortions were performed in a clinical setting in the United States in 2017. That includes surgical abortions conducted in clinics or hospitals, or induced by medication provided by a certified facility, like a doctor’s office. That number increased to 930,160 abortions in 2020, representing about one in five pregnancies.

Recent data indicates that more than half of all abortions in the U.S. are medication abortions. Both medical and surgical abortions are considered effective and reliable methods for terminating a pregnancy. “In general, they are very safe,” agrees Michael Tahery, MD, an OB/GYN with a private practice in Los Angeles.

Additionally, experts say that you really don’t need to worry too much about your ability to conceive in the future if you’ve had an abortion in the past.

According to OB/GYN Rudy Quintero, MD, if you’ve had an abortion, it should not have an impact on
your future fertility. “That’s been proven,” says Dr. Quintero, founder and medical director of CARE Fertility.

A landmark report titled “The Safety and Quality of Abortion Care in the United States” from the National Academies of Sciences, Engineering, and Medicine found no association between
abortion and secondary infertility—that is, the inability to get pregnant after a previous pregnancy. In fact, the report noted that research shows that first-time parents with a prior abortion were less likely to be treated for secondary infertility than those with their first pregnancy.

Complications to Keep in Mind

Abortions are considered a safe medical procedure when carried out appropriately, according to
the World Health Organization (WHO). In fact, the National Academies of Sciences, Engineering, and Medicine report concluded that abortions, 90% of which are performed during the first 12 weeks of pregnancy, are both safe and effective in the United States.

That’s not to say that nothing ever goes wrong. Complications can occur from any surgical procedure, including an abortion.

One example of a complication that could potentially hamper your ability to get pregnant in the future is a rare condition known as Asherman's syndrome.

This condition can occur if you’ve had tissue scraped off the inside of your uterine walls from a dilation and curettage (D&C), or experienced an infection of the endometrium, or the mucus membrane that lines the uterus. With this disorder, scar tissue or adhesions can develop and fuse portions of the uterine walls together, effectively shrinking the size of your uterine cavity. Fortunately, according to the National Organization for Rare Diseases (NORD), it's not a common occurrence.

In fact, complications from abortion are generally rare in the United States. While the risks of complications do increase with gestational age, the rates of complications remain low.

If you’ve undergone an uncomplicated abortion and no tissue was accidentally left behind in the uterus that could cause bleeding or infection, conceiving again shouldn’t be an issue, says Dr. Tahery. Barring any other reasons, like age, limited ovarian reserve, or other relevant medical conditions, you shouldn’t have trouble getting pregnant again.

However, regardless of whether you’ve had an abortion or not, if you’re struggling with infertility, consult your healthcare provider for a potential fertility assessment. It’s possible that you may have a condition that’s causing ovulation problems, which is the most common reason behind most infertility trouble. Polycystic ovarian syndrome (PCOS) and primary ovarian insufficiency (POI) are some frequent causes for ovulation problems.

Additionally, if you have a male partner and you're struggling with conceiving, it's also important to talk to your healthcare provider about the possibility of a semen analysis. Nearly half of all infertile couples are dealing with male infertility.

How to Decide When to Conceive Again

For some people who get an abortion, getting pregnant again might not be high on their to-do list. In fact, it may be something they plan to put off for a while—or maybe even indefinitely.

But for others, particularly if they underwent an abortion for a planned pregnancy, trying to conceive again might be something that they’re eager to do.

“It all depends on how long it takes for the body to get back to normal,” says Dr. Tahery.  

That includes both emotional readiness and physical readiness. You’re the only one who can determine if you’re emotionally ready to try to get pregnant again. As for your body, Dr. Tahery says that it’s a good idea to wait at least one full menstrual cycle after you’ve recovered from an
abortion before you actively try to conceive.

You may need to take more time to let your body heal longer after undergoing a second-trimester abortion. “Those will require more recovery time than, say, a seven-week abortion,” says Dr. Quintero.

You may also need some time to mentally reset. Or your body might need a little more time to recover from surgery, since people who undergo a second trimester abortion are most likely to undergo a procedural abortion like a dilation and evacuation (D&E), according to the American College of Obstetricians and Gynecologists (ACOG). A D&E is considered a safe procedure, but it does carry the risk of some possible complications.

A Word From Verywell

Abortion is an intensely personal decision. But if you are worried about how undergoing an abortion will affect your future fertility, the odds are in your favor, barring other factors that might be at play. However, as with any aspect of your medical history, it’s always best to discuss your pregnancy prospects and medical history with your healthcare provider.