The science on fertility and abortion is clear: Having an abortion does not make it harder to get pregnant in the future.
There are many reasons why someone decides to have an abortion, including because they do not want to have a child at that specific moment. But having an abortion may not reflect someone’s desire to have a child at some point in the future.
For someone who is wondering whether having an abortion could cause future infertility, decades-worth of research is clear: Having an abortion does not make it harder to get pregnant later—there is no impact on future fertility.
Keep reading for more on what the science says about abortion and fertility.
No. The leading body of OB-GYNs, the American College of Obstetricians and Gynecologists (ACOG), is very clear: Abortions don’t increase the risk of future infertility. And in 2018, after combing through all of the relevant research published after the year 2000, a National Academies of Sciences, Engineering, and Medicine (NASEM) panel affirmed ACOG’s stance.
Let’s look at one very large, high-quality study from that review: The panel found a 2016 study that compared data from the Finnish National Birth Registry (2008-2010) to data from the Induced Abortion Registry (1983-2007). Among the follow-up visits of 5,167 eligible people who had past abortions, the researchers found no demonstrated connection between abortion and “secondary infertility” (which means the inability to conceive or carry a pregnancy to term after previously conceiving and/or giving birth).
The only situations in which fertility issues could arise after an abortion are if there are complications, which are extremely rare. One 2021 study reported “major” complication rates (e.g., required hospitalization, surgery, blood transfusion) as low as 0.02% for abortion pills administered via telemedicine and 0.04% for abortion pills administered via in-person care. In a 2015 study, major adverse events occurred only .16% of the time after a vacuum aspiration, and 0.41% after a later abortion procedures.
Abortion procedures that were used more frequently in the past, like dilation and curettage (D&C), were more likely to cause complications like adhesions in the uterus. Since the 1970s, the much gentler vacuum aspiration has mostly replaced D&C as an abortion procedure (though it may still be used after miscarriage).
Although medication abortion is extremely safe, ACOG recommends people who’ve had abortions talk to their care provider if they experience severe pain that does not respond to pain medication, soak two pads an hour for at least two hours, or have foul-smelling discharge or a fever 24 hours after taking misoprostol to ensure that they do not require additional medical care.
You can get pregnant almost immediately after having an abortion—even if you’re still bleeding from the procedure or haven’t yet had your period. The amount of time that elapses between when you have an abortion and when you can get pregnant again depends on the length of your menstrual cycle (which impacts ovulation—or when the ovary releases an egg) and how many weeks pregnant you were before the abortion.
Prior to having an abortion, ovulation will have stopped due to pregnancy, however, after an abortion, your body will restart its menstrual cycle. Assuming that the cycle begins the day after the abortion, ovulation usually occurs within the next 2-3 weeks. (According to research, ovulation returned approximately 3 weeks following a medical abortion with the drugs mifepristone and misoprostol, on average.)
The answer to this question is really up to the individual. For most people, going back to any regular activity, penetrative sex included, is fine as long as the person feels up to it physically, mentally, and emotionally.
Any challenges with getting pregnant after an abortion are extremely unlikely to be related to the abortion itself (unless a rare complication has occurred).
In general, experts recommend reaching out to a fertility specialist to investigate what’s happening if someone’s under 35 and has been trying to get pregnant for more than 12 months through penis-in-vagina, or six months if they’re over 35. Anyone who has irregular periods, a condition that impacts fertility (e.g., polycystic ovary syndrome, thyroid disorders), or who knows they’ll be using fertility treatment (including people in same-sex relationships who want to have biological children or people who want to have biological children on their own) should reach out to a specialist before trying to get pregnant.
Have more questions about medication abortion? Hey Jane’s here to help—check out our FAQs or text our clinical care team at (405) 643-7957. We’re here to support you.