Although abortion is much controversial, clinically speaking, abortion performed by a medical professional in proper sanitary conditions is a safe and simple procedure, especially when performed early in pregnancy. There is no scientific evidence to suggest that abortions performed in such circumstances pose a significant risk to a woman’s future fertility.

Millions of women who have had abortions have had one or more   full-term pregnancies and births. However, like any medical procedure, there are certain risks involved. Most cases of abortion affecting fertility are the result of post-operative infections following illegal abortions that are not performed in a proper medical setting. When women have access to safe, legal abortions performed by medical professionals, there is no significant risk to fertility. 

Surgical and medical abortion and sterilization

Abortion can be done surgically or medically. Surgical abortion is a relatively simple outpatient procedure, usually performed using vacuum aspiration (in the first 6-12 weeks of pregnancy) or dilation and curettage (12-15 weeks). Under the right conditions, abortion does not damage the cervix or uterus and does not affect future pregnancies. Women who have had a surgical abortion should go home and monitor their temperature and bleeding to make sure they do not have any postoperative infections, and should notify their health care provider immediately if anything seems wrong.

With a medical abortion, a combination of two oral medications are taken to terminate a pregnancy early in the pregnancy. A health care professional gives the woman mifepristone, a hormone blocker that blocks progesterone, which the body needs to maintain the pregnancy. Then, 24 to 72 hours later, she self-administers a prescribed amount of misoprostol, which causes uterine contractions and leads to a miscarriage a few hours later. Follow-up tests ensure the procedure was completed successfully and that there is no infection.

 A 2007  study published in the New England Journal of Medicine found that medical abortion is ” as safe as or safer than surgical abortion in terms of the risk of  ectopic pregnancy, spontaneous abortion, low birth weight , and preterm birth in the first subsequent pregnancy .” Previous studies cited in the report have found no significant effects on future pregnancies in women who have had medical or surgical abortions. Similarly, a 2004 study published in  the American Journal of Epidemiology  concluded that medical abortion is safe and does not affect future pregnancies.     

Abortion and Infertility

Every medical procedure carries certain risks, and abortion is no exception. The most serious problems occur in rare cases when an infection develops after the procedure. If a woman has had multiple abortions, scar tissue may form on the top of the cervix or in the uterus. If this interferes with future pregnancies, it can often be medically corrected. Women who have had multiple abortions may also develop cervical incompetence due to repeated cervical dilation during previous procedures. This can cause the cervix to dilate (open) prematurely, making it difficult to maintain subsequent pregnancies. Often, a weakened or incompetent cervix can be sutured closed during pregnancy.

Furthermore, abortion can be an emotionally difficult experience for women, which may indirectly affect their fertility if they avoid sex due to feelings of guilt or conflict.