Can Abortion Cause Infertility?

Whether you’ve had an abortion in the past or are preparing for one in the near future, you might be wondering: Can abortion cause infertility? It’s a valid question, given how much misinformation surrounds topics like the reproductive system, infertility, and especially abortion. And, of course, many people who have abortions hope to add to their families at a later time but have chosen to terminate their current pregnancy for any number of reasons. With all of that in mind, it’s only natural to wonder if getting an abortion could have an impact on future fertility.

The short answer: There is no evidence that either surgical or medical abortions cause infertility, Kimberley A. Thornton, M.D., reproductive endocrinologist and infertility specialist at RMA of New York, tells SELF. Of course, we’re referring here to abortion practiced in a safe way with the help of legitimate health care providers. The longer answer is that, while abortion procedures do not cause infertility, there are several other factors and possible complications of any reproductive procedures that can impact your fertility, which we’ll go over here.

Before we explore what experts want you to know about the relationship between abortion and fertility, let’s go through the two types of abortion. Learning the differences can help you better understand how abortion can and cannot influence fertility.

Here’s what happens in a medication abortion.

A medication abortion is the U.S. FDA-approved regimen consisting of two pills you can take to terminate a pregnancy that’s up to 10 weeks along.

The first pill, mifepristone, blocks progesterone, a crucial hormone the body needs to continue the pregnancy. Progesterone helps thicken the uterine lining, which is what provides the nourishment a fertilized egg needs to grow. Interrupting progesterone’s action is the first step in ending a pregnancy with medication. The second pill, misoprostol, taken 24 to 48 hours later, induces cramping to expel the contents of the uterus.

During a medication abortion, you’re likely to experience these side effects, according to the American College of Obstetrics and Gynecologists (ACOG):

  • Bleeding much heavier than your usual period
  • Cramping that may be severe
  • Nausea
  • Vomiting
  • Fever
  • Chills
  • Diarrhea

As SELF previously reported, medication abortion has certain advantages over its surgical counterpart. Medication abortion can feel less invasive than going in for surgery, and some people prefer being able to pass the pregnancy at home (though you may have to take the medication in the presence of a medical professional, depending on your local laws). Even with a medication abortion, your doctor will advise that you visit a week or two weeks after the termination to make sure the abortion was successful (as in, the pregnancy is completely terminated and none of the tissue is still in your uterus), ACOG explains.

Here’s what happens in a surgical abortion.

There are a few different ways doctors can perform a surgical abortion. One method is known as suction curettage, and it’s often used in the first trimester, which is at or before 13 weeks. Abortion is by far most common in this time frame—according to data from the Centers for Disease Control and Prevention (CDC), 91 percent of abortions in 2016 took place in the first trimester.

During a suction curettage, a health care practitioner will insert a speculum into your vagina and pass a suction tube into your uterus through your cervix, which can either be dilated before or during the procedure, according to ACOG. A suction or vacuum pump on the other end of the tube then works to remove the tissue from the pregnancy. If your next question is what kind of pain management is available for this, you might receive sedatives or general anesthesia beforehand, and you should also receive local anesthesia to reduce sensation in your cervix, ACOG explains. After a suction curettage, you might have cramping for a day or two and see some vaginal bleeding for up to two weeks.

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