We Answer: Why Can’t I Get Pregnant After an Abortion?
Abortion is defined as ending a pregnancy through medical means. There are many women across the world who choose to have an abortion for health, safety, and lifestyle reasons on an annual basis. Just because a woman does not wish to have a baby at the time of the abortion does not mean she never will want to have a baby. For this reason, many women have concerns about how having an abortion may impact their future fertility.
Fertility can be a complicated issue for both a woman and a man. Timing, health, and many other factors must all come together for a woman to successfully conceive. Carrying a baby to term is also challenging. However, if a woman did have a history of previous abortion, it is highly unlikely to prevent her from getting pregnant in the future. There are, of course, some exceptions to this statement. The discussion of abortion and future fertility also should emphasize the importance of having an abortion performed by a licensed medical provider in a safe and sterile setting. Having an illegal abortion can be one of the greatest risk factors to a woman’s future fertility and overall health.
Considerations on Abortion Types
While having a single abortion performed by a qualified medical professional should not impact a woman’s fertility, there may be exceptions for women who have multiple procedures. To consider this, it is important to understand the two types of abortions.
Medical abortions are those that involve taking oral medications to result in a miscarriage. An example is the medication misoprostol or taking a combination of methotrexate and misoprostol or mifepristone followed by misoprostol. These drugs work by causing the lining of the uterus to shed and/or causing contractions that will effectively push out the fertilized egg. According to the Comprehensive Women’s Health Center, a medical abortion will effectively end about 95 to 98 percent of all pregnancies without the need for surgical abortion. Some women who are having a miscarriage may also take these medications to speed up the miscarriage process. According to “Self” magazine, medical abortions should not have an effect on future pregnancies. The medications are FDA-approved and do not carry any long-term risks. They do, however, have short-term risks that include:
Surgical abortions are invasive procedures that involve inserting an instrument into the cervix and progressed into the uterus to remove the fetus. Because the procedure is more invasive, it’s possible that scarring or other damage that occurred could result in more difficulty conceiving or carrying a child to term. The more surgical abortions a woman has, the more her risk increases for difficulty.
“For women who have had multiple abortions, it’s the same risk as a woman who has had multiple pregnancies in general,” said Kimberley A. Thornton, MD, a reproductive endocrinologist and infertility specialist at RMA of New York in an interview with “Self” magazine.
While there are many women who have had surgical abortions that have no problems conceiving at a later time, it is possible that scar tissue could be affecting the maintenance of a successful pregnancy. There are surgical procedures that can remove the scar tissue that may help to restore her fertility.
ABC News reported on a study published in the “New England Journal of Medicine” regarding medical abortions. The study examined more than 12,000 Danish women who had undergone medical or surgical abortion for non-medical reasons and then gone on to have a pregnancy. According to the study’s researchers, there were no statistically significant differences between the women who had undergone any type of abortion and women who hadn’t in terms of pregnancy complications. The researchers considered factors such as ectopic pregnancy, miscarriage, pre-term labor, and low birthweight babies. This research provides hope for women wishing to conceive after either type of abortion.
What Else Could Affect My Fertility?
When a woman is trying to get pregnant and cannot conceive after six months to a year, her first thought may be to blame the abortion she had some time ago. However, it is important she understand there are many factors that affect fertility and could be leading to difficulty conceiving. Examples of these factors include:
- Age: Age is one of the biggest factors to consider in regards to fertility. After age 30 and especially after age 35, the quality and number of a woman’s eggs can decline. As a result, a woman may have significantly more difficulty conceiving. A doctor can perform blood testing to estimate a woman’s “ovarian reserve” or amount of healthy eggs that she may have remaining. Examples of these testing include a follicle stimulating hormone (FSH) level and estradiol levels. Doctors commonly recommend these types of testing as well as ultrasound imaging to determine if a woman has signs of a healthy ovarian reserve when they are attempting to conceive at an older age.
Men are also affected by this as the amount and quality of their sperm can decrease with time. However, the rate of this decrease does tend to be slower than a woman’s. If a woman had an abortion at age 17 and is trying to conceive at 36, it’s likely her fertility may be more related to age than a previous abortion.
- Medical History: There are a number of medical conditions that can affect a woman’s uterine health and hormone balance, which can affect pregnancy. For example, a history of polycystic ovary disease or endometriosis may affect a woman’s ability to get pregnant. If a woman has a history of having a sexually transmitted disease, this could lead to a condition known as pelvic inflammatory disorder that affects her chances of getting pregnant.
She could also have a disorder related to ovulation due to her weight or family history that may be unknown. If a woman is not currently having regular periods, she may not be ovulating (the release of an egg for fertilization). Lack of ovulation (known as anovulation) means that a women cannot get pregnant. Some women may ovulate, but have what is known as tubal factor where their fallopian tubes are not open. In this instance, a woman cannot become pregnant. Tubal factor is a contributing cause of nearly one-third of fertility problems that affect a woman’s ability to conceive.
- Partner’s Sperm Health: Both men and women can have problems with fertility. Perhaps a woman has a different partner later in life she is trying to conceive with. It is possible that male partner may have sperm that is of a lower quality or quantity. A man may also have hormone imbalances of testosterone that could impact his fertility. Fortunately, testing is available to determine if a man’s fertility may be impacting a couple’s abilities to get pregnant.
It is also possible that a doctor may not be able to determine the cause of a woman’s infertility. This is known as unexplained fertility and occurs in an estimated 10 percent of all couples. However, options still remain for conception. Adoption is also possible for couples who may not be able to conceive due to fertility concerns.
The good news is that having a history of successfully getting pregnant increases a woman’s chances for getting pregnant in the future. If a couple has been having unprotected sex for more than a year without getting pregnant, they should contact their physician to discuss aspects that could be impacting their fertility. The doctor can recommend testing that will start the process of learning why a couple may be unable to conceive.
How Long Should I Wait to Conceive After an Abortion?
Many American women who have abortions may wish to get pregnant at a later and/or more advantageous time in their lives. They should speak with their physician about timing in the event that the doctor has individual recommendations regarding trying to get pregnant. According to New Kids Center, many doctors recommend waiting at least three months before trying to get pregnant again after having an abortion. The reason for this timeline is that the time allows the body to heal in order to provide the best environment to grow a healthy baby. Additionally, women planning on becoming pregnant should make considerations, such as taking a prenatal vitamin to prevent neural tube defects and making healthy lifestyle choices, such as refraining from smoking and maintaining a healthy weight.
Doctors also often recommend waiting to have sex for anywhere from two to three weeks after having an abortion, according to Columbia University. This is true for both medical and surgical abortions. Having sex during this period could lead to increased risk for infections as more of the woman’s tissue is healing and more vulnerable to bacteria and other organisms that could lead to infection. Many doctors will recommend going to a follow-up appointment to ensure all portions of the pregnancy do not remain in the uterus. Otherwise, remaining tissue could lead to health complications for a woman and further surgical intervention may be required.
When deciding when to conceive again after an abortion, it is important that a woman consider not only her body, but also her mental health and physical safety. For example, some women may get an abortion because they are in an unsafe or abusive relationship where they fear for their baby. If these circumstances have not changed, a woman should likely wait to get pregnant again until her circumstances are more stable. It is important also to remember that a baby does not “fix” a bad situation or fill a psychological void.
From a physical perspective, providing a woman underwent a legally sound abortion from a medical provider, they can get pregnant at their next ovulation cycle. This makes using some form of birth control especially important for women just after abortion if they do not wish to get pregnant. According to New Kids Center, women can get pregnant as soon as one week to 10 days after an abortion.
Conclusions on Why Can’t I Get Pregnant After an Abortion
If a woman is concerned about her fertility, her history of having an abortion or abortions is only one piece of the fertility puzzle. She should make an appointment to see a reproductive endocrinologist or ask her obstetrician for a referral to a fertility specialist. If a woman is age 35 or older, she should seek the expertise of a reproductive endocrinologist about six months after trying to conceive and being unsuccessful in doing so.
The desire to conceive again after an abortion allows relays the importance of seeking a legal abortion at a safe medical facility with a medical professional. Illegal abortions and those who provide them do not have to follow the same health code standards and safety measures that can protect a woman’s fertility. For this reason, it is very important that a woman seek a legal abortion, both for her current health and for considerations regarding her future fertility. These are provided in private offices, hospitals, and/or family planning clinics.
There are many techniques and technologies available today to help a woman successfully conceive. Examples include in vitro fertilization and intrauterine insemination. There are medications that can encourage ovulation and the release of multiple eggs for fertilization. Lifestyle changes can also enhance a woman’s fertility. A woman should never let the fear or memory of a past abortion stop her from seeking out these and other treatments to conceive again.
Columbia University: Can You Get Pregnant Within Two Weeks of Having an Abortion?
Comprehensive Women’s Health Center: Medication Abortion: FAQs
New Kids Center: Pregnancy After Abortion