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Can Abortion Cause Infertility? Procedure Types, Risks, and Complications

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On July 31, 2025
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Can Abortion Cause Infertility? Procedure Types, Risks, and Complications

Most abortions, whether medical or procedural, are safe when performed by trained healthcare providers. But as with any medical intervention, there are some risks to be aware of.

Infection

Infection is one of the more serious complications of abortions, though it’s uncommon, explains Dr. Robles.

You may develop an infection of the uterus (called endometritis) if bacteria enter the uterus during or after the procedure.

 If left untreated, endometritis can spread to the fallopian tubes and ovaries, causing pelvic inflammatory disease (PID), says Robles. PID can cause scarring or blockages in the fallopian tubes, which may make it harder to get pregnant in the future, he adds.

Healthcare providers typically give antibiotics at the time of procedural abortions to prevent infection, says Eve Feinberg, MD, a reproductive endocrinologist, infertility specialist, and the medical director at Northwestern Fertility and Reproductive Medicine in Chicago. But an infection can still occur, particularly if an abortion is performed under unsafe conditions, such as without clean, sterilized equipment or by someone without proper medical training.

Excessive Bleeding

Heavy bleeding can occur after either type of abortion.

 Excessive bleeding is a bigger risk with medical abortions, says Prati Sharma, MD, a board-certified gynecologist, reproductive endocrinologist, and infertility specialist, and a medical adviser at Bird&Be.

In rare cases, excessive bleeding may require medications to control it or a blood transfusion, says Dr. Feinberg. While it can be alarming, excessive bleeding typically doesn’t affect fertility, explains Robles.

Retained Pregnancy Tissue

Sometimes, not all of the pregnancy tissue is expelled or removed from the uterus after an abortion (known as an incomplete abortion). When this occurs, you may require a follow-up procedure, like a dilation and evacuation, to remove the remaining tissue, says Robles.

An incomplete abortion itself usually doesn’t affect fertility. But repeated procedures can increase the risk of uterine scarring, which can affect the ability to get pregnant in the future, he adds.

Asherman’s Syndrome

Asherman’s syndrome is a rare condition in which scar tissue forms inside the uterus.

 It’s more likely after surgical procedures like dilation and curettage (D&C) or if multiple procedures are needed, says Robles.

This condition can interfere with the menstrual cycle and make it harder for a fertilized egg to attach to the uterine wall, which needs to happen for pregnancy to continue, says Robles. It can also increase the risk of miscarriage.

 But Asherman’s syndrome can often be treated with surgery.

Uterine Perforation

A small hole can accidentally occur in the uterine wall during a surgical abortion, says Feinberg. This is called a uterine perforation and rarely happens.

 “Most uterine perforations heal without any long-term consequences,” she says. But if the perforation affects blood vessels in the uterus, it can cause significant bleeding and may require emergency surgery, such as a hysterectomy, she says.

A uterine perforation can also weaken the uterine muscle, says Dr. Sharma. This weakness may lead to problems with future pregnancies, such as uterine rupture (in which the uterus tears) or issues with the placenta (the organ in the uterus that supplies nutrients and oxygen to the baby).

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