The effect of induced abortion on subsequent fertility.
Level 3 - non-randomized controlled study
Prospective and retrospective non-randomized cohort studies
PubMed 8334095 · doi:10.1111/j.1471-0528.1993.tb15313.x
What was done
Researchers evaluated the association between induced abortion and subsequent fertility using data from general practices in England, Scotland, and Wales (recruitment 1976–1979, follow-up through 1987). The analysis included two components: (1) a prospective cohort of women with an unplanned pregnancy at recruitment ending in induced abortion (n = 433) versus natural pregnancy outcomes (n = 1,035) who subsequently attempted conception, and (2) a retrospective cohort of 9,299 women presenting with a planned pregnancy. The primary outcome was time to conception analyzed via Cox proportional hazards models to estimate fertility rate ratios (FRR).
What was found
In the prospective cohort, future fertility did not differ significantly between the abortion and non-abortion groups (FRR 0.94, 95% CI 0.83 to 1.07, P = 0.37). Among primigravid women, 12-month conception rates were 89% in the abortion group versus 93.3% in the non-abortion group (p = 0.068). In the retrospective cohort, fertility rates were comparable among women with one prior induced abortion (FRR 1.02) and those with two or more induced abortions (FRR 0.93) relative to women with natural pregnancy outcomes.
Why it matters
This large comparative study provides reassurance that induced abortion does not have a clinically meaningful negative impact on future ability to conceive.
Limits
Observational designs are vulnerable to residual confounding by baseline reproductive health, socio-demographics, or lifestyle factors. The abstract does not report specific abortion methods or post-procedure complication rates, and retrospective time-to-pregnancy estimates may be susceptible to recall bias.
Cited by
- supports Scientific studies show that having an elective termination of pregnancy does not negatively impact long-term fertility.