Return of Ovarian Function After Abortion

Abstract

The first menstrual cycle after a therapeutic abortion was studied in eighteen women by measuring plasma oestradiol and progesterone concentrations and the urinary excretion of LH until the first menstruation. The plasma concentrations of oestradiol and progesterone declined rapidly, reaching low values as early as the second day after the abortion. An increase in plasma oestradiol levels was observed from the seventh post-abortal day onwards. P peak of short duration in the plasma progesterone concentrations occurred during the increased oestradiol synthesis. The concentration of progesterone during the luteal phase of the cycle was lower than in a normal cycle, indicating an inadequate luteal function. Return of ovulation was observed in 83% of patients during the first cycle; as judged by a biphasic oestradiol profile in plasma, a mid-cycle LH peak, and subsequent elevation of progesterone. The first LH peak was observed 16 days after the abortion. The rapid return of the ovulatory function makes immediate post-abortal contraception a necessity.

Controversies in family planning: timing of ovulation after abortion and the conundrum of postabortion intrauterine device insertion

“…Lahteenmaki et al [2] looked at 18 women following first trimester therapeutic abortion via vacuum aspiration. Serum estradiol and progesterone as well as urine LH were assessed by radioimmunoassay.…”

“…As is noted in a number of the studies presented, [2, 4, 5, 11], women will continue to have a positive urine or blood pregnancy test at these short time points following abortion, making it difficult to be reasonably certain your patient returning for delayed contraception is not newly pregnant. As a result, we recommend that those women unable to have an immediate post-abortion IUD insertion return within 7 to 10 days, regardless of abortion method or gestational age at the time of their procedure, for IUD insertion.…”

Sequential hormone measurements after first trimester abortion in normal Nigerian women

“…More recently, L~hteenm~iki and Luukkainen [4] reported the return of ovulation in 83% of their subjects within the first cycle, as determined by serum LH, estradiol, and progesterone concentrations. The first LH peak was seen 16 days postabortion.…”

Postabortal insertion of IUD

“…After abortion, ovulation precedes the first menstrual period in 85% of women, indicating the need for contraception immediately after termination of the pregnancy [1,2].…”