Return of Ovarian Function Following Spontaneous Abortion

Donnet, M L; Howie, P. W.; Marnie, M.; Lewis, Mark

doi:10.1097/00006254-199101000-00021

Cited by 9 publications

(17 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consistent with the hormone patterns after spontaneous miscarriage, which showed lower LH and shorter luteal phase length [1,2], our data suggest a lower pre-ovulatory LH and a slightly shorter luteal phase length. However, these differences were small, and confidence intervals were large.…”

Section: Discussionsupporting

confidence: 90%

“…In contrast we found no evidence of reduced luteal progesterone or estrogen, as has been reported for cycles after a spontaneous miscarriage. [1] Though our sample of very early losses was limited, we have the power to detect most of the changes previously reported for spontaneous miscarriages (Table 4). The differences between post-loss cycles and comparison cycles in our data are either smaller or in the opposite direction as those reported for spontaneous miscarriages (Table 4).…”

Section: Discussionmentioning

confidence: 99%

“…[1,2] One suggested reduced pituitary function with lower follicle stimulating hormone and luteinizing hormone (LH) levels. [2] The second also suggested lower LH levels in addition to lower luteal estrogen and progesterone.…”

Section: Introductionmentioning

confidence: 99%

“…[2] The second also suggested lower LH levels in addition to lower luteal estrogen and progesterone. [1] These hormonal changes would lead to reduced fecundability in the post-spontaneous miscarriage cycle. To our knowledge, hormone levels after very early (subclinical) pregnancy loss have not been investigated.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effects of early pregnancy loss on hormone levels in the subsequent menstrual cycle

Jukic¹,

Weinberg

Wilcox³

et al. 2010

Gynecological Endocrinology

View full text Add to dashboard Cite

Previous studies of hormone patterns after clinical miscarriage suggest reduced pituitary function. Hormonal effects of very early pregnancy loss (before six weeks gestation) have not been described. We used within-woman differences between menstrual cycles in urinary hormone measurements from women in the North Carolina Early Pregnancy Study to describe hormonal changes after very early pregnancy loss (n=28 early losses; 80 non-conception comparison cycles). We found lower pre-ovulatory luteinizing hormone and shorter luteal phase length after very early pregnancy loss, but the differences were non-significant (p>0.3) and smaller than those reported in the spontaneous miscarriage literature. Consistent with the reduced pituitary function reported post-spontaneous miscarriage, we found a slower rate of estrogen rise (p=0.08). There was no evidence of lower midluteal steroid levels as has been suggested for post-spontaneous miscarriage cycles. Very early pregnancy losses do not appear to influence subsequent menstrual cycles to the same degree as spontaneous miscarriages.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of early pregnancy loss on hormone levels in the subsequent menstrual cycle

Jukic¹,

Weinberg

Wilcox³

et al. 2010

Gynecological Endocrinology

View full text Add to dashboard Cite

show abstract

“…With women obtaining miscarriage care in diverse settings and potentially receiving inconsistent attention to future reproductive planning, women experiencing SAB may be at particularly high risk for future undesired pregnancy. This is especially of concern given the rapid return to fertility, with median ovulation 20 days post-miscarriage (range 13–103 days) [18]. Understanding the prevalence and correlates of unintended pregnancy ending in SAB may further inform the importance of reproductive and contraceptive counseling for women experiencing miscarriage.…”

Section: Introductionmentioning

confidence: 99%

Examining intendedness among pregnancies ending in spontaneous abortion

et al. 2017

View full text Add to dashboard Cite

Objectives: Spontaneous abortion (SAB) affects over 1 million US women each year, yet little is known about the intendedness of these pregnancies. We examined prevalence and correlates of unintended and unwanted pregnancies ending in SAB. Study design: We used nationally-representative cross-sectional data of US women aged 15–44 from the 2011–2013 National Survey of Family Growth to examine pregnancies ending in SAB. We used modified Poisson regression models to evaluate associations between demographic and pregnancy characteristics with unintended and unwanted pregnancy. Results: Among 1351 pregnancies ending in SAB, 44.5% were unintended (i.e. unwanted or occurring sooner than desired). Younger women with SAB were more likely to report unintended pregnancies than women 30–44 years, and women 15–19 years reported unintended pregnancy most often [adjusted relative risk (aRR) = 3.0; 95% confidence interval (CI): 2.2–4.1]. Unintended pregnancy was two times more likely among unmarried than married women [never married: aRR=2.2; 95% CI: 1.7–2.7; previously married: aRR=2.2; 95% CI: 1.7–3.0]. Other factors associated with unintended pregnancy were multiparity compared to nulliparity [aRR=2.6; 95% CI: 1.7–4.1 for ≥3 children; aRR=1.8; 95% CI: 1.3–2.5 for 2 children] and inter-pregnancy interval ≤12 months compared to >12 months [aRR=1.4; 95% CI: 1.2–1.7]. We found similar associations with unwanted pregnancies ending in SAB (15.3% of pregnancies). Neither race/ethnicity nor socioeconomic indicators were independently associated with unintended or unwanted pregnancy ending in SAB. Conclusions: Many pregnancies ending in spontaneous abortion are unintended and/or unwanted. Women with pregnancy loss, like all reproductive-aged women, should receive comprehensive counseling about reproductive planning and contraception. Implications: Similar to all pregnancies, nearly half of pregnancies ending in spontaneous abortion are unintended and/or unwanted, suggesting that many women experiencing spontaneous abortion may benefit from a review of family planning desires and the provision of reproductive planning counseling and effective contraception to prevent future undesired pregnancy.

show abstract

Systemic hormonal contraception initiation after abortion: A systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

Background: Immediate contraceptive initiation, including start of a method before abortion completion, is a convenient option for women seeking abortion care. Objectives: To evaluate the effect of systemic hormonal contraception initiation on medical abortion effectiveness and the safety of hormonal contraceptive methods following abortion. Data sources: PubMed, Popline, Cochrane Library, and Clinicaltrials.gov. Study eligibility criteria: Studies that assessed medical abortion effectiveness after systemic hormonal contraception initiation and the safety of hormonal contraception initiation after abortion. Participants: Pregnant persons undergoing or who had recently undergone an abortion. Interventions: Initiation of systemic hormonal contraception post abortion or on the day of the first pill of the medical abortion. Study appraisal and synthesis methods: We assessed study quality using the US Preventive Services Task Force evidence grading system. We created narrative summaries and calculated pooled relative risks when appropriate. Results: We identified 16 studies for inclusion, 7 randomized controlled trials, and 9 cohorts. Nine studies assessed medical abortion effectiveness with hormonal contraception initiation and generally found no decreased risk of abortion success or increased risk of additional treatment. One fair-quality study reported a small increase in ongoing pregnancy rate with immediate depot medroxyprogesterone (DMPA) compared with delayed DMPA initiation (3.6% vs 0.9%, risk difference 2.7%, 90% confidence interval 0.4-5.6). We identified no bleeding-related safety concerns following hormonal contraception initiation after medical or surgical abortion. Pooled results were too imprecise to draw firm conclusions. Limitations: Included studies were poor or fair quality and primarily in high-income or upper-middleincome settings. Conclusions: Abortion effectiveness did not differ between immediate vs delayed initiation of most systemic hormonal contraceptive methods after a first trimester medical abortion. However, immediate DMPA initiation did show increased ongoing pregnancy. Bleeding effects with hormonal contraception initiation postabortion appeared minimal. Implications: Initiating a hormonal contraceptive method after an abortion and as early as the same day as the first pill of the medical abortion is an option if contraception is desired. The slight increase in ongoing pregnancy with immediate DMPA initiation highlights the importance of information provision during contraceptive counseling.

show abstract

Return of Ovarian Function Following Spontaneous Abortion

Cited by 9 publications

References 0 publications

Effects of early pregnancy loss on hormone levels in the subsequent menstrual cycle

Effects of early pregnancy loss on hormone levels in the subsequent menstrual cycle

Examining intendedness among pregnancies ending in spontaneous abortion

Systemic hormonal contraception initiation after abortion: A systematic review and meta-analysis

Contact Info

Product

Resources

About