Post-Abortion Ovulation Concerns: What to Expect After a Procedure

Ovulation issues after abortion?

Hello Doctor, I underwent a surgical abortion at 9 weeks of pregnancy on March 27 (not due to fetal demise).
For the first 1-2 days post-operation, the bleeding was within the absorbent capacity of a pad, and then there was no further bleeding.
After my follow-up appointment on March 31, I noticed there were still large blood clots, so I used Cytotec 3# vaginally.
I then traveled abroad and did not have a follow-up, but I did not experience any bleeding during my trip.
Upon returning on April 7, I had another appointment and still had small blood clots, so I took Cytotec 3# sublingually.
On April 8, an ultrasound showed that the blood clots had disappeared, but a pregnancy test still showed a reaction (though faint).
Today, April 10, the pregnancy test still shows a reaction, but the color is lighter compared to the last test.
I asked the doctor about my menstrual cycle, and he said that I should wait until the pregnancy test shows a negative result before calculating my next menstrual cycle.
However, I found information online stating that menstruation typically resumes 1-1.5 months after the procedure.
Therefore, I would like to ask the doctor: 1.
Should I consider my next menstrual cycle to begin 1-1.5 months after the March 27 procedure, or do I really need to wait until the pregnancy test shows a single line before counting 1-1.5 months? 2.
When can I expect to ovulate normally? Will it be in April? (My usual cycle is about 35-40 days.) 3.
Today, April 10, the ovulation test shows a single line.

Peng, 20~29 year old female. Ask Date: 2023/04/10

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is expected to have a negative pregnancy test two weeks after a normal surgery.
Until you receive a negative result, it is not conclusive.
Please continue to follow up with your original obstetrician-gynecologist.
Wishing you good health.

Reply Date: 2023/04/10

More Info

After undergoing an abortion procedure, it is common to have questions regarding the timeline for the return of normal menstrual cycles and ovulation. Based on your situation, here are some insights and clarifications regarding your concerns:
1. Menstrual Cycle Resumption: After an abortion, it is typical for menstruation to resume within 4 to 6 weeks. However, the exact timing can vary significantly from person to person. In your case, since the abortion was performed on March 27, you can generally expect your next period to arrive around late April to early May. The information you found online suggesting that menstruation may return 1 to 1.5 months post-procedure is accurate, but it is also essential to consider that your body may take some time to adjust, especially if you had a longer menstrual cycle prior to the abortion (35-40 days).
The presence of a faint line on a pregnancy test indicates that there may still be residual hCG (human chorionic gonadotropin) in your system, which is common after an abortion. It is advisable to continue monitoring the test until it shows a negative result. Once you receive a negative test result, you can start counting the days to your next expected period.

2. Ovulation Timing: Ovulation typically occurs about 14 days before the start of your next menstrual period. Given your usual cycle length of 35-40 days, ovulation may occur around 21 to 26 days after your abortion, which could place it in late April to early May. However, since your body has just undergone a significant hormonal change, it is possible that your ovulation may be delayed.
If you are using ovulation predictor kits (OPKs) and are seeing only one line, it indicates that you have not yet surged in LH (luteinizing hormone), which is necessary for ovulation. It is important to continue testing regularly, as your body may take some time to return to its normal ovulatory patterns.

3. Monitoring Your Body: After an abortion, it is crucial to monitor your body for any unusual symptoms, such as excessive bleeding, severe pain, or signs of infection. If you experience any concerning symptoms, it is essential to consult with your healthcare provider.
Additionally, maintaining a healthy lifestyle, including proper nutrition and hydration, can support your body in returning to its normal hormonal balance.
In summary, while you can expect your menstrual cycle to resume within 4 to 6 weeks post-abortion, the exact timing can vary. It is essential to wait for a negative pregnancy test before calculating your next cycle. Ovulation may occur later than usual, and using OPKs can help you track this process. Always consult your healthcare provider for personalized advice and to address any concerns you may have during your recovery.

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