Concerns About Medication Abortion: Risks of Pregnancy After Treatment

Medication abortion issues

On October 7, I took RU486, and on October 9, I took the second dose.
During my follow-up appointment on October 10, it was confirmed that the embryo had been expelled, but the endometrium was not yet completely cleared, so I continued taking uterotonics.
On October 17, the endometrium still had not completely cleared, with a small amount remaining, so I continued taking uterotonics.
On October 19, I had unprotected intercourse.
Is there a possibility of pregnancy? Do I need to take emergency contraception?

wen, 20~29 year old female. Ask Date: 2023/10/19

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, you can take emergency contraception just in case.
Wishing you good health.

Reply Date: 2023/10/19

More Info

When it comes to concerns about medication abortion and the risks of pregnancy after treatment, it's essential to understand the timeline and implications of the medications involved, particularly mifepristone (RU486) and misoprostol, which are commonly used in medication abortions.

In your case, you took mifepristone on October 7 and followed up with misoprostol on October 9. By October 10, it was confirmed that the embryo had been expelled, although the uterine lining had not yet completely cleared. This indicates that the abortion process was initiated successfully, but the body may still be in the process of expelling all remaining tissue.

Regarding the potential for pregnancy after this treatment, it is important to note that the risk of becoming pregnant immediately after a medication abortion can vary. Generally, ovulation can occur as soon as two weeks after the abortion, which means that if you had unprotected intercourse on October 19, there is a possibility of becoming pregnant again. Sperm can survive in the female reproductive tract for up to five days, so if you ovulate shortly after your abortion, there is a chance that sperm could fertilize an egg.

As for whether you should take emergency contraception (often referred to as the "morning-after pill"), it is advisable to consider this option if you wish to prevent an unintended pregnancy. Emergency contraception is most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours, but some forms can be effective up to five days after. Given that your unprotected intercourse occurred on October 19, you should consult with a healthcare provider about the best course of action, including the possibility of taking emergency contraception.

It is also crucial to follow up with your healthcare provider regarding the incomplete expulsion of the uterine lining. If the lining does not clear out completely, it could lead to complications such as infection or prolonged bleeding. Your healthcare provider may recommend additional medications or procedures to ensure that the uterus is entirely clear.

In summary, while there is a possibility of becoming pregnant after a medication abortion, the timing of ovulation and the effectiveness of emergency contraception are critical factors to consider. It is always best to consult with a healthcare professional for personalized advice and to ensure that you are taking the appropriate steps for your reproductive health.

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