Induced regeneration of endometrium following curettage for abortion: a comparative study

Abstract

A significant increase in endometrial thickness and volume was observed in 30 patients given oestrogen and progestin supplementation following curettage for first trimester abortions, compared with 30 women who received no treatment. This indicates an enhanced regeneration of the endometrium following treatment. The ability to induce this response, creating a space between the intra-cavity surface area a short time after abortion, may theoretically be suggested as preventative treatment to reduce the risk of intrauterine adhesions.

PIP: In Israel, gynecologists randomly assigned 60 women who underwent dilatation and curettage (D&C) during the 1st trimester of pregnancy at either the Golda Medical Centre in Petah Tikva or Sackler Medical School of Tel Aviv University to the estrogen and progestin treatment group or the no-treatment group. They wanted to examine the effect of estrogen-progestin therapy on endometrial response after surgical abortion. All the women received prophylactic oral antibiotic therapy after the D&C. 30 women received daily 2 mg estradiol valerate for 21 days and 0.5 mg norgestrel for the last 10 days during the 1st cycle after the D&C. None of the women had any complications during or after the abortion. Women who underwent estrogen-progestin therapy experienced significantly greater endometrial thickness (0.84 cm vs. 0.67 cm; p = 0.02), endometrial width (0.81 cm vs. 0.64 cm; p = 0.002), and endometrial volume (3.85 sq. cm vs. 1.97 sq. cm) than the control group. These findings suggested that estrogen-progestin therapy may overcome curettage's adverse effect on endometrial regeneration. Even though the literature does not show that enhanced regeneration of the endometrium prevents intrauterine adhesions, this treatment does cause significant increase in endometrial thickness and volume which might play a significant role in preventing intrauterine adhesions in women at high risk of developing them.