Serum human chorionic gonadotropin decline following aspiration abortion in early pregnancy less than 42 days gestation



      To define serum human chorionic gonadotropin (hCG) decline following complete aspiration abortion.

      Study Design

      We performed a secondary analysis of 86 patients who underwent uncomplicated aspiration abortion for ultrasound-confirmed pregnancy ≤42 days gestation and had serum hCG at the time of aspiration and within 3 days postprocedure.


      Median hCG declines were 72.9% by day 1 (n = 14), 87.6% by day 2 (n = 50), and 92.8% by day 3 (n = 22). Ninetieth percentile declines were 67.8%, 81.5%, and 90.8%. Minimum hCG declines were 56.2%, 77.3%, and 83.2%. Trends did not vary by gestational age or by initial hCG <3000 mIU/mL.


      Postprocedure hCG trend varies over the first few days in early gestation. At ≤42 days gestation, serial hCG decline at 1 day after completed aspiration abortion is greater than 50%, consistent with the decline observed in medication abortion.


      This study confirms previously estimated human chorionic gonadotropin decline after aspiration abortion of at least 50% at 24 hours for completed procedure in very early gestations. Minimum declines on days 2 and 3 are approximately 70% and 80%.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Contraception
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Marrs RP
        • Kletzky OA
        • Howard WF
        • Mishell Jr, DR
        Disappearance of human chorionic gonadotropin and resumption of ovulation following abortion.
        Am J Obstet Gynecol. 1979; 135: 731-736
        • Steier JA
        • Bergsjo P
        • Myking OL
        Human chorionic gonadotropin in maternal plasma after induced abortion, spontaneous abortion, and removed ectopic pregnancy.
        Obstet Gynecol. 1984; 64: 391-394
        • van der Lugt B
        • Drogendijk AC
        The disappearance of human chorionic gonadotropin from plasma and urine following induced abortion.
        Disappearance hcg induc abort. Acta Obstet Gynecol Scand. 1985; 64: 547-552
        • Rivera V
        • Nguyen PH
        • Sit A
        Change in quantitative human chorionic gonadotropin after manual vacuum aspiration in women with pregnancy of unknown location.
        Am J Obstet Gynecol. 2009; 200: e56-e59
        • Creinin MD.
        Change in serum beta-human chorionic gonadotropin after abortion with methotrexate and misoprostol.
        Am J Obstet Gynecol. 1996; 174: 776-778
        • ACOG Practice Bulletin No. 193
        Tubal ectopic pregnancy: correction.
        Obstet Gynecol. 2019; 133: 1059
        • Baldwin MK
        • Bednarek PH
        • Russo J
        Safety and effectiveness of medication and aspiration abortion before or during the sixth week of pregnancy: a retrospective multicenter study.
        Contraception. 2020; 102: 13-17