Surgical vs. Medical Abortion on Sexual Function After Early Pregnancy Loss (SF-EPL)

June 9, 2026 updated by: Omer Tammo, MD, Harran University

Surgical Abortion for Early Pregnancy Loss is Associated With Greater Short-Term Decline in Sexual Function Compared to Medical Abortion: A Prospective Comparative Study

This study compares the medium-term effects of surgical and medical abortion on sexual function in women who have experienced early pregnancy loss (6-12 weeks gestation). A total of 86 women (45 medical abortion, 41 surgical abortion) were followed for 6 months. Sexual function was measured using the Female Sexual Function Index (FSFI) before treatment and at 6 months after the procedure. The surgical abortion group showed a significant decline in total FSFI score at 6 months compared to baseline, with decreases observed in all six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. The medical abortion group showed no significant change in total FSFI score. Between-group comparison at 6 months revealed significantly lower total FSFI scores in the surgical group compared to the medical group. These findings suggest that surgical abortion for early pregnancy loss is associated with a significant decline in sexual function that persists up to 6 months after the procedure, whereas medical abortion appears to have a neutral effect during the same period. Due to the non-randomized design, these findings should be considered hypothesis-generating.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This prospective, comparative cohort study was conducted at Harran University Faculty of Medicine between April 2025 and January 2026. Women aged 18-40 diagnosed with early pregnancy loss (6-12 weeks gestation) were allocated to surgical or medical abortion based on shared decision-making. The Female Sexual Function Index (FSFI) was used to evaluate sexual function before treatment and at 6 months follow-up. Statistical analyses were performed using non-parametric tests (Mann-Whitney U, Wilcoxon signed-rank) with Bonferroni correction. Effect sizes (r) were calculated for all primary outcomes.

Study Type

Interventional

Enrollment (Actual)

88

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Şanliurfa
      • Sanliurfa, Şanliurfa, Turkey (Türkiye), 63200
        • Harran University, Department of Gynecology and Obstetrics

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • - Diagnosis of early pregnancy loss (6-12 weeks gestation)
  • Planned to undergo either surgical or medical abortion
  • Age between 18 and 40 years
  • Proficiency in speaking and reading Turkish
  • Voluntary participation and provision of written informed consent

Exclusion Criteria:

  • A known pre-existing diagnosis of sexual dysfunction (baseline FSFI total score ≤ 26.55)
  • A documented history of severe psychiatric disorders (e.g., schizophrenia, bipolar disorder)
  • History of chronic pelvic pain conditions (e.g., endometriosis, vulvodynia) or any other chronic medical condition known to significantly affect sexual function (e.g., unmanaged diabetes mellitus, multiple sclerosis)
  • Current use of medications that can impact sexual function (e.g., SSRIs, SNRIs, antipsychotics, antihypertensives)
  • Insufficient communication ability, defined as difficulty understanding and speaking Turkish or having cognitive/communication impairments that would prevent reliable completion of the study questionnaires

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Medical Abortion
Participants received 200 mg oral mifepristone under supervision at the clinic, followed by 800 µg misoprostol administered at home 24-48 hours later.
Drug: mifepristone and misoprostol
Participants received 200 mg oral mifepristone under supervision at the clinic, followed by 800 µg misoprostol administered at home 24-48 hours later.
Active Comparator: Surgical Abortion
Participants underwent vacuum aspiration under local or general anesthesia in an operating room.
Procedure: Vacuum Aspiration
Participants underwent vacuum aspiration under local or general anesthesia in an operating room for early pregnancy loss at 6-12 weeks gestation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Female Sexual Function Index (FSFI) Total Score
Time Frame: Baseline (pre-treatment) and 6 months post-abortion procedure
The FSFI is a 19-item, multidimensional self-report questionnaire assessing female sexual function over the past four weeks. It evaluates six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. The total score is the sum of six domain scores (range 2-36). Lower scores indicate worse sexual dysfunction. A total score of ≤26.55 is the validated cutoff for female sexual dysfunction.
Baseline (pre-treatment) and 6 months post-abortion procedure

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in FSFI - Desire Domain Score
Time Frame: Baseline and 6 months
Desire domain consists of 2 items assessing sexual desire and interest over the past 4 weeks. Domain score range: 1.2-6.0.
Baseline and 6 months
Change in FSFI - Arousal Domain Score
Time Frame: Baseline and 6 months
Arousal domain consists of 4 items assessing sexual excitement and arousal over the past 4 weeks. Domain score range: 0-6.0.
Baseline and 6 months
Change in FSFI - Orgasm Domain Score
Time Frame: Baseline and 6 months
Orgasm domain consists of 3 items assessing ability to achieve orgasm over the past 4 weeks. Domain score range: 0-6.0.
Baseline and 6 months
Change in FSFI - Lubrication Domain Score
Time Frame: Baseline and 6 months
Lubrication domain consists of 4 items assessing vaginal lubrication during sexual activity over the past 4 weeks. Domain score range: 0-6.0.
Baseline and 6 months
Change in FSFI - Pain Domain Score
Time Frame: Baseline and 6 months
Pain domain consists of 3 items assessing pain during vaginal penetration and sexual activity over the past 4 weeks. Domain score range: 0-6.0.
Baseline and 6 months
Change in FSFI - Satisfaction Domain Score
Time Frame: Baseline and 6 months
Satisfaction domain consists of 3 items assessing sexual satisfaction over the past 4 weeks. Domain score range: 0.8-6.0.
Baseline and 6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Harran University

Investigators

  • Principal Investigator: ömer tammo, Harran University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 1, 2025

Primary Completion (Actual)

January 31, 2026

Study Completion (Actual)

January 31, 2026

Study Registration Dates

First Submitted

June 9, 2026

First Submitted That Met QC Criteria

June 9, 2026

First Posted (Actual)

June 12, 2026

Study Record Updates

Last Update Posted (Actual)

June 12, 2026

Last Update Submitted That Met QC Criteria

June 9, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • HRU-FSFI-2025-01

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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