What The Science Really Says About Pregnancy After A Miscarriage
Couples trying to conceive after a miscarriage may have trouble finding fact-based recommendations. Here's what the research says.
Getting pregnant can be difficult. The same goes for staying pregnant, considering that nearly 25% of pregnancies end in miscarriage. Enduring a loss of pregnancy is often painful. But as much as healing takes time, couples may not want to wait too long before they try getting pregnant after a miscarriage. So how soon after a miscarriage can you get pregnant? Are you super fertile after a miscarriage, or is that just a myth? Contrary to popular belief and even many official recommendations, couples who try getting pregnant within three months of a miscarriage may actually be more likely to conceive and have a healthy pregnancy than those who wait longer.
People who got pregnant within three months after after a miscarriage had a higher live birth rate than those who waited longer — 53% compared to 36%, according to a study from the National Institutes of Health. Additional research has found that people who got pregnant again within three months of a miscarriage reduced their risk of another pregnancy loss compared to those who conceived after three months.
And a recent large review study found that getting pregnant within three months after a miscarriage is not linked to six major complications: preterm birth, spontaneous preterm birth, small for gestational age, large for gestational age, preeclampsia, or gestational diabetes. Rather, getting pregnant within three months was actually linked to smaller risk of gestational diabetes in pregnant people. And pregnancy within six months after a miscarriage was linked to a smaller risk of the baby being small for gestational age compared to pregnancies six to eleven months after a miscarriage.
So why wait?
When Getting Pregnant After Miscarriage, Sooner Is Better Than Later
In general, the risk of having a second miscarriage is low. Only about 1% of women have repeated miscarriages. But “if a woman decides to wait to attempt conception, the risk of a miscarriage is slightly higher,” says Mark Trolice, M.D., an OB/GYN and reproductive endocrinologist based in Florida.
This thinking goes against recommendations from very big organizations. The World Health Organization, for one, recommends that couples wait up to six months after a miscarriage before trying again. The reasoning here is mostly psychological. It’s fair to say that extreme emotional distress is not healthy for pregnant people or their developing babies. Bereavement during pregnancy has been linked with an increased risk of stillbirth. And depression during pregnancy is associated with a greater risk of sleep and mental health problems for their children later in life.
But extreme emotional distress doesn’t accurately characterize every person’s experience with miscarriage.
Trolice puts it more bluntly: “This recommendation was not based on solid medical evidence.” In fact, it was based on only one large study in Latin and South America. In contrast, a 2017 review of studies that included more than one million women found that getting pregnant within six months after a miscarriage led to a lower risk of another miscarriage and of preterm birth.
Exactly why it’s advantageous to try to conceive within several months of a miscarriage is not settled science. Trolice suspects that couples who conceive right away might be more likely to make the health and lifestyle adjustments needed for a healthy pregnancy. For instance, women who waited longer to get pregnant after a miscarriage had higher rates of obesity compared to women who tried to get pregnant right away.
Another possibility: Couples who try to get pregnant within three months of a miscarriage may have more luck for the simple and unflattering fact that prospective parents aren’t getting any younger. As more and more parents opt to have children later in life, advancing age has put many pregnant people at an increased risk of miscarriage. Advancing paternal age comes with risks for the fetus as well. Given parents’ ticking biological clocks, it makes sense not to wait too long to try to conceive after a miscarriage.
“A woman’s peak fertility starts in her mid-to-late twenties and declines more rapidly after the age of 35,” says Tom Molinaro, M.D., a reproductive endocrinologist at the Reproductive Medicine Associates of New Jersey. “Because of this, a couple should begin trying to conceive as soon as they are ready.”
How Soon After a Miscarriage Can You Get Pregnant?
Every pregnancy is different, and so is every miscarriage, so there are many limitations to consider with this data. If the miscarriage involved any medical procedure, it’s crucial to take advice from a doctor about when to hold off on baby-making in order to avoid complications and infections. For couples who have had recurrent pregnancy loss or who experienced a miscarriage after 13 weeks (most miscarriages occur before), there are caveats about trying sooner rather than later. It could pose a health threat to the pregnant person and their baby, and it’s important to discuss these details with medical professionals.
That said, the American College of Obstetricians and Gynecologists says there is usually no reason to wait before trying to conceive again. In most cases, ovulation doesn’t pick up until two weeks after a miscarriage. And most people shouldn’t have sex until two weeks after a miscarriage, according to the Mayo Clinic. That’s the earliest most couples could start trying again.
If you’re ready that quickly, there may be a benefit of trying right away: Fertility may actually be higher than usual in the first cycle following a miscarriage, according to one study from 2003.
Both Molinaro and Trolice agree that there is no one-size-fits-all prescription for getting pregnant after a miscarriage. However, if couples are physically and psychologically ready to get back on the baby-making horse, there’s no need to wait six months to start trying.
On the other hand, there is no need to minimize the loss or rush the grief process either. “The impact of miscarriage on the couple is often akin to a death in the family. A grieving process is important to ensure full emotional recovery,” Trolice says.
“If the couple feels they have healed emotionally and the woman has recovered physically, then they can attempt conception within three months following a pregnancy loss — with reassuring evidence of no increase in miscarriage and probably a higher live birth rate.”
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