Is Pregnancy Right After Miscarriage Risky?

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Doctors often advise women to wait a few months before getting pregnant again after a miscarriage, but will getting pregnant sooner increase the risk of a repeat miscarriage?

There isn't any reliable evidence showing an increased risk of miscarriage when getting pregnant again immediately after a miscarriage, though physicians commonly recommend waiting one to three months before trying again for a new pregnancy.

Why You Might Not Want to Wait

One study published in 2002 looked at 64 pregnancies that took place after miscarriage and found no evidence of pregnancy complications in those who conceived immediately vs. those who waited two cycles. In addition, a 2003 study found evidence that women might have increased fertility in the cycle immediately after a miscarriage.

Two much more recent and larger-scale studies support the theory that there is no physiological reason to delay trying to conceive. One 2016 study followed over 1,000 women who had one or two previous pregnancy losses and found that those who conceived in the first one to three cycles after their loss were more likely to go on to have a viable pregnancy, vs. those who conceived three to six months after their loss.

A second study, published in 2017, analyzed 10 previous studies and concluded that conceiving less than six months after led to a significantly reduced risk of miscarriage and pre-term deliver in subsequent pregnancies.

Why You Might Want to Wait

An Israeli study from 1994 found that women who had miscarried faced a high risk of having a subsequent pregnancy affected by neural tube defects or congenital heart defects. The study authors recommended delaying conception after miscarriage and treating with folic acid during the wait. However, it's possible that the findings may not apply to women whose diets already included adequate folic acid (usually supplied via a daily prenatal vitamin) prior to the miscarriage.

If a woman miscarries due to a medical condition (such as polycystic ovary syndrome, a thyroid problem, uncontrolled diabetes, an immunologic disorder, a uterine abnormality, or an incompetent cervix) or in the presence of a modifiable risk factor (such as smoking cigarettes, using drugs, drinking alcohol, or consuming large amounts of caffeine), then getting pregnant immediately without addressing that underlying condition or addiction might increase the risk of another miscarriage.

There are a few other factors to consider. First off, you'll want to wait for your menstrual cycle to normalize and become complete again, which can sometimes take a month or two. If you had a D&C following your miscarriage, you'll want to let your uterine lining heal properly so it's ready to receive another fertilized embryo.

It's also a good idea to let your level of human chorionic gonadotropin (hCG) drop to zero or at least to an undetectable level before you start trying again. This is a hormone that is produced by your body during pregnancy and it can be measured through a urine or blood test. If you don't let it drop, a pregnancy test might give you what's known as a "false positive" reading and reveal that you're pregnant when, in reality, you're not. Also: If your hCG level from the original pregnancy is still detectable and dropping, a doctor might interpret those numbers as a second miscarriage, when it's actually not.

It's common to feel rattled and heartbroken after experiencing something as devastating as a miscarriage. So you're not stressed during a second pregnancy, you may want to allow yourself some time to mentally process what has happened. (Then again, many women find the process of coping with miscarriage to be more difficult when they have to wait before trying to get pregnant again.)

How Should You Proceed?

Ask your doctor what's best, because every woman and every pregnancy is different. If you're comfortable waiting one to three months, that's generally recommended. If you're in a hurry to get pregnant before then, talk to your doctor about your particular situation so you can come up with the safest time-frame.

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