How Long Until hCG Falls to Zero After Miscarriage?

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Human chorionic gonadotropin (hCG) is a hormone that the placenta makes during pregnancy. In healthy pregnancies, it rises dramatically through the early stages of pregnancy, doubling every 24 to 48 hours during the first eight weeks or so of gestation and peaking during weeks eight to 11. HCG levels then begin tapering off until around 16 weeks.

After 16 weeks, hCG levels remain relatively stable for the remainder of the pregnancy. If you miscarry, your level of hCG will gradually fall, eventually returning to a pre-pregnancy level of zero (or it will become so low that it's undetectable during testing). Below, we take a closer look at hCG levels after pregnancy loss and how this hormone impacts optimal timing for conception after miscarriage.

What Happens If You Take a Pregnancy Test After Miscarriage

The exact length of time that it takes for hCG to leave your system after a miscarriage varies, ranging from several days to a few months. The timing depends on how high the hCG level was when the pregnancy was lost. In general, a person who had a very early miscarriage is likely to have their hCG return to zero faster than someone whose loss occurred later in the pregnancy.

That said, the amount of hCG may still be high enough to trigger a positive on a pregnancy test for several weeks after a miscarriage. Keep this in mind if you suspect another pregnancy, as a false positive can be likely.

It typically takes from one to nine weeks for hCG levels to return to zero following a miscarriage (or delivery). Once levels zero out, this indicates that the body has readjusted to its pre-pregnancy state—and is likely primed for conception to occur again.

Recovering From a Miscarriage

After experiencing a first-trimester miscarriage, you can expect moderate to intense cramping that subsides within a day or two. Bleeding similar to a heavy period can occur, and you may see large clots or clumps. Heavy bleeding should ease after two or three days, but light to moderate bleeding can continue for up to two weeks. In most cases, you will begin to feel physically normal once the bleeding stops, but losses that involve a D&C or surgical procedure may require additional recovery time. Menstrual periods usually begin four to six weeks after the cessation of bleeding.

If your loss included a D&C (dilation and curettage) or D&E (dilation and extraction), bleeding may or may not occur. Your healthcare provider might prescribe medications to cause your uterus to contract to reduce bleeding, and antibiotics might also be prescribed. People who have had a D&C or D&E can usually resume normal activities within several days of the procedure. It is recommended to avoid inserting anything in the vagina for up to two weeks; this includes tampons and sexual intercourse.

Losses that occur later in pregnancy may require a longer recovery. Large clots and heavy bleeding are not unusual after a vaginal birth, and you may feel sluggish or tired for several days afterward. Perineal tearing may also occur. You may also experience breast engorgement and hormone fluctuations similar to those experienced after a live birth.

Emotional recovery after a miscarriage is different for everyone, and there is no one right way to deal with a loss. Take the time and space you need to recover, and don't feel pressured to "bounce back" if you aren't ready.

Trying to Get Pregnant Again

If you want to try to conceive again after a miscarriage, it's ideal to wait until your hCG level has dropped to either zero or an undetectable level—but there's no need to wait any longer unless you choose to do so. This hormone readjustment signals that the uterine lining is back to normal and can receive a newly fertilized egg. 

Ask your doctor how long it's best for you to wait before trying for another child, as recommendations will vary depending on multiple factors, including the specifics of your miscarriage and medical history. In the past, it was routine for medical professionals to recommend waiting at least three to six months after pregnancy loss before trying again.

However, recent research has debunked the need for extended postponement. In fact, once hCG levels normalize, new guidelines suggest couples try sooner, rather than later.

Studies show that the chance of conception may be higher for those that begin trying again sooner than three months after pregnancy loss rather than for those that wait longer. So, it makes sense to pay attention to your hCG levels so that you can start trying to get pregnant as soon as your hormone levels reach zero.

Why Wait at All?

Why is it a problem to try to conceive too soon after a miscarriage? The most important reason is to allow time for your body to return to its pre-pregnancy state, in order to be ready to support a new pregnancy. This allows the uterus and hormone levels to be in optimal condition for an embryo to take hold and thrive. You'll also want to give yourself time to heal emotionally.

Not waiting long enough before trying again can render diagnostic testing inaccurate, making it hard to know if and when you've gotten pregnant again, which can cause more heartache and potentially complicate your prenatal care.

Pregnancy tests (including home urine-based tests and blood tests) measure hCG levels. If your hCG level is still high from the previous pregnancy, you may get what's called a "false positive" reading from the tests. This means that you might end up thinking that you're pregnant again—even though you're actually not.

Additionally, if tests show that your hCG level is dropping (a urine-based pregnancy test won't be able to do this, but a quantitative blood-based test will), a doctor may think that you're miscarrying a second time—even though those numbers may still be referring to your first miscarriage. Finally, it can often take a month to a couple of months to have a normal menstrual cycle after a miscarriage. 

Ectopic Pregnancy

If you have an ectopic pregnancy (when a fertilized egg implants outside the uterus, such as in a fallopian tube), you may need to wait a bit longer for your body to fully heal before you can attempt to conceive again. Studies show that it often takes six to eight weeks for hCG levels to return to normal after an ectopic pregnancy, particularly for women who experience any complications with their treatment.

An ectopic pregnancy usually requires treatment with drugs or surgery to remove the embryo, which can add to recovery time. If hCG levels do not fall, it may indicate that some of the tissue from the pregnancy remains in the body and will need to be removed with further treatment. You'll need time for any medications to clear your system before trying to get pregnant again, as well. 

Consult Your Doctor

To be sure that your hCG levels have returned to zero, you can ask your doctor for a blood test after the pregnancy loss. A blood test is more sensitive than a pregnancy test as it can detect how much hCG might be in your body, not just whether it is present. So, this testing will let you know how your hCG levels are progressing and if/when they reach zero.

Your doctor can advise you on when it's safe to try to conceive again.

A Word From Verywell

Miscarriage is often a devastating experience, so be sure to take the time to process and cope with your loss. That said, many people take comfort in trying to conceive again. Once your hCG levels reach zero, it's usually safe (and often encouraged from a conception standpoint) for you to get pregnant.

3 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Library of Medicine. Human chorionic gonadotropin.

  2. Schliep KC, Mitchell EM, Mumford SL, et al. Trying to conceive after an early pregnancy loss: An assessment on how long couples should wait. Obstet Gynecol. 2016;127(2):204-12. doi:10.1097/AOG.0000000000001159

  3. Kurt-mangold M, Van voorhis BJ, Krasowski MD. Persistent human chorionic gonadotropin after methotrexate treatment and an emergency surgical procedure for ectopic pregnancy. Lab Med. 2015;46(3):254-8. doi:10.1309/LMTDRFGJVJIM3VNM

Additional Reading

By Krissi Danielsson
Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage.