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When Can I Try to Get Pregnant Again After a Miscarriage?


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  #1  
October 4th, 2009, 09:50 AM
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Question: When Can I Try to Get Pregnant Again After a Miscarriage?


Many couples want to try again as soon as possible following a miscarriage, especially if the pregnancy loss occurred when they were actively trying to conceive. If you ask three different doctors, however, you may get three different answers!
  • Wait Three Months
For many years, doctors advised women to wait three months before conceiving again. The rationale was that this would allow for better dating of the next pregnancy, by re-establishing the menstrual cycle, and it would give the couple time to deal with grief and emotions over the pregnancy loss. In addition, some practitioners feel that waiting three months allows the body more time to heal and replenish nutrient stores.

Waiting three months takes a cautious approach to subsequent conception. Waiting longer will definitely not hurt you in any way, and if you miscarry again, you will not be left wondering if waiting would have prevented the next miscarriage. But unless your loss happened late in pregnancy, your body may recover fairly quickly from the loss, and evidence suggests that waiting three months does not decrease the odds of another miscarriage.
  • Wait Until Your Next Menstrual Period
Some doctors advise waiting for one menstrual period, again for the purposes of dating the next pregnancy if conception happens immediately. Waiting for one cycle also establishes that hCG levels have returned to zero and that the body’s hormone levels have normalized.
  • Try As Soon As You Feel Ready
Despite the traditional advice to wait for dating purposes, many doctors feel that ultrasound is an accurate enough way to date early pregnancies and they advise women that they can try again as soon as they feel ready. Evidence suggests that waiting to conceive again does not alter the risk of miscarriage, and some women cope with pregnancy loss better by trying again right away.
If you want to try again right away and your doctor advises you to wait, talk to your doctor about the reasoning behind the recommendation and ask whether specific circumstances in your situation may merit a longer wait. If you have lost a baby due to neural tube defects, for example, your doctor may ask you to take high doses of folic acid for a time before trying to conceive again. In any case, it is best to discuss your concerns with a medical practitioner you trust.


Sources:
Goldstein, Rachel R. Pruyn, Mary S. Croughan, and Patricia A. Robertson. "Neonatal outcomes in immediate versus delayed conceptions after spontaneous abortion: A retrospective case series." American Journal of Obstetrics and Gynecology June 2002 1230-1236.
Martin, Eva. "Miscarriage." Health Library. 03 Feb. 2000. University of Illinois Medical Center. 30 Sep 2007.
Mayo Clinic Staff, "Understanding miscarriage." MayoClinic.com. 27 Oct. 2006. Mayo Clinic. [Online]. 30 Sep 2007. Roberts, Peter H. R.. "Ask an Expert: Trying again after miscarriage." Pregnancy Center. Mar. 2003. Providence Health & Services. [Online]. 30 Sep 2007.
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  #2  
October 4th, 2009, 10:04 AM
Celena's Avatar Proud JM hostess
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Question: Will Getting Pregnant Again Right After Miscarriage Cause Another Miscarriage?
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?


Answer:
There doesn't seem to be any reliable evidence to indicate that there's any increased risk in getting pregnant again right after miscarriage. Physicians commonly recommend waiting one to three months before trying for a new pregnancy, but often this is just a standard precaution "to be on the safe side" rather than a recommendation based in solid evidence.

Of the evidence that does exist, a June 2002 study in the U.S. looked at 64 pregnancies after miscarriage and found no evidence of pregnancy complications in those who conceived immediately vs. those who waited two cycles. In addition, a March 2003 study found evidence that women might have increased fertility in the cycle immediately after a miscarriage.

On the side of advising a wait, a 2005 Israeli study 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 diet already included adequate folic acid and supplements prior to the miscarriage.

It also makes sense to assume that if a woman miscarries due to a medical condition or in the presence of a modifiable risk factor that getting pregnant immediately without addressing that condition might increase the risk of another miscarriage.

That aside, for women without underlying medical issues and who eat healthy, balanced diets, it's possible that there's no increased risk in getting pregnant again right away. Obviously, if your doctor does advise you to wait, there may be a specific reason -- but don't be afraid to ask questions. Many women find the process of coping with miscarriage to be more difficult when they have to wait before trying to get pregnant again, so if this applies to your situation, it is perfectly okay to have a conversation about the reasons behind the recommendation.




Sources:

Carmi, R., J. Gohar, I. Meizner, and M. Katz, "Spontaneous abortion-high risk factor for neural tube defects in subsequent pregnancy." American Journal of Medical Genetics Jun 2005. Accessed 22 Jul 2008.

Goldstein, Rachel R. Pruyn, Mary S. Croughan, and Patricia S. Robertson, "Neonatal outcomes in immediate versus delayed conceptions after spontaneous abortion: A retrospective case series." American Journal of Obstetrics and Gynecology 2002. Accessed 22 Jul 2008. Wang, Xiaobin, Changzhong Chen, Lihua Wang, Dafang Chen, Wenwei Guang, and Jonathan French, "Conception, early pregnancy loss, and time to clinical pregnancy: a population-based prospective study." Fertility and Sterility 2003. Accessed 22 Jul 2008.
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