“No need to wait to conceive after miscarriage”

Research published today [1] has highlighted that couples wanting to conceive after a miscarriage don’t have to worry about the risks of trying again too soon [2].

The authors conclude that conceiving within the first six months after miscarriage does not increase the risk of miscarriage or of other adverse outcomes [3] in the new pregnancy.

On the contrary, it showed that pregnancies conceived in the first six months after a miscarriage were actually less likely to result in another loss than pregnancies conceived more than six months later.  Conceiving in those first six months was also associated with a lower risk of a pre-term birth.

Dr Sohinee Bhattacharya, from the University of Aberdeen, who led the research, acknowledges that it is not clear why conceiving within six months leads to better outcomes.  Nevertheless, this comprehensive review of all the published studies about the effects of timing of conception after miscarriage has confirmed research she first published in 2010.

The new study concludes: “There is now ample evidence to conclude that delaying a pregnancy following a miscarriage is not beneficial and unless there are specific reasons for delay, couples should be advised to try for another pregnancy as soon as they feel ready.”

So what does this mean for you?

There are several key messages here:

• It’s important news.  Above all, it confirms that couples can choose to try again whenever they feel ready to do so.
• It’s encouraging news if you want to try to conceive again soon after your miscarriage and you feel emotionally and physically ready.  Once any bleeding has stopped there’s almost certainly no need to wait (unless your doctor has advised otherwise, or unless you’ve had an ectopic or molar pregnancy).
• It’s reassuring news if you worry that you might have miscarried because you conceived too soon after a previous loss.  That’s highly unlikely.
• It’s confusing news if you don’t feel ready to try again, as you might worry that you’re increasing your risk of miscarriage. But waiting till you feel ready is likely to be best for both your mental and physical health and the researchers themselves emphasise that “… couples should be advised to try for another pregnancy as soon as they feel ready“.  (Our italics)
• It’s possibly upsetting news if it takes you longer than six months to conceive, or if you simply don’t have the option of trying again that soon, for whatever reason.

Perhaps it will help to remember that this is a statistical analysis and it talks about averages and trends – not necessarily about you and your circumstances.  It tells us that overall, there is no benefit in waiting and that conceiving earlier can reduce the chance of another loss, though we don’t know why.

We do know that miscarriages happen for many reasons that have nothing to do with pregnancy interval and that most of these reasons are beyond your control.  All you can do is the best you can with your own situation [4], and try again when you are ready and able to do so.

Notes:

[1] Kangatharan C, Labram S & Bhattacharya S Interpregnancy interval following miscarriage and adverse pregnancy outcomes: systematic review and meta-analysis.  Human Reproduction Update (2016) doi: 10.1093/humupd/dmw043

[2] Press release

[3]  Other adverse outcomes: pre-term birth, pre-eclampsia, low birth weight babies, stillbirth.

[4]  See here.