- A Leading Fertility Expert’s Guide-
A miscarriage is the loss of a pregnancy before 24 weeks, with most miscarriages actually occurring during the first 12 weeks of pregnancy.
Miscarriages are rarely discussed but unfortunately are a fairly common part of the journey many couples experience on the path to starting a family. Despite affecting one in five pregnancies, many couples feel ashamed and guilty following the miscarriage. Here Dr Venkat, Director of the Harley Street Fertility Clinic explains why it occurs, when to try again and offers "Top Tips" on getting pregnant after a miscarriage.
Q1: Why do miscarriages happen?
A: There are many reasons why a woman may miscarry, but overwhelmingly the majority occur due to chromosomal abnormalities in the embryo that has implanted.
Although these abnormalities can stem from either the sperm or the egg, they tend to come from the egg rather than sperm. Eggs are just much more vulnerable given the fact that they have been lying dormant but growing fragile in the ovaries for decades, while sperm is made fresh continuously.
Q2: Will it happen again?
A: More than 85 percent of women who miscarry are able to get pregnant again and give birth to healthy babies, the anxiety of it happening again can be a very real concern, so it's important to have coping strategies for combating anxiety after a miscarriage. I think it’s important for my patients to focus on self-calming techniques, meditation, writing down, and working through negative thoughts as a means of combating anxiety around pregnancy.
Q3: How long should I leave it to try again?
A: Each case should be treated uniquely and when you decide you want to try again is dependent on many factors. In circumstances such as a molar pregnancy or ectopic pregnancy, a patient may be advised to wait a little bit longer before trying to get pregnant. Many doctors advise waiting until you have had at least one period after your miscarriage before trying again, as this makes it easier to calculate the dates in the next pregnancy.
This doesn’t mean that you are more likely to miscarry if you do conceive before then. There is even some evidence that conceiving in the first six months after a miscarriage actually lowers your risk of miscarriage next time. In most cases, you and your partner are the best judges of when to try again.
Q4: How long does it take to ovulate and get your period after a miscarriage?
A: The actual loss itself is usually accompanied by uterine bleeding, but that is not really what we call a period, it's just your uterus trying to clear itself out. Your first real period after a miscarriage will occur about 2 weeks after the first ovulation you experience after the pregnancy loss. If you have a lot of BhCG in your system, your ovulation could be delayed significantly until it drops closer to zero. But if you have a very early loss, with very low BhCG levels, then you may not even be aware of being pregnant as you may get a period nearly on time.
Q5: Could I be 5 weeks pregnant after miscarriage 2 months ago?
A: In short yes. Women can ovulate as early as 2 weeks following a loss, and if sexually active at that point they can become pregnant again that quickly. However, it is important to refrain after a miscarriage, when the blood pregnancy hormone in your system is back down to zero. It is the only real way to make sure that there is no residual pregnancy tissue left in the uterus. Sometimes small remnants can remain, and if they do remain, they can lead to future issues like diminished fertility or abnormal uterine bleeding. However, if your blood pregnancy hormone hits zero, and you feel physically well, then there is no reason why you shouldn’t try to conceive again.
Q6: What if more than one miscarriage is experienced?
A: If a woman has two or three miscarriages in a row, this is known as a recurrent spontaneous miscarriage. It is vital that this is investigated by a gynaecologist to solve the root of the problem.
If after vigorous testing into a patient’s health, the results are negative, then the chances of your next pregnancy being successful are fairly high. If, however, you are diagnosed with a problem, then it is more than likely that your next pregnancy will miscarry unless you seek treatment.
We are committed to informing our patients about miscarriages. We hold informative Instagram sessions in collaboration with our partners to discuss topics as infertility after miscarriage and baby loss. More information about miscarriages and recurrent implantation failure can be found in our webinar and podcast discussing miscarriages.
To find out more about miscarriages, please visit the Miscarriage Association's page.
