A miscarriage and all the complicated and devastating feelings and emotions that can come with it are unfortunately all too common. While they’re often not spoken about, the American Pregnancy Association states that up to 25% of all clinically recognized pregnancies can result in miscarriage. For couples who wish to get pregnant again, making the decision to move forward with trying to get pregnant again can be difficult and overwhelming.
We spoke with Rony T. Elias, MD, Assistant Professor, Weill Cornell Medicine for his expert advice in how to navigate trying again.
Dr. Elias stresses that miscarriages are very common and, “having one usually means that the couple is able to get pregnant and likely to have a live birth in the future,” which is reassuring. He explains that most miscarriages are often due to chromosomal abnormalities in the fetus, and that having one doesn’t predispose the woman to have another one.
Additionally, he explains that miscarriages rarely run in the family. If someone feels that many family members like their mom or sisters have had then it’s usually “because the family members typically reveal their reproductive history to loved ones.”
Dr. Elias also adds, “Most of your friends with many kids are likely to have had many miscarriages as well.”
Following a miscarriage, couples will undoubtedly have lots of questions and concerns, so it’s ideal to talk about these with your doctor. Dr. Elias explains, “Like almost everything else in medical care, there is no one size that fits all. While many medical diagnoses are ‘standard’ for the clinician, each patient as a unique case.” As a result, he suggests you discuss things such as how many miscarriages you have experienced, if you are ready to think about getting pregnant again, if there is any reason that explains the miscarriage, or any possible etiologies that can be looked at and/or treated.
While women are sometimes quick to blame themselves or seek reasons that were within their control, Dr. Elias clarifies, “The one standard idea that I have is that there is almost nothing that the couple could have done to cause or avoid a miscarriage except for smoking, drugs, etc.”
For couples who have been trying for a family for quite some time, or who have undergone extensive fertility treatments like IVF (especially if they have had products of conception testing that were revealed to be chromosomally normal) he recommends medical testing as well as, “extensive counseling about the different etiologies and to make sure the couple understands miscarriages are very common.” After two or more consecutive miscarriages, or one single miscarriage that was tested to be chromosomally normal, a patient should consider doing a full workup, Dr. Elias advises.
Immediately following a miscarriage, it can take time for your HCG hormone levels to drop and to your menstrual cycle to return. While there is no “ideal” time to try again, Dr. Elias says it is “very true” that sometimes following a miscarriage a woman is most fertile. He explains that once the pregnancy hormone is at a negative level, usually 4-6 weeks, and the couple is ready to try again, they are cleared. He adds, “There is an old notion, unfortunately still practiced by some physicians, to advise patients to wait six months before attempting again. More recent evidence not only shows that there is no value in waiting six months, but that soon after a miscarriage the chance of conception and live birth is higher.”
It’s important for a couple to have healed and coped with their loss prior to beginning again. While Dr. Elias says there is no objective measure for an emotional readiness, he explains, “Some women cope by trying again as soon as possible, while others need time to recover before they can try again.”
Just remember to do whatever feels right for you and your family and not get caught up in any social stigma that you may feel. This is a time to take care of yourself and your needs, and heal and move on in a way that feels natural to you.