Trying to conceive after a pregnancy loss

After a pregnancy loss, many couples wonder when to begin trying to conceive again. Kati Molin/iStock/Thinkstock

A pregnancy loss, also called miscarriage or spontaneous abortion, is the unexpected loss of a fetus before the 20th week of pregnancy. After such a loss, many doctors recommend that couples wait at least 3 months before conceiving again. The World Health Organization recommends waiting at least 6 months. However, there’s little evidence to support such delays.

A research team led by Dr. Enrique Schisterman at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) investigated the link between how long couples waited after an early pregnancy loss before trying to conceive again and their success in achieving live births. The team analyzed data from a trial that took place from 2007 to 2011. The trial’s primary goal was to evaluate the effect of daily low-dose aspirin on reproductive outcomes in women, ages 18 to 40 years, with a history of pregnancy loss.

The participants were followed for up to 6 menstrual cycles and, if they became pregnant, until the outcome of their pregnancy was known. The investigators examined data from more than 1,000 of these women. Their analysis excluded women with pregnancy complications known to require longer follow-up care. Results were published online on January 7, 2016, in Obstetrics & Gynecology.

The researchers found that more than 76% of the women began trying to conceive within 3 months after losing a pregnancy. Compared to those who waited longer, this group was more likely to become pregnant (69% vs. 51%) and to have a pregnancy leading to a live birth (53% vs. 36%). The investigators didn’t find any difference in the risk of pregnancy complications between the groups.

“Couples often seek counseling on how long they should wait until attempting to conceive again,” Schisterman says. “Our data suggest that women who try for a new pregnancy within 3 months can conceive as quickly, if not quicker, than women who wait for 3 months or more.”

“While our data show no basis for delaying attempts at conception following a pregnancy loss, couples may need time to heal emotionally before they try again,” says first author Dr. Karen Schliep. “For those who are ready, our findings suggest that conventional recommendations for waiting at least 3 months after a loss may be unwarranted.”