TTAL, no need to wait!

PoeMasque · February 2016

I haven't experienced a loss before, but I know many on this board have abs I've heard people talk about their OBGYN telling them to wait before trying again.....looks like that is an outdated practice (obviously if there are complications follow medical advice!).

this study clearly states there is no medical need to "rest" your body after a 1st trimester loss.

https://www.jwatch.org/na40397/2016/02/10/wait-over-attempting-conception-after-early-pregnancy-loss

MollySm · February 2016

My sister is a doctor, and after my loss a few years ago I asked her to look into it for me. She also came back saying that all research shows there is no need to wait. We started again right away. It's good that the info is finally getting out.

chloe97 · February 2016

I couldn't read the article, but I think you have to rest after a D&C because the lining need time to heal. One Dr told me 1 cycle another told me 2. I don't think my body was ready after 1 cycle because I didn't get pregnant and my period was a bitch. Hopefully the 2nd cycle will be the charm. I also know that it's important to follow HCG down go below 5 so that you can be sure there's no product of conception left in the uterus that could cause infectuon or other complications. Each case is different so you should consult with your doctor!

PoeMasque · February 2016

@chloe97 of your HCG is still above 5 your body won't ovulate anyway, so there's no risk of getting pregnant at that point and zero risk in trying (you just won't be successful). Retained POC normally cause continuous bleeding so most of the time women know when there's a problem (which is why you are supposed to return to the OB or go to the ER of you are going through more than a pad an hour or bleeding for longer than a certain amount of time). I agree that it's a good idea to check with your provider if something is off, but if not there's no reason to wait at all to try again and no higher risk of miscarriage even if you conceive right after.

chloe97 · February 2016

I'm not sure that I believe that you won't ovulate before your HCG is less than 5. I temped my first cycle after MC and confirmed ovulation and my HCG was somewhere between 30 and 15 based on bloodwork. I would feel comfortable trying again right away after a CP or pregnancy less than 6 weeks, but there are legitimate reasons to wait after a D&C. That article requires sign in so I couldn't read it, so Im not sure if addresses only natural miscarriages or also D&C, but I've never read anything anywhere that says it's ok to conceive the cycle after D&C. The lining needs to heal.

PoeMasque · February 2016

Here's the article text (it doesn't talk specifically about D&C and I wasn't suggesting trying right after a procedure, my post was about first trimester loss, which isn't specifically D&C)

As far as ovulating while HCG is still above 5, it's highly unlikely. Levels above 5 tell your body that you are pregnant, you body is made to NOT ovulate when you are pregnant. I'm sure there are rare exceptions, but it's very unlikely.

"Limited, flawed evidence underlies the recommendation that couples wait ≥3 months after an early pregnancy loss (i.e., <20 weeks' gestation) before attempting to conceive again. In a secondary analysis of a trial of preconception aspirin use among women with histories of pregnancy loss, investigators capitalized on the availability of self-reported data about timing of pregnancy attempts (not just the actual pregnancy events). Birth outcomes were stratified according to whether subsequent pregnancy was attempted within 3 months or longer than 3 months after early pregnancy loss or termination.

Of 1083 women, 77% attempted another pregnancy within 3 months of an early loss. Compared with women who waited longer, those who started trying to conceive within the first 3 months were more likely to achieve pregnancy that resulted in live birth (53% vs. 36%). Median time to pregnancy was shorter for those who started trying earlier (5 months vs. 6 months).

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High-quality data are accumulating to refute old recommendations to wait at least 3 months after an early pregnancy loss before trying to conceive again. In this era of patient-centered care, we should share these data with women who have experienced a pregnancy loss, many of whom are eager to attempt conception as soon as is “safe.” While reproductive life planning should take into account emotional and financial preparation, we must stop misinforming women that their bodies are physically unready for another pregnancy soon after a first-trimester loss."

chloe97 · February 2016

@PoeMasque Okay, so you are just referring to natural/medication assisted MCs, not those of us who had D&Cs. I still don't understand why Drs have to follow your HCG down if you can't ovulate before your levels are at 5 anyway?

PoeMasque · February 2016

As far as I can tell it was only referring to a loss not assisted by procedure, but it doesn't say. I think they follow your HCG down to make sure nothing is unknowingly retained. I often see women in the ER who are several weeks post miscarriage, but still bleeding or having bad cramping. Their HCG levels are tested and compared to previous levels as well as US and pelvic exam. They either go for a D&C or the OB comes down to remove any tissue within reach. If all tissue is removed, bleeding and cramping stop almost immediately (crazy,but I've seen it happen!), I assume they follow up with HCG levels to make sure they are dropping. It can take up to 6 weeks for HCG to drop below 5. I've often wondered if post loss HCG levels have to do with how far along you are...whether the placenta has fully taken over or whether you are still getting hormones from the corpus luteum.

This isn't my specialty area, but I do see women with pregnancy complications and early loss often (L&D won't usually see women until they are past 24 weeks).

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TTAL, no need to wait!

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