Pregnancy After a Miscarriage or Abortion – When to Conceive Again

By BSc, MSc (embryologist).
Last Update: 06/28/2021

There are many women who, after going through a miscarriage or gestational loss, question whether they will be able to get pregnant again or if, on the contrary, the miscarriage will have affected their fertility.

In this regard, we must make a distinction according to the type of abortion. Pregnancy after a miscarriage is usually not a problem for most women. However, induced abortion and miscarriage with curettage may pose a risk to female fertility if not performed properly.

In any case, we must not forget that suffering a miscarriage can be a stressful situation for patients and can affect their emotional state. For this reason, it is sometimes recommended to seek psychological help before attempting a new pregnancy, either naturally or through assisted reproduction techniques.

Miscarriage Types

Miscarriage is the loss of the embryo before the 20th week of pregnancy. This can occur spontaneously (miscarriage) or induced (elective abortion). Depending on this, the effect on fertility and the woman's body will be more or less serious.

Miscarriage or spontaneous abortion

This type of miscarriage occurs naturally. The patient is aware that she is having a miscarriage because she begins to have bleeding and severe abdominal pain. Miscarriage most commonly occurs in the first few weeks of pregnancy. The earlier the pregnancy loss occurs, the lesser the possible consequences on female fertility.

In many cases, especially in more advanced abortions, it is required to perform what is known as a curettage. This is a gynecological technique that involves scraping the uterine walls to remove any embryonic tissue that may have remained in the uterus. As a surgical procedure, uterine curettage could compromise a woman's fertility if not performed correctly.

However, the need for curettage does not occur in all cases. Many women go through a miscarriage without it affecting future conceptions.

If recurrent miscarriages occur, the woman's situation must be analysed to determine the cause and to find a solution that allows the pregnancy to evolve. These types of miscarriages are associated with problems such as chromosomal alterations, advanced age, etc.

Voluntary or induced abortion

Induced abortion is what is known as voluntary termination of pregnancy, since it is the woman herself who decides to terminate the pregnancy.

In these situations, embryonic development is usually stopped by pills, which is called a chemical abortion chemical abortion. However, if it occurs beyond the first eight weeks of pregnancy, surgery must be performed and is called a surgical abortion.

When surgery is needed to stop the pregnancy, two methods can be used:

Aspiration
is most common if the abortion is induced before 12 weeks. Surgical vacuum aspiration abortion involves removing the embryo/fetus by suction using a syringe or vacuum pump. This procedure requires local or general anesthesia.
Dilation and curettage
is performed when aspiration is not possible. This involves causing the cervix to open and removing part of the lining of the cavity by scraping (curettage). The procedure is very similar to cases of curettage after miscarriage.

As with miscarriage, the earlier the miscarriage is performed, the less risk it poses. It is also essential that it is carried out by an experienced professional to avoid possible negative consequences.

Abortion Risks

Most health professionals describe abortion as a low-risk procedure with no serious effect on fertility and the achievement of future pregnancies. In fact, if the abortion has been normal and uncomplicated, a gynecological examination should not even recognize that the woman has gone through this situation.

Despite this (with the exception of early miscarriage), it is still a surgical procedure and, as such, has its risks. The main side effects of abortion that can lead to infertility are:

  • Tearing of areas of the female reproductive tract.
  • Vaginal Bleeding.
  • Infection of the genital tract.
  • Damage in the cervix.
  • Tearing in the uterus.
  • Perforation in the uterus.
  • Abscess inside the abdomen: if left untreated, it can lead to pelvic inflammatory disease.

In the case of a surgical abortion, in addition to the risk of injury to the uterus, other organs such as the bowel and bladder may be affected. In these cases, extra surgery will be needed to repair the damaged organ.

We must not forget that, although correctly performed it is a low-risk process, using non-professional methods to provoke an abortion can have serious consequences for the woman, not only for her fertility, but also for her general health.

Abortion and Pregnancy

Unfortunately, abortion is more common than we would like. Many pregnancies end in miscarriage in early stages of embryonic development. Many times, even before the woman discovers she was pregnant.

Most of these abortions are one-time cases and do not prevent a new pregnancy. The exception is recurrent miscarriages, the main reason for which is chromosomal malformation. We may also encounter difficulties in achieving conception after multiple curettages, as this increases the likelihood of uterine injury.

Another possible miscarriage-related process that could complicate conception is uterine dilatation. This procedure can weaken the uterus and lead to cervical insufficiency or incompetent cervix, i.e., a cervix that dilates prematurely. In many cases, this is solved by performing a cervical cerclage, a procedure that involves keeping the cervix closed with a stitch.

Assisted procreation, as any other medical treatment, requires that you rely on the professionalism of the doctors and staff of the clinic you choose. Obviously, each clinic is different. Get now your Fertility Report, which will select several clinics for you out of the pool of clinics that meet our strict quality criteria. Moreover, it will offer you a comparison between the fees and conditions each clinic offers in order for you to make a well informed choice.

FAQs from users

Is it true that you are more fertile after a miscarriage?

By Zaira Salvador BSc, MSc (embryologist).

Yes, it is not a myth. It has been scientifically proven that a woman is more fertile after a miscarriage, but only for a short time period.

Usually, the woman is "super fertile" for only around 4 to 6 weeks after miscarrying. After this period, her fertility will return to normal, which does not mean that it decreases.

However, this extra "amount" of fertility does not mean that you should get pregnant straight after a miscarriage, as your body might not be prepared yet.

Is it easier to get pregnant after a miscarriage?

By Zaira Salvador BSc, MSc (embryologist).

Assuming that you are emotionally ready, and keeping in mind that your fertility is higher after a short period of time after miscarriage, the answer to this question may be yes.

The chances for you to have a successful pregnancy after 1 miscarriage are 85%, and 75% after 2 or more. In fact, miscarrying in early pregnancy is so common that many doctors consider it a normal part of the conception process.

Under normal circumstances, trying to conceive immediately after a miscarriage is good, safe, and easier as long as you and your partner are ready. The odds of having another natural abortion are significantly lower if you TTC within the first 6 months of the initial miscarriage.

Sometimes, doctors advise waiting to try to get pregnant again until your cycle becomes regular again, as it will be easier for them to calculate the Estimated Due Date (EDD)—medically, it is counted from the first day of the last menstrual cycle.

When do you ovulate after an abortion?

By Zaira Salvador BSc, MSc (embryologist).

Abortions that are carried out without complications have no negative impact on the woman's fertility as a general rule. This means that your next ovulation is expected to occur about 2 weeks after the induced abortion.

How can you get pregnant after miscarriage before first period?

By Zaira Salvador BSc, MSc (embryologist).

It is possible to get pregnant in the first menstrual cycle after a miscarriage. The exact date of ovulation is difficult to calculate at this point, and for this reason using an Ovulation Test would be useful. However, experts do not recommend that women who have had a miscarriage try for pregnancy again so early, as it takes time for the body to recover from it, and for the woman to overcome the emotional aftermath.

Can you get pregnant after abortion pill?

By Zaira Salvador BSc, MSc (embryologist).

Yes, you can get pregnant again after abortion pill if you dot use any type of birth control. As explained above, if no complication or incidental occurs, you will ovulate again after 2 weeks after the abortion, which means that you can get pregnant again immediately. It is safe for you to go on to have a baby unless otherwise indicated by your doctor.

When should you see a fertility specialist after miscarriage?

By Zaira Salvador BSc, MSc (embryologist).

Anyone who has experienced 2 or more miscarriages should visit a fertility specialist (reproductive endocrinologist). The goal is to detect what is causing you to miscarry and apply the most adequate treatment. Common causes include problems like diabetes, genetic abnormalities in the embryo, thyroid disease, advanced reproductive age, structural problems in the uterus, etc.

Can you get pregnant after abortion while bleeding?

By Zaira Salvador BSc, MSc (embryologist).

Yes, you can get pregnant right after it, to be precise, as soon as 7-10 days after ending the pregnancy, even if you are still bleeding or spotting. For this reason, if you do not want to have another unplanned pregnancy, you should use a reliable birth control method right away. Read more: Which Contraceptives Really Work?

Can you get pregnant during your period after a miscarriage?

By Zaira Salvador BSc, MSc (embryologist).

After a miscarriage, you are likely to have one or two abnormal menstrual cycles until your ovarian function works with normality again. This means that you can have shorter or longer menstrual periods. If you have a short menstrual period, you could get pregnant. Get more info here: Is It Actually Possible for You to Get Pregnant While on your Period?

Suggested for you

We have talked about both induced abortion and spontaneous abortion; however, it is the latter that most worries women who wish to become mothers. For this reason, we leave you some information about it: Why Does a Miscarriage Happen? - Causes, Symptoms & Treatment.

We believe that it is important to know the signs of a threatened miscarriage in order to act in time to prevent it from occurring. Here we explain it in detail: What Does It Mean to Have a Threatened Miscarriage?

Our editors have made great efforts to create this content for you. By sharing this post, you are helping us to keep ourselves motivated to work even harder.

References

A Kulczycki, M Potts, A Rosenfield. Abortion and fertility regulation. Lancet. 1996 Jun 15;347(9016):1663-8. doi: 10.1016/s0140-6736(96)91491-9.

Elisabeth L Ahman, Iqbal H Shah. Contraceptive use, fertility, and unsafe abortion in developing countries. Eur J Contracept Reprod Health Care. 2006 Jun;11(2):126-31. doi: 10.1080/13625180500279813.

Hendricks, M. S., Chow, Y. H., Bhagavath, B. and Singh, K. (1999), Previous Cesarean Section and Abortion as Risk Factors for Developing Placenta Previa. Journal of Obstetrics and Gynaecology Research, 25: 137-142. doi:10.1111/j.1447 0756.1999.tb01136.x

McCarthy, F. P., Khashan, A. S., North, R. A., Rahma, M. B., Walker, J. J., Baker, P. N., … Kenny, L. C. (2013). Pregnancy loss managed by cervical dilatation and curettage increases the risk of spontaneous preterm birth. Human Reproduction (Oxford, England), 28(12), 3197–3206.

T Frejka. Induced abortion and fertility. Fam Plann Perspect. Sep-Oct 1985;17(5):230-4.

Yao Wang, Yun Sun, Wen Di, Yan-Ping Kuang, Bing Xu. Association between induced abortion history and later in vitro fertilization outcomes. Int J Gynaecol Obstet. 2018 Jun;141(3):321-326. doi: 10.1002/ijgo.12481. Epub 2018 Mar 27.

FAQs from users: 'Is it true that you are more fertile after a miscarriage?', 'Is it easier to get pregnant after a miscarriage?', 'When do you ovulate after an abortion?', 'How can you get pregnant after miscarriage before first period?', 'Can you get pregnant after abortion pill?', 'When should you see a fertility specialist after miscarriage?', 'Can you get pregnant after abortion while bleeding?' and 'Can you get pregnant during your period after a miscarriage?'.

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Author

 Zaira Salvador
Zaira Salvador
BSc, MSc
Embryologist
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV

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