There are many women who, after a miscarriage, gestational loss or abortion, question whether they will be able to become pregnant again or if, on the contrary, it will have affected their fertility.
To address this, a distinction must be made according to the reason the pregnancy ended. Pregnancy after miscarriage is usually not a problem for most women. However, induced abortion and curettage following miscarriage could 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 affect their emotional state. For this reason, it is sometimes recommended to seek psychological help before trying for a new pregnancy, either naturally or through assisted reproduction techniques
Provided below is an index with the 8 points we are going to expand on in this article.
Miscarriage is the involuntary interruption of pregnancy due to the loss of the embryo or fetus before the 20th week of pregnancy. Abortion is a medical procedure to terminate a pregnancy. Their effect on a woman’s fertility can be more or less serious, depending on how and when.
This occurs naturally. The patient is aware that she is having a miscarriage because she begins to have bleeding and severe abdominal pain. Most commonly, miscarriage occurs in the first weeks of gestation. The earlier the pregnancy loss occurs, the lesser the possible consequences on female fertility.
In many cases, especially when the pregnancy had advanced further, a procedure known as a curettage is often necessary. This is a gynecological technique that consists of scraping the uterine walls to remove any embryonic tissue that may have remained in the uterus. Being a surgical procedure, uterine curettage could compromise a woman's fertility if not performed correctly.
However, curettage is not necessary in all cases. Many women go through a miscarriage without it any effects on future conception.
If recurrent miscarriages occur, the woman's situation must be analyzed to determine the cause and to seek a solution that will allow the pregnancy to come to term. Spontaneous miscarriage is associated with problems such as chromosomal alterations, advanced age, etc.
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 means of a pill, called a medical abortion. However, if it occurs beyond the first eight weeks of pregnancy, surgery will be necessary and it will be called surgical abortion.
When surgery is necessary to terminate the pregnancy, two methods can be applied:
- is most common if the abortion is induced before 12 weeks. Surgical abortion by aspiration consists of removing the embryo/fetus by suction using a syringe or vacuum pump. This procedure requires local or general anesthesia.
- Dilation and curretage (D&C)
- is performed when aspiration is not possible. This involves opening the cervix and removal of part of the lining of the cavity by curettage. The procedure is very similar to cases of curettage after miscarriage.
As with miscarriage, the earlier it is occurs, the lower the risk. It is also essential that it is carried out by an experienced professional to avoid possible adverse consequences.
Most health professionals describe abortion as a low-risk procedure with no serious effect on fertility or future pregnancies. In fact, if the abortion has been normal and uncomplicated, a gynecological examination should not even reveal that the woman has had one.
Despite this (with the exception of early termination), it is still a surgical procedure and, as such, has its risks. The main side effects of an abortion that can lead to infertility are:
- Tearing of areas of the female reproductive tract.
- Vaginal hemorrhage.
- Genital tract infection.
- Damage to the cervix.
- Tearing in the uterus.
- Perforation of the uterus.
- Abscess inside the abdomen: if left untreated, this can lead to pelvic inflammatory disease.
In the case of a surgical abortion, in addition to the risk of injuring the uterus, other organs such as the bowel and bladder could be affected. In these cases, an extra surgery must be performed to repair the damaged organ.
We must not forget that when correctly performed it is a low-risk process. However, using non-professional methods to provoke abortion can have serious consequences on the woman, not only with respect to her fertility, but also on her general health.
Unfortunately, miscarriage and abortion is a more common occurrence than we would like. Many pregnancies end in miscarriage in early stages of embryonic development. Often, even before the woman discovers she was pregnant.
Most of these miscarriages are one-time cases and do not prevent a new pregnancy. The exception is recurrent miscarriages, where the main reason 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 consists of 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.
An Interview with Dr Guillermo Quea Campo
In an inteview with Dr. Guillermo Quea Campo, medical co-director and gynecologist at Pronatal Fertility Clinics, he tells us about how miscarriage affects a woman's fertility and her chances of becoming pregnant again.
Although a miscarriage is not per se an influence on future fertlity, if you have two miscarriages, whether consecutive or not, a study should be done to determine the reasons why, and if treatment is needed to prevent future miscarriages occuring. Natural pregnancy is possible after a miscarriage, just as it is before.
If the miscarriage was complete you can try for a baby again in the next cycle. However if you have had a curettage, is advisable to wait for a complete menstrual cycle to pass before trying for a baby again. The curettage, if done correctly does not risk the chances of future pregnancy.
Finally, a miscarriage due to a chemical pregnancy in IVF does not influence any furture attempts at trying to get pregnant in the future.
FAQs from users
Does abortion affect future pregnancies?
One in 4 pregnancies of a normal woman ends in first trimester abortion. It is a relatively frequent situation, therefore, but one that generates a great deal of concern in patients. In women over 35 years of age, the fundamental cause is chromosomal, that is to say, a genetic alteration of the embryo that hinders its implantation or evolution, fundamentally due to maternal age.
After having had one miscarriage, the risk of suffering another is 20%, but if you have had three or more, the risk increases to 45%.
There is really nothing to prevent this from happening, although it is important to maintain healthy habits, go regularly to gestational check-ups and take vitamin supplements. It is essential to try to overcome the upset and resume trying a couple of cycles after the miscarriage.
Can I try again to get pregnant after a miscarriage without waiting for a period?
Although there are studies that indicate that it is possible, many professionals recommend waiting at least one or two cycles after the miscarriage to start trying for a baby again. In any case, it will depend on the moment in which the miscarriage happened, the qualities of each woman, etc.
Will I achieve pregnancy after a miscarriage without curettage?
The usuala answer to this is yes. Many women suffer a spontaneous early miscarriage without any affect on their fertility. The worrying thing would be if this situation were repeated more than three times. In this case, we would speak of recurrent miscarriage and it would be necessary to do specific fertility tests to determine the cause.
Could I get pregnant after a miscarriage and before I have my first period?
Yes, it is possible to get pregnant during the first menstrual cycle after a miscarriage. The ovulatory period will be difficult to calculate and an ovulation test should be used for this purpose. However, it is not advisable to seek pregnancy so soon because the body has not yet recovered and it is possible that the woman' many not be emotionally recovered.
What is the treatment so that delayed abortion does not affect fertility?
A missed abortion or delayed abortion is defined as the arrest of embryonic development without expulsion of the embryo, i.e. when the embryo/fetus dies, but the woman's body is not able to expel it.
In this case, an induced abortion must be performed, usually by dilatation and curettage. It is also possible that it is carried out with specific medications for this purpose. In any case, it must be performed in an appropriate manner and by a specialist to prevent it from affecting the woman's fertility, and to prevent her from having problems in achieving a new pregnancy.
How long do I have to wait to have sex after a miscarriage?
The general recommendation is to avoid sexual intercourse for a period of two weeks after a miscarriage. In this way, it is easier to prevent possible infections. In addition, a woman may experience light bleeding after a miscarriage occurs.
I want to get pregnant fast after a miscarriage, is it possible?
Although the WHO recommends waiting about six months to seek pregnancy again, there are numerous studies that indicate that the sooner the pregnancy is resumed, the lower the chances of suffering a new miscarriage or other gestational complications.
The WHO recommendations are based fundamentally on emotional aspects, since miscarriage is a hard trauma and it is convenient to have overcome this grief and be prepared to face the new pregnancy with illusion. On the other hand, the studies that indicate that it is not necessary to wait to conceive again after the abortion are based on physiological aspects of the female body.
In any case, it is important to consult your doctor. Many specialists recommend waiting an average of two menstrual periods before trying again. However, this depends very much on the type of miscarriage that has occurred and the consequences of the miscarriage both physically and emotionally.
Will an abortion affect my fertility?
Generally speaking, the probability of achieving a pregnancy will be the same after having a miscarriage. In addition, women who have had a miscarriage in their lifetime have the same probability of becoming pregnant as women who have not had a miscarriage.
Special care should only be taken in women with several episodes of miscarriage, that is, in situations of repeated miscarriages. This is considered after 3 or more gestational losses. In these cases we would speak of a fertility problem and it would be necessary to carry out a more detailed study to evaluate the origin of the problem.
Is it advisable to do tests before attempting a new pregnancy after three miscarriages?
Yes, after 3 or more miscarriages it is considered a situation of recurrent or repeated miscarriages. The ideal would be to visit a fertility specialist to assess the origin of the problem and find the cause of the miscarriages.
Therefore, some tests such as karyotypes, ultrasound, hysteroscopy, hysterosalpingography, etc. can help the doctor to make a better therapeutic orientation.
Here we have discussed both elective abortion and spontaneous miscarriage. However, it is the latter that is of most concern to women who wish to become mothers. For this reason, here is some information on the subject: What is a miscarriage
We have also mentioned that, both in cases of miscarriage and voluntary abortion, it may be necessary to scrape the uterus to completely remove any embryonic remains. Do you want to know more about this process known as curettage? Click here: What is curettage?
Finally, we believe that it is important to know the signs of a possible miscarriage to be able act in time and prevent it from occurring. In this article we give a detailed explanation: Miscarriage warning signs.
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FAQs from users: 'Does abortion affect future pregnancies?', 'Is it true that you are more fertile after a miscarriage?', 'Is a pregnancy test reliable after having an abortion?', 'Can I try again to get pregnant after a miscarriage without waiting for a period?', 'Is it easier to get pregnant after a miscarriage?', 'If the abortion is induced, do I also have to wait 3 months to become pregnant?', 'Will I achieve pregnancy after a miscarriage without curettage?', 'Could I get pregnant after a miscarriage and before I have my first period?', 'What is the treatment so that delayed abortion does not affect fertility?', 'How can you get pregnant after miscarriage before first period?', 'Can you get pregnant after abortion pill?', 'How long do I have to wait to have sex after a miscarriage?', 'Can you get pregnant after abortion while bleeding?', 'I want to get pregnant fast after a miscarriage, is it possible?', 'Will an abortion affect my fertility?', 'Is it advisable to do tests before attempting a new pregnancy after three miscarriages?' and 'Can you get pregnant during your period after a miscarriage?'.
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