Pregnancy After a Miscarriage or Abortion – When to Conceive Again

Both terms miscarriage and induced abortion refer to the termination of pregnancy, either incidentally or voluntarily. Whatever your case, terminating a pregnancy usually generates a roller coaster of emotions and feelings that vary from woman to woman. For this reason, experts recommend that you wait until you have overcome the loss both emotionally and physically.

The effects that it can have on future fertility depend on the type of abortion, that is, if it was natural or induced. The World Health Organization (WHO) recommends to wait at least 6 months before trying to conceive again. However, some experts have different opinions on this and affirm that starting earlier could be more beneficial.

The various sections of this article are assembled in the following table of contents.

Pregnancy termination methods

By abortion we refer to the termination or loss of a pregnancy before the 20th week of pregnancy, whether it is a miscarriage or spontaneous abortion, or an induced choice. Depending on the method used, the effects on future fertility and your chances of conceiving again can vary.

Miscarriage or spontaneous abortion

When a woman miscarries, it comes in the form of a heavy bleeding and a sharp abdominal pain that usually appears during the first weeks of pregnancy. The earlier the miscarriage occurs, the less severe the effects it will have on future fertility.

In some cases, and especially when the miscarriage occurs after the first weeks, your may be required to undergo a “cleaning” procedure known as curettage, whereby the uterine walls are scraped in order to remove any embryonic tissue that may be still remaining in the uterus. It is a surgical procedure, and as such, special care should be taken. Otherwise, it may affect the woman’s future fertility.

Going through a miscarriage does not translate into your future fertility being affected by default. However, if it turns into recurrent pregnancy loss (RPL), we recommend that you visit your doctor to have it checked and find the cause behind it. This way, you will be recommended the most effective treatment for you to have successful pregnancy. RPL is often caused chromosomal abnormalities, advanced maternal age, etc.

Induced or therapeutic abortion

Also known as Voluntary Termination of Pregnancy (VTOP), as it is the pregnant woman herself who voluntarily decides to terminate the pregnancy.

Normally, abortion is caused using abortion pills (chemical abortion), although surgery may be necessary if the woman wants to terminate the pregnancy from week 8 onwards. The proper medical term in such case is surgical abortion, and it involves certain risks in relation to the woman’s ability to get pregnant in the future, as in any other uterine surgery.

Surgical abortion procedures can be performed in two different ways:

Aspiration or vacuum
It is the most commonly used type of surgical abortion if done before week 12. The embryo/fetus is removed with a suction device or a vacuum pump. Local or general anesthesia may be required.
Dilation and Curettage (D&C)
It is the option of choice when performing an aspiration or vacuum is not possible. D&C involves causing the lining of the uterus to dilate in order to remove part of it by scraping it with a curette. The procedure is very similar to the one carried out in cases of miscarriage.

As in cases of miscarriage, the earlier an abortion is performed, the lesser the chances for fertility to be compromised in the future. To this end, turning to a duly qualified professional with experience in performing such procedures is crucial to avoid negative side effects.

Effects on future pregnancy

The vast majority of healthcare professionals consider a miscarriage or abortion as a low-risk event that has no significative impact on the woman’s fertility and her chances of getting pregnant in the future. In fact, if it happens as expected, it is likely to go unnoticed on future routine gynecological explorations.

In spite of that (except in the case of early pregnancy loss or EPL), one should not forget that it is a surgical intervention and, as in any other procedure where surgery is involved, various risks are present. The following is a summary of the side effects that are most likely to lead to infertility:

  • Damage to one or various areas of the female reproductive tract
  • Vaginal bleeding
  • Genital tract infections
  • Damage to the cervix
  • Uterine rupture
  • Uterine perforation
  • Abdominal abscess (if untreated, it can lead to Pelvic Inflammatory Disease or PID)

If you decide to terminate a pregnancy by means of a surgical abortion, you should know that, besides the womb, other organs such as the bladder or bowel may be damaged as well. In such cases, an additional surgical procedure may be necessary to repair the affected organ(s).

It should be clear that, even though it is a low-risk procedure if done properly, using non-professional methods to end a pregnancy can have very serious consequences on the woman’s fertility and her overall health.

Menstrual cycle & ovulation

Bleeding is a totally normal symptom after a miscarriage or an abortion. The duration can vary depending on the gestational age when the pregnancy loss occurred.

If it was an incomplete miscarriage, as explained earlier, your OB/GYN will perform a curettage on you in order to remove all the embryonic tissue that may be remaining in your uterus. After this procedure, bleeding for a few days is completely normal as well.

In both cases, we recommend that you abstain from sexual intercourse and do not start trying to conceive until your body has recovered completely from all the changes.

After an abortion, most women recover their ovarian function and have normal menstrual cycles again after 1 to 2 months. Throughout this time period, you are likely to experience a varied range of hormonal changes that vary from woman to woman.

Do not be surprised if you experience a delay in your first menstrual period after the abortion or miscarriage. Your menstrual period showing up is an indicator that your ovaries are working. In other words, that ovulation is taking place again.

Determining the exact day of ovulation during the first months after a pregnancy loss is complicated. For this reason, the risk for an unplanned pregnancy to occur will be higher.

How long to wait to try to conceive again

According to the World Health Organization (WHO)’s guidelines, women who have gone through a miscarriage should wait 6 months before trying to conceive again, as this is the estimated time a person needs to recover emotionally from such experience.

However, some studies suggest that trying to get pregnant again earlier than 6 months after the pregnancy loss has some benefits, including:

  • You are less likely to miscarry again
  • You are less likely to have an ectopic pregnancy
  • You are less likely to have a preterm birth or cesarian section
  • Your baby is less likely to have low-birth weight

Also, the answer to the question on how long to wait before trying to conceive agin is that it depends on the type of abortion and your gestational age when it occurred. Ending a pregnancy at an advanced gestational age (second trimester miscarriage) requires time and greater efforts to recover physically and emotionally, as overcoming emotions such as anxiety, fear, nostalgia, and guilt is more difficult in these cases.

Generally, experts do recommend that you wait for at least three months or have had two menstrual periods in a row before trying to conceive again in order to allow your body and mind to recover from the experience.

Chances of getting pregnant

Unfortunately, miscarriage occurs more often than one may expect. A large number of pregnancies end in spontaneous abortion, especially during the earliest stages of embryo development. At times, it happens even before the woman is aware that she is pregnant.

The good news is that the vast majority of natural abortions occur as an isolated event, and do not translate into experiencing trouble when trying to conceive again later. In other words, having miscarried once is not an indicator of a pre-existing female fertility problem or an abnormality in the organism.

As a matter of fact, statistics have shown that chances of getting pregnant in women who have had a miscarriage previously are the same as in women who have never miscarried before.

Recurrent Pregnancy Loss (RPL) is an exception to this. In most cases, RPL is caused by chromosomal malformations in the embryo. Also, having gone through various D&C procedures can lead to uterine damage and cause the woman to experience trouble conceiving in the future.

Cervical or cervix dilation is another induced procedure that is often associated with spontaneous abortions. It often leads to a weakened cervix, which may cause cervical incompetence or insufficiency—the cervix begins to widen earlier than expected. It can be treated through cervical cerclage, a procedure whereby stitches are placed in the cervix to hold it closed.

If you are considering undergoing a fertility treatment to have a baby and want to get estimates from different fertility clinics, we recommend that you use this useful tool: Cost Calculator.

Useful tips for succeeding

After a miscarriage or abortion, the emotional aftermath often causes women or couples to go through a grieving process in which understanding their feelings and maintaining hope may be complicated. For this reason, the following tips can help you endure this stage:

  • Hope is the last thing to die: As we have explained earlier, most natural abortions occur as one-off events. In fact, according to the American Society for Reproductive Medicine (ASRM), even in cases of recurrent unexplained miscarriage (RM), women of childbearing age have a 50/50 chance of having successful pregnancies in the future.
  • Be emotionally resilient: Resilience is the capacity to recover quickly from difficulties. Emotionally resilient people have the ability to understand emotions like grief. In cases of miscarriage, learning to cope with your feelings and being able not to throw in the towel are material steps to achieving a pregnancy in the future.
  • Increase your risk awareness: Unless yours is a case of RM, the causes of miscarriage are often associated with advanced maternal age (35 or over), chronic health conditions, chromosomal malformations, or bad habits such as smoking. Get informed on how to deal with whatever has caused you to miscarry and your chances of having successful future pregnancies.
  • Take care of yourself: Overcoming the emotional aftermath of a miscarriage or abortion ir a process that needs time, so don’t be afraid to take time to just take care of yourself physically and emotionally. If you need help to cope with grief, seek professional assistance. Receiving psychological counseling and expert emotional care can result in better birth outcomes in subsequent pregnancies.
  • Seek medical care: Especially if you have had 3 or more miscarriages in a row or a loss after 20 weeks, we recommend that you visit your doctor and talk about testing before trying to get pregnant again. Discovering what is causing you to miscarry is essential for its prevention in future pregnancies. Sometimes, a progesterone-based therapy helps prevent repeat miscarriages.

FAQs from users

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

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?

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?

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?

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?

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?

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?

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?

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

Although we have talked about both natural and induced abortions throughout this post, the most worrying type of abortion for the majority of women who are planning to get pregnant are spontaneous or natural abortions. For this reason, we recommend that you get more information by visiting this article: What Is a Miscarriage & How Common Is It?

As you may have guessed after reading this post, there exist various types of abortions based on what causes each and their characteristics. If you want to learn more about them, do not miss the following guide: What Are the Different Types of Miscarriages or Abortions?

After going through a miscarriage or abortion, many women wonder why their hCG levels are still high if there is no embryo development anymore. Check the following post to learn more about the reasons behind it and much more: hCG Levels After a Miscarriage or Medical Abortion.

2 comments

  1. Featured
    avatar
    lydia

    Hello! Just wondering if it’s normal to feel early pregnancy symptoms after a miscarriage… Is it possible that I’m pregnant again? It’s been 3.5 weeks since I miscarried and starting to have the first symptoms I had on my previous pregnancy… Pls, help!

    • avatar
      Sandra F.Fertility counselor

      Dear lydia,

      It is likely that the reason behind your pregnancy-like symptoms is due to pregnancy hormones still present in your blood system. It takes time for your hCG levels to diminish after a miscarriage (about 30 or more days on average). Because hCG is what causes the typical pregnancy symptoms in pregnant women, having nausea and other pregnancy symptoms during these time period is normal, especially if you miscarried later in the 1st trimester.

      See also: hCG Levels After a Miscarriage or a Medical Abortion.

      I hope this helps,

      Best wishes

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