How long do I need to wait before trying again after two miscarriage with D&C?

A miscarriage usually occurs because the pregnancy is not developing properly Miscarriage is very common in the first few weeks of pregnancy. Studies show that up to one in five women,who know they are pregnant, will have a miscarriage before 20 weeks. Most of these happen in the first 12 weeks.The actual rate of miscarriage is even higher because some women have very early miscarriages without ever realisingthat they were pregnant.
There is no right time to try for another pregnancy. Some couples decide they need time to adjust to their loss, while others want to try again right away. It is usually suggested you wait until after your next period before trying again. As it is possible to become pregnant again straight away, it is important to use contraception until you are ready to try again.
Brenda
Women’s Health Educator
Health Information Line, Women’s Health Queensland Wide

Women living in Queensland can also call our Health Information Line - a free information and referral service for Queensland women - on 3839 9988 or 1800 017 676 (toll free outside Brisbane).

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I am sorry to hear about your recent losses.

There is no specific time to wait before TTC again - you can try again this cycle, as long as there are no signs of infection after the D&C (fever, pain, ongoing bleeding, discharge).

It is a decision that is up to you and your partner. Some couples would like to try again immediately, others feel they would benefit from a little “break”.

In the meantime, stay positive and look after yourself. You might like to visit your GP for another chat about TTC and about how you are travelling emotionally.

It is recommended that you wait until you have built up your nutrient reserves before conceiving again.  This could take up to 6 months.  Pregnancy and miscarriage are very hard going on a woman's body in terms of the nutrients she needs to supply to the baby and the loss of blood through miscarriage usually causes a severe depletion of iron stores.  The stress of miscarriage is also taxing on both partners and remember it takes a healthy sperm and a healthy egg to create a healthy, viable pregnancy and baby.

The best way to ensure that you are in optimal health prior to conceiving is to follow a preconception care plan under the guidance of a naturopath who specialises in this area.  This will entail blood tests for both you and your partner and a treatment plan based on the results of those tests.

I would also highly recommend meditation and counselling to help you cope with the stress of your loss.

Importantly, there is NO medical evidence to support delaying conception after a miscarriage, beyond the time needed by you and your partner to heal emotionally from your losses. 

There is some suggestion that a conception occurring before the first menstrual period after a miscarriage may be at slightly higher risk of miscarriage, but certainly beyond the first period there is no additional benefit.  Additionally, as mentioned above, awaiting the return of your menstrual period allows easier clarification of your “dates” with your next pregnancy.

Miscarriage is a very common outcome of pregnancy; knowing this fact does not make the loss any less painful or cruel, but it does mean that one or even two miscarriages does not imply that an underlying disease process has caused them.  Having three consecutive miscarriages is a little unlikely, from a statistical point-of-view, and should prompt investigations for an underlying cause.  That said, frequently no cause is found.  That is not to say that you can't be investigated after two miscarriages, but the investigations can be invasive, and the likelihood of them turning up something is very small.

Of course, your individual management would depend on your particular circumstances, and in particular, your age.  The risk of miscarriage increases with age and, therefore, unnecessarily delaying pregnancy (out of belief of benefit after miscarriage) can be detrimental to overall fertility. 

Your GP is well-placed to assess your overall pre-pregnancy health as they are usually most familiar with your medical history.  Some women with complex medical histories may benefit from referral to a specialist for preconception management.

In short, it doesn't sound like you need to be put under a microscope.  After your next period, you and your partner can try to conceive again when you feel emotionally ready.  There is some evidence of benefit for couples who receive frequent review for support and reassurance during early pregnancy and, again, you may like to talk to your GP about this. 

I wish you all the best with your future pregnancies.

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