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If you’ve experienced any form of pregnancy loss, the first thing to do is to give yourself grace. It’s crucial during this devastating time to embrace as many resources as you need, for both your physical and mental healing. You’re allowed to grieve, rest, and nourish your body, for as much time as it takes to feel better. Accept support from loved ones, and know that you’re not alone (about 10% to 20% of known pregnancies end in miscarriage).
But when you’re ready to try to conceive once more, it can be challenging to know when and how to even start. Rescripted spoke with Dorothy Bestoyong, DO, an OB/GYN based in Orlando, Florida, to help us understand how soon after a miscarriage people can start ovulating, and, in turn, TTC.
How soon can I try to conceive after a miscarriage?
Ovulation occurs when a mature egg is released from the ovary, making its way down the fallopian tube and into the uterus, where it awaits potential fertilization from sperm. From a clinical standpoint, ovulation can restart within a few weeks after a miscarriage, says Dr. Bestoyong. “You can conceive again within a few weeks/months [after a miscarriage] as long as you resume having regular periods/cycles.” Keep in mind that post-miscarriage bleeding can last for two to three weeks.
Patients are also usually advised to refrain from sexual intercourse for two weeks after the miscarriage to give the cervix time to close and to reduce the risk of infection.
TTC after pregnancy loss is not just a case of physical healing, however. “I always recommend people to wait until they are mentally, emotionally, and physically ready,” says Dr. Bestoyong. There is no shame in seeking out professional mental health resources if you need help processing your emotions.
But if you feel ready to try again, Dr. Bestoyong advises “making sure that your cycles return to normal,” first. She also recommends cycle tracking to determine ovulation, as that “can increase chances of pregnancy.”
Why cycle tracking is important following a miscarriage
Dr. Bestoyong recommends tracking your menstrual cycle as it “will bring insight into how you can determine when you start to ovulate again” following a miscarriage. You can even do this on your smartphone! In addition to numerous “period tracker” apps, Apple allows users to track their cycles using the iPhone Health app or the Cycle Tracker on the Apple Watch.
Typically, ovulation will occur about 14 days before your next menstrual period. However, since periods can become irregular following a miscarriage, Dr. Bestoyong strongly supports cycle tracking after pregnancy loss. “[Miscarriage] is a stressor on the body, so an individual’s menstrual cycle may be off for a few months,” she says. But if your cycle remains irregular, then she advises seeing your healthcare provider for a further workup.
The most tell-tale signs that you’ve resumed ovulating after a miscarriage are a “change in discharge and possible ovulation pain/cramping,” says Dr. Bestoyong. These changes in vaginal secretions usually identify as an increase in clear, wet, and stretchy cervical mucus. The appearance of cervical mucus decreases just after ovulation. You can also check your basal body temperature (BBT; your body’s temperature at rest) in the mornings to determine when you’re ovulating, as your BBT increases slightly during ovulation.
Finally, an over-the-counter ovulation predictor kit, which tests your urine for a pre-ovulation hormonal surge, is another good way to know if you’ve started ovulating again.
Could miscarriage affect my overall fertility?
“There is a risk for subsequent miscarriage if there has been a history of miscarriage,” says Dr. Bestoyong. It’s important to keep in mind, though that “the miscarriage itself is not the cause of infertility.”
The good news is that most pregnant people who have experienced pregnancy loss don’t have a second miscarriage, with many of them going on to have healthy pregnancies. The risk of a second miscarriage is about 20%.
But if you’ve experienced recurrent pregnancy loss (two miscarriages or more), Dr. Bestoyong advises speaking with your OB/GYN or reproductive endocrinologist about further testing. These workups can include blood tests to figure out if there’s an issue with your hormones or immune system, or chromosomal tests to see if your chromosomes (or your partner’s) are having an impact on your pregnancies. An ultrasound or an MRI may also be recommended if your healthcare provider believes there’s an issue with your uterus.
Remember, there is no set timeline after a miscarriage. Once you receive medical clearance from your physician, when and if you want to start trying again is completely up to you. Make sure you maintain a healthy diet and lifestyle (don’t forget those prenatal vitamins!), seek out any necessary mental health support, and go at your own pace.
Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Visit her website here, or follow her on Instagram or Twitter.