How Long After a Miscarriage Can You Try Again?

Oct 22

I’m a reproductive endocrinologist and miscarriage specialist who's been helping people build families for over 15 years. A miscarriage can be a devastating loss, and if you’re trying to build a family, one of the first things you might be wondering is when you can try again.

In this blog post, I want to help you learn more about miscarriage (and how common it is) and understand the evidence we have about trying again. I hope you’ll be kind to yourself and empowered to learn more about your personal situation with your doctor.

Let’s get started.

Miscarriage is common.

First of all, if you are reading this post because you’ve had a miscarriage, I am so very sorry. It is a horrible loss. The media and movies have conditioned us to think that the process of having a baby is fast and predictable—from a positive pregnancy test in one scene to delivering the baby in the next—when, in reality, the road to building a family can be quite challenging for some.

I want you to know that miscarriage is much more common than you might realize. One in every four clinically recognized pregnancies ends in miscarriage. If you include earlier losses called biochemical pregnancies (positive pregnancy test followed by a late period), that occurrence could be as high as 70 percent.

Because miscarriage is common doesn’t mean it’s okay or you shouldn’t grieve the loss. Miscarriage is a loss, and it deserves and often requires emotional recovery in addition to physical. It’s important to know that the most common cause of miscarriage in the first trimester is usually a chromosome imbalance in the embryo, which is out of your control. I hope you realize that miscarriage is common, human reproduction is inefficient, and you can stop blaming yourself. You are not broken.

The majority of miscarriages occur in the first trimester.

For this blog post, I’ll focus on trying again after experiencing loss in that timeframe. The first trimester is the first 12 weeks of pregnancy. Eighty percent of miscarriages will occur in the first trimester, sometimes called a spontaneous abortion.

(If you have a pregnancy loss after 13 weeks, ectopic pregnancy, or molar pregnancy, please talk to your healthcare provider or fertility specialist about when you should try again.)

Before trying again, make sure the pregnancy is resolved.

There are no clear guidelines on when to start trying after a miscarriage, so don’t be surprised if you hear different recommendations from different healthcare providers.

However, no matter what, it’s important to ensure the pregnancy is completely resolved before trying to conceive again. Sometimes people experience heavy bleeding and/or cramping, and when that’s over, they’ll assume that everything is out of the body. Talk to your doctor about recommendations, but sometimes ultrasounds or pregnancy hormone blood tests are used to ensure the pregnancy is fully resolved.

Ensure that you are mentally recovered before trying again.

In addition to physical recovery, please check in with your mental health before trying again after a miscarriage. This is deeply personal, and I would recommend seeking support from trusted people—your healthcare team, your partner if you have one, or a therapist—to give yourself the space and grace to heal emotionally.

There is conflicting evidence about when you can try again after experiencing a first-trimester miscarriage.

I’ve heard many different recommendations on trying again in my medical training. Whether it was in medical school at Wake Forest University, residency at UCSF, or my fellowship at Stanford, attendings would make different recommendations. This is because there’s no solid evidence on the exact suggestion for each patient. We’re all different, and each pregnancy is unique.

One recommendation I heard in training is to wait three to six months before trying again. However, waiting for three to six months can be excruciating if you are ready to be a parent. If you get this time period from your provider, please ask them to expand on their reasoning for this recommendation for your personal situation. (They might have a good reason, so it doesn’t hurt to ask.)

For most first-trimester miscarriages that are completely resolved, you do not need to wait for three to six months. The American Board of Obstetricians and Gynecologists says to (generally) wait to have intercourse for one to two weeks after a miscarriage so your body has time to heal.

In terms of what I advise my patients, I recommend refraining from actively trying until they get a period after miscarriage. This gives the body time to heal (pelvic rest) and reset back into its cycle.

If you haven’t gotten your period within six to eight weeks of miscarriage, please get in touch with your doctor to ensure everything is okay.

You are not broken.

I want to say this one more time: I'm so very sorry for your loss. It is not your fault, and I hope you find the support you need. Your medical team is there to help with your personal situation, and your doctor will give you the best recommendation.

If you have questions, please comment on my YouTube video. I hope this was helpful. For an additional resource, my book Not Broken: An Approachable Guide for Miscarriage and Recurrent Pregnancy Loss is for anyone who wants to learn more about recurrent first-trimester miscarriage.

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Lora Shahine, MD

Dr. Lora Shahine, reproductive endocrinologist at Pacific NW Fertility and Clinical Assistant Professor at the University of Washington in Seattle, completed her residency in OBGYN at the University of California in San Francisco and fellowship in reproductive endocrinology at Stanford University. She is dedicated to educating and advocating for increased awareness of infertility, miscarriage, and the impact on environmental toxins on health through an active social media presence, teaching, clinical research, and authoring multiple blogs and books including best selling, ‘Not Broken: An Approachable Guide to Miscarriage and Recurrent Pregnancy Loss.’