Learn when you can start trying again after a miscarriage.

By Chaunie Marie Brusie, RN, BSN

For women who have experienced a miscarriage, there is no "one size fits all" solution to grieving and living life after loss. Some women may be anxious to try again to expand their family while others may decide that pregnancy is not the best option for them at the moment.

Many women, however, are concerned about the health and safety of future pregnancies after experiencing a miscarriage and may wonder if there's a perfect time for getting pregnant after miscarriage.

"We generally recommend waiting two months," explains Dr. Zev Williams, M.D., Ph.D., director of the Program for Early and Recurrent Pregnancy Loss (PEARL) at Montefiore Medical Center and Albert Einstein College of Medicine in New York. However, Dr. Williams goes on to say, "it is most likely safe to try to conceive following one full menstrual cycle after the miscarriage."

Generally speaking, it takes a full two months for a woman to have her cycle return after experiencing a miscarriage. Waiting a full two months, or for a complete and normal menstrual cycle, (which generally takes about two months) ensures that the pregnancy hormone hCG has dipped to levels so low that it's undetectable and the uterine lining has returned to normal, making it receptive to receive a future fertilized embryo.

The timing and type of miscarriage can also impact the safety for future pregnancies. "It's important to make sure that your hormone levels and the uterine lining have returned to normal," says Dr. Williams. "And that can take longer when a pregnancy has been farther along."

With trying for a pregnancy following a miscarriage, the goal, explains Dr. Williams, is to "reset" the body by allowing a full menstrual cycle to occur. If a woman attempts pregnancy right away, before the pregnancy hormones from the miscarriage have cleared from her body, she may receive a false positive on a pregnancy test; Conversely, her doctor may mistakenly pick up falling pregnancy hormone levels from the miscarriage and deduce that she is miscarrying the second pregnancy.

How can you know for sure?

Unfortunately, the only way to know for sure if the pregnancy hormones have completely decreased down to "zero" is to receive a blood test to determine the level of pregnancy hormones in a woman's body. Although Dr. Williams admits that it may not be the standard of care in all offices to administer a blood test to a woman following a miscarriage, he encourages women to ask their doctors for the blood test, especially if they are hoping to try for another pregnancy as soon as possible. The further along in the pregnancy a woman is, the higher her pregnancy hormones will be, so it is important to allow enough time for the hormones to clear the body. In general, Dr. Williams recommends waiting about six weeks in the case of a first trimester miscarriage before asking for the hCG blood test as a confirmation that it is safe to try again for another pregnancy.

What about ectopic pregnancy?

Additionally, if a woman has experienced an ectopic pregnancy -- which is a pregnancy that occurs outside of the uterus, generally in one of the fallopian tubes -- she may need even longer to recover and heal before attempting pregnancy again. Dr. Williams states that the time frame for trying to get pregnancy after an ectopic pregnancy is longer and depends on whether the ectopic pregnancy was treated with medication or surgery and what type of surgery was performed. For instance, women who have been treated with methotrexate, a long-lingering medication that stops DNA synthesis, will need to wait a full six months to ensure that the medication is completely cleared from the body. Women who received surgery to treat an ectopic pregnancy (generally, the removal of the affected fallopian tube), can usually get pregnant after about two or three months.

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