Conceiving After Pregnancy Loss – Is Waiting Beneficial?
A common question for providers following an early pregnancy loss is how long to wait before trying to conceive again. The authors performed a secondary analysis of a previous randomized controlled trial (RCT) to determine if there is any benefit to waiting after miscarriage by comparing time to pregnancy and live birth among couples based upon the time interval from fetal loss to attempting to conceive.
The authors found that in women who tried to conceive within a 3 month interval rather than waiting:
There was a statistically significant higher pregnancy rate – 68.9% compared to 51.1% (P< 0.01)
There was a statistically significant higher live birth rate – 53.2% compared to 36.1% (P<0.001)
After adjusting for age, race, BMI, education and subfertility, the 0-3 month group had a shorter time to achieve a pregnancy and shorter time to a pregnancy that resulted in a live birth
Waiting longer than 12 months may increase time to achieve pregnancy
There were no increased pregnancy complications in the 0 to 3 month group
The authors of this study (Obstet Gynecol, 2016) analyzed data from a well designed RCT that looked at the effects of preconception-initiated aspirin in women with prior losses (Lancet, 2014). In this present study the authors were able to compare 765 couples who attempted conception within 3 months to 233 couples who waited longer. The authors did adjust for aspirin therapy, although results did not show any significant effect.
This results of this paper do not support delaying pregnancy after a loss
The decision to conceive after loss may involve issues beyond physiological factors, which should be included in the informed decision making process between provider and patient
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