A miscarriage or pregnancy loss is a very difficult event for any couple to go through. Usually there is a process of grieving before a couple wants to try again.
However, once they’re ready to try, the questions occur: When does ovulation restart after a miscarriage, is it safe to try to conceive and what are the chances of miscarriage happening again?
How Soon Does Your Menstrual Cycle Restart After Miscarriage?
You will usually have your first period after miscarriage about 4-6 weeks after a miscarriage or pregnancy loss. However, ovulation may occur (and you may be able to get pregnant) just 2 weeks after a miscarriage.
Some doctors recommend waiting until your period has restarted so that the date of a new pregnancy can be more accurately calculated based on your menstrual cycle. In general, we would advise you to work closely with your healthcare provider at this time.
Ovulation Test Kits
One of the best ways of knowing when you ovulate is to use an ovulation predictor kit (OPK).
These tests identify the LH surge (luteinizing hormone) that happens 24-36 hours before ovulation. It’s important to factor in that sperm can survive in a woman’s body up to 5 days, so if you have sex before ovulaion, there can still be sperm present to fertilize the egg.
Other Signs & Symptoms
Ovulation usually goes unnoticed in many. But there are some ovulation symptoms that most women can learn to track or pay attention to to help understand when to take ovulation tests:
Your Basal Body Temperature Falls
One of the most objective ovulation symptoms is that your basal body temperature drops a little bit just before your egg is released from your ovary. Then, 24 hours after the egg is released, your basal body temperature rises and stays up for several days. If you're trying to get pregnant, it's advisable to take your temperature to understand when you're ovulating.
According to Healthlink BC, Basal body temperature averages between:
36.1°C (97°F) and 36.4°C (97.5°F) before ovulation and
36.4°C (97.6°F) and 37°C (98.6°F) after ovulation
The changes in your cervical mucus over the course of your cycle also hold clues about when you might be ovulating.
If your cervical mucus is...
- Dry or sticky: It’s unlikely you’re ovulating
- Creamy cervical mucus: Ovulation may be coming
- Wet or watery: Ovulation may start soon
- Wet and stretchy (egg white texture): You may be at your day of ovulation
Your Cervix Softens and Opens Up
As you approach your most fertile time, your cervix softens. This is sometimes known as having a short, high, open and wet cervix.
You May Experience Slight Twinge or Cramping
Mittelschmerz translates literally as “middle pain” and is the name for the slight twinge or cramp that some women experience when the follicle releases the egg on the day of ovulation during your menstrual cycle.
According to the Mayo Clinic “Mittelschmerz pain occurs on the side of the ovary that's releasing an egg (ovulating). The pain may switch sides every other month, or you may feel pain on the same side for several months. Keep track of your menstrual cycle for several months and note when you feel lower abdominal pain. If it occurs midcycle and goes away without treatment, it's most likely mittelschmerz.”
Some Light Spotting May Occur
When the ovaries release the egg, a tiny follicle ruptures to allow the egg to be released. This can be a cause of spotting for a day or so.
Increased Libido or Sex Drive
The most well-known sign of ovulation is an increased sex drive.
Getting Pregnant After Miscarriage
There are two perspectives to consider when asking the question of whether you're ready for pregnancy after miscarriage: Are you emotionally ready and are you physically ready to start trying again?
While your body might return to normal soon after a miscarriage or pregnancy loss, at an emotional level, there’s usually grieving involved in the recovery process.
It’s important to take the time to mourn your loss and give adequate time for grieving. If this is a particularly difficult loss for you (and/or your partner) you might want to seek professional grief counselling or therapy to work through the complex emotions.
It’s important to acknowledge that this loss is different for every person, though comfort may be found in talking to others who’ve been through the same thing. At the end of the day, don’t compare your timeline to others. Take the time you need to grieve and recuperate before trying to conceive again.
Your healthcare provider will probably tell you to abstain from sex for two weeks after a miscarriage to prevent infection. Depending on the cause of your miscarriage they might make other specific recommendation about your care and when you should try again.
The WHO recommends waiting about 6 months before trying to conceive again. However, according to the American College of Obstetrics and Gynaecologists, there is no reason to wait that long for many women. They say:
“You can ovulate and become pregnant as soon as 2 weeks after an early pregnancy loss. If you do not wish to become pregnant again right away, be sure to use a birth control method. You can use any contraceptive method, including having an intrauterine device inserted, immediately after an early pregnancy loss. If you do wish to become pregnant, there is no medical reason to wait to begin trying again. You may want to wait until after you have had a menstrual period so that calculating the due date of your next pregnancy is easier.”
Outlook for Pregnancy After Miscarriage
Although miscarriages are very common, only 1% of women will have two or more miscarriages.
According to the Mayo Clinic:
“Miscarriage is usually a one-time occurrence. Most women who miscarry go on to have healthy pregnancies after miscarriage. A small number of women — 1 percent — will have repeated miscarriages.
The predicted risk of miscarriage in a future pregnancy remains about 20 percent after one miscarriage. After two consecutive miscarriages the risk of another miscarriage increases to about 28 percent, and after three or more consecutive miscarriages the risk of another miscarriage is about 43 percent.”
The likelihood of an early pregnancy loss increases as for older women. According to ACOG, early pregnancy loss occurs in more than one third of pregnancies in women older than 40 years.
Whatever you decide, it is a very personal decision if and when you try to get pregnant again after a miscarriage. Work closely with your healthcare provider to make sure you’re ready, emotionally and physically to try again.