Written by: Dr. Amy Beckley, PhD, Founder and Inventor of the Proov test — the first and only FDA-cleared test to confirm successful ovulation at home.
Written on 10/15/21
**Trigger warning: This blog discusses miscarriage and early pregnancy loss.
Keep reading to learn more about pregnancy after miscarriage.
When my husband and I were trying to conceive, we endured a total of 7 miscarriages. I know first-hand that any loss, no matter how far along you are, can be devastating.
If you have recently experienced a pregnancy loss, please know the entire Proov team is here to support you. We want to help you get that rainbow baby as soon as possible. Keep reading to learn more about pregnancy after miscarriage.
What causes miscarriage?
When we think of miscarriage, we tend to think of early pregnancy losses since the occur more frequently. But, medically speaking, a miscarriage is any loss which occurs before week 23 of pregnancy.
As we mentioned though, most miscarriages occur in the first trimester and the likelihood of miscarrying drops drastically once a heartbeat has been detected.
There are many causes for miscarriage and they can differ depending on how far along the pregnancy is:
Chromosomal abnormalities
Every human embryo has a total of 46 chromosomes, or 23 pairs, which carry our DNA. Sometimes, by pure coincidence or because one of the parents has a certain genetic disorder, an embryo may have too many or too few chromosomes.
When this happens, the embryo often cannot survive. The mother’s body will recognize this issue, often resulting in miscarriage. It’s important to note that not all chromosomal abnormalities end in miscarriage, such as those with Down syndrome or Turner syndrome, among others.
Failure to implant successfully
Sometimes, the embryo fails to implant into the uterine lining. Often, insufficient progesterone production during the luteal phase causes failed implantation since without progesterone, the uterine lining can’t be fully receptive to an embryo.
Progesterone stabilizes the uterine lining and makes it “sticky” enough for an embryo to implant during the implantation window (about days 7-10 past peak fertility). If progesterone levels do not remain elevated to a healthy level across the entire implantation window, it can be more difficult for successful implantation and pregnancy to occur.
While scientific controversy still surrounds low progesterone as a cause of miscarriage, a recent British study concluded progesterone supplementation might prevent as many as 8,500 miscarriages in the United Kingdom alone. This finding held particularly true in women who experienced recurrent miscarriage or bleeding in early pregnancy.
Exposure to toxins
Exposure to toxins and pesticides can happen just about every day. As hard as we try to avoid it, endocrine disruptors are everywhere: in the plastic surrounding us, the toiletries we use daily, the cleaning products in our house, even in our food. Studies show that environmental exposure, specifically to endocrine disruptors, can cause miscarriages.
Incompetent cervix
Incompetent cervix usually occurs in the second trimester. The cervix protects the fetus from the outside world like a barrier and keeps it inside the uterus until the end of the pregnancy.
In the event of incompetent cervix, the cervix shortens and opens too soon under the weight of the growing baby and lets vaginal bacteria into the uterus. Infection weakens the membranes which surround the fetus and may cause preterm premature rupture of the membranes (PPROM), which ultimately can cause premature birth.
When incompetent cervix occurs before the 24th week of pregnancy (when a fetus is considered to have reached viability), it’s a second trimester miscarriage. Cervical incompetence can also occur in subsequent pregnancies.
Cervical incompetence can also occur in subsequent pregnancies.
Other reasons
A few other causes of miscarriage includes infections (such as sexually transmitted infections), uterine abnormalities, and uterine fibroids, among others. If you are concerned about the causes of miscarriage, we recommend reaching out to your doctor.
How soon can you get pregnant after miscarriage?
How soon you can get pregnant after miscarriage varies from person to person; there is no standard amount of time. As with any cycle, you can get pregnant after a miscarriage as soon as you ovulate.
Before you can ovulate, however, your hormones that control ovulation need to return to baseline levels and your body needs to heal. This can depend on how far along you were in your pregnancy. We always recommend consulting your doctor about how soon you can start trying again, as every situation is different.
For some women this happens immediately after a loss, as if the miscarriage was a normal period. But For others, it can take much longer. Getting back on track after a chemical pregnancy physically often takes less time than recovering after a second trimester loss.
Of course, the most important thing is to make sure you are ready, both physically and mentally, before starting to try again. A loss is a loss, no matter how far along, and we recommend being gentle with yourself by taking the time you need to grieve and move forward.
Is there a risk of having another miscarriage?
Unfortunately, roughly 15-20% of all known pregnancies end in miscarriage. However, a second miscarriage occurs in only about 2% of women and a third in one 0.5% of women.
It’s important to note that having one miscarriage doesn’t necessarily mean you’ll have another, just as it doesn’t mean you can’t go on to have a perfectly healthy pregnancy the next time.
Better understanding your potential risk for a subsequent miscarriage depends on what caused your miscarriage in the first place. This, of course, is easier said than done as it can be difficult to pinpoint the exact cause of a pregnancy loss, especially if it occurs at home without further testing.
About half of early miscarriages are due to chromosomal abnormalities. If these genetic issues are inherited, the risk of having another loss with the same cause may be higher. Chromosomal abnormalities can also be spontaneous flukes, meaning they’re unlikely to happen again.
The other half have different causes, and unless you identify and address the cause, you may endure recurrent losses. Repeated miscarriages occurs in instances such as low progesterone levels, intrauterine infections, incompetent cervix, blood clotting issues, and endocrine disrupters.
After pregnancy loss, we always recommend following up with your doctor for further testing and to address any potential problems.
After pregnancy loss, we always recommend following up with your doctor for further testing and to address and potential problems.
After a miscarriage, what can I do to give myself the best possible chance at pregnancy?
Miscarriage is never your fault, no matter how much it feels like it. While pregnancy is never a guarantee, there are certain things you can do to put your best foot forward.
Lead a healthy lifestyle
A healthy lifestyle is one of the main steps towards a healthy pregnancy. Eating a well-balanced diet, with green, leafy vegetables, lean proteins, and natural vitamins can get you the right nutrients to promote a healthy cycle. This includes limiting sugar, saturated fats, processed foods, alcohol, and caffeine.
You can also try taking a prenatal vitamin to help up those critical nutrients for conception. Always be sure to check with your doctor before adding anything new to your regimen!
Confirm successful ovulation
Successful ovulation refers to an ovulatory event in which an egg is released and PdG (progesterone marker) levels remain adequately elevated for long enough during the implantation window. Confirming successful ovulation can help you identify low levels that could potentially hurt your chances at successful pregnancy.
In fact, recent studies* show that elevated PdG levels during the luteal phase lead to a 92% chance of successful pregnancy, compared to just a 19% in those with lower-than-ideal levels.
Luckily, you can confirm successful ovulation with Proov Confirm — the first and only FDA cleared PdG test to confirm successful ovulation at home. Testing with Proov PdG tests on days 7-10 past peak fertility gives you valuable insight into the quality of your ovulation and chances of successful pregnancy.
Even better, when paired with the free Proov Insight app, you can take your Proov Confirm results one step further with numeric hormone values, info on what they mean, and personalized action plans to help you move forward. It’s like having a fertility coach in your pocket!
If you and you partner have endured miscarriage, we are so sorry for your loss but hope that you are taking the time and best next steps for you. If you ever need support, we invite you to join our private support group here.
*Rothchild I. Role of progesterone in initiating and maintaining pregnancy. In: Bardin CW, Milgrom E, Mauvais-Jarvis P, editors. Progesterone and Progestins. New York: Raven Press; 1983. p. 219.
