January 12, 2016

Trying to Conceive Soon After a Pregnancy Loss May Increase Chances of Live Birth

BETHESDA, Md -- January 12, 2016 -- Couples who attempt to conceive within 3 months after losing an early pregnancy, defined as less than 20 weeks gestation, have the same chances, if not greater, of achieving a live birth than those who wait for 3 months or more, according to a study published today in Obstetrics & Gynecology.

The finding questions traditional advice that couples should wait at least 3 months after a loss before attempting a new pregnancy. The World Health Organization (WHO), for example, recommends waiting a minimum of 6 months between a pregnancy loss and a subsequent attempt.

“Couples often seek counselling on how long they should wait until attempting to conceive again,” said senior author Enrique Schisterman, PhD, National Institute of Child Health and Human Development (NICHD), part of the National Institutes of Health (NIH), Bethesda, Maryland. “Our data suggest that women who try for a new pregnancy within 3 months can conceive as quickly, if not quicker, than women who wait for 3 months or more.”

Previous studies of pregnancy spacing have focused on when women should become pregnant after experiencing a loss, but few have addressed the question of when couples should start trying to conceive.

For the current study, researchers analysed data from the Effects of Aspirin in Gestation and Reproduction (EAGeR) trial, a multisite block-randomised, double-blinded, placebo-controlled trial that took place from 2007 to 2011. The trial, which evaluated the effect of daily low-dose aspirin on reproductive outcomes in women with a history of pregnancy loss, enrolled 1,228 women aged 18 to 40 years.

The researchers concentrated on 1,083 of these women -- more than 99% of whom had lost a pregnancy at less than 20 weeks gestation. None of the women had an ectopic pregnancy or a molar pregnancy. The participants were followed for up to 6 menstrual cycles and if they became pregnant, they were followed until the outcome of the pregnancy was known.

The researchers found that more than 76% of the women attempted to conceive within 3 months after losing a pregnancy. Compared with those who waited longer, this group was more likely to become pregnant (69% vs 51%) and to have a pregnancy leading to a live birth (53% vs 36%). The investigators did not observe any increase in the risk of pregnancy complications in this group.

“While we found no physiological reason for delaying attempts at conception following a pregnancy loss, couples may need time to heal emotionally before they try again,” said Karen Schliep, PhD, NICHD Epidemiology Branch. “For those who are ready, our findings suggest that conventional recommendations for waiting at least 3 months after a loss may be unwarranted.”

SOURCE: National Institutes of Health

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