Starting Out > Pregnancy Loss, Stillbirth or Neonatal Loss

Guide to Trying again after Loss


Guide to Trying again after Loss

At some point after a pregnancy loss you will start to think about trying again.  There is no right or wrong time to have these thoughts.  People who’ve not been through such a heartbreaking experience may be quick to offer lots of unhelpful advice  about needing more time or not leaving it too long or even offering the usual ‘have you thought about adoption’ or ‘you’re more fertile after a pregnancy/miscarriage’. 

It is normal to think about your next steps even in the very early days after loss and the guidance is that if trying to conceive naturally you can start as soon as the miscarriage bleed ends, as to avoid the risk of infection.  There is no set time given to wait anymore, although many GPs advise waiting for one period just to help you calculate dates more effectively.  However needing fertility treatment adds in many other aspects to your decision.  Many ladies do go on to have healthy pregnancies and babies after a loss and sometimes this takes time and a different approach to medication and treatment.  The most important thing to keep with you is hope. 

How long should I wait?

Most clinics advise a wait of 2-3 AF (period) cycles before commencing treatment such as IUI, IVF, ICSI or FET.  This is to ensure you have recovered physically from the pregnancy and that your cycles are back to normal so that you have the best chance of your next treatment cycle working for you.  After ectopic or molar pregnancies the guidance is normally longer, around 6 months, due to the drugs given.  With a late miscarriage or still birth the clinic may want confirmation from testing or a post mortem that there were no issues with the baby (such as genetic ) that may result in the need for extra treatment options such as PGD (Pre-implantation genetic diagnosis). 

You may be classed as having experienced recurrent miscarriages.  Usually the NHS class this as having 3 or more first trimester losses or 1 second trimester loss, however each case should be assessed individually and in some circumstances women have managed to secure testing after 2 early losses due to the need to fertility treatment.  Once you have been diagnosed with recurrent miscarriages you will be referred to a recurrent miscarriage clinic and offered tests.  A guide to these tests and investigations can be found in the immune section of FF

Every case is different and so a review appointment at your fertility clinic will enable you to plan your next steps on the options available to you.  Most clinics include a review appointment in with each cycle of treatment so this doesn’t normally incur an extra cost.

There is also the emotional recovery to consider before trying again.  Fertility treatment cycles are hard, more so after a loss.  You need to make sure you are strong enough to cope with the drugs, increased clinic visits and things not going to plan.  It is important to remember that even a scan showing less follicles than expected or a thinner lining can really knock you back at the best of times.  It is really hard not to compare treatment cycles, even though every cycle is different, you will be thinking about how many days you stimmed for last time and will be analysing every 2ww symptom even more closely.  You also need to be prepared that sadly this cycle may not be successful and you will have all the emotions of a BFN to deal with too.

Financial implications have a major part to play in the timings too, fertility treatment is expensive.  It may be that you want to research other options such as treatment abroad or egg sharing to help with these costs.   

How do I cope with the wait?

Once you’ve made the decision to try again it is natural to want to start straight away and get things moving but for many different reasons there will be a wait.  As frustrating as it can be this is an ideal time to make any life style changes you’ve been thinking about.  Loosing a few pounds, becoming healthier, starting on the vitamins or supplements are all positive steps before starting a new cycle.  Some people find taking up a new hobby helps occupy their time too.

Going through treatment after loss

No matter how much you’ve willed the time away to start again, once it becomes more real, such as the drugs arriving, the nerves kick in.  Lots of emotions resurface and you may find you are thinking much more about the baby you lost.  There is a really supportive trying again after loss thread and charities like SANDS  can offer help and support at this time too.  Many clinics offer counselling services too and this maybe something that is of benefit during your cycle.

Pregnancy Test Results

Getting a negative pregnancy result after trying again is heartbreaking.  It can feel like the pregnancy you lost was your only chance and it can take you back emotionally to how you felt after loosing your baby.  This is all normal and although it is hard to believe at the time, the days won’t feel so dark forever.  There are many supportive threads on Fertility Friends to help you through this but ultimately be gentle on yourself.  Take time to be sad and angry and do whatever you need to get through it.

Here are links to threads you might find helpful Negative cycles  Coping after pregnancy loss .

Since deciding to try again one thing you’ve probably dreamed about is being pregnant again.  It is fantastic to get a BFP but these can also bring a wide mix of emotions after a loss.  You may worry that you will loose the baby again and depending on the stage of pregnancy when your previous loss occurred you may find you’re unable to relax or feel happy until you pass this stage.  The usual early pregnancy worries of symptoms/lack of symptoms can be heightened and you will no doubt compare this pregnancy to your last.  There is a fantastic pregnant after loss thread  where all the ladies have experienced previous loss/losses at various stages and truly understand how scary a new pregnancy can be. 

Your GP may refer you to your local EPAU (Early Pregnancy Assessment Unit) as most offer an earlier scan to ladies who’ve experienced previous loss, usually from 7 weeks.  Depending on the circumstances and timing of your previous loss you may have a special care plan in place for this pregnancy.  Particularly in the case of later losses you should be offered extra support and monitoring.  This is often something discussed at a post mortem review and should then be implemented once you are pregnant again.  Don’t be afraid to speak to your midwives and consultant about your concerns and worries.  SANDS  are another great source of support.

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