24/10/2023 - 4 min read
Can a miscarriage affect your fertility?
Miscarriages can be devastating, especially if you have undergone fertility treatment or have been trying for a long time to pregnant in the first place.
“From a fertility Doctor’s point of view, despite miscarriage being a very upsetting and unwanted complication of pregnancy, it’s an encouraging sign because if you have managed to get pregnant once, you'll get pregnant again”
Often, women can feel utterly helpless, as do their partners and immediate family. This often leads to statements from your loved ones which are meant to be helpful and encouraging but in fact, are anything but. "Don't worry, you can always try again' or words to that affect can be hurtful and make you feel worse. Remember, your body has areas undergone many changes in anticipation for the pregnancy and simply cannot just reset itself instantly.
It is essential therefore, that following an unexpected pregnancy loss, irrespective of how many weeks pregnant you were, you need to grieve, and grieve properly. Often you are grieving for the child you never saw which can be particularly difficult.
Commonly, we have a misconception of what a miscarriage or pregnancy loss is, especially when it happens in the early stages. We have this perception that inside the uterus there is a tiny well-formed baby, hanging on by his fingertips, shouting "please mummy, don't let me fall out," and somehow when it happens, it is our fault.
Well, this is simply not true; a good number of human embryos that are created either naturally or in the laboratory, as with IVF, are chromosomally abnormal. As we get older, the number increases. When a woman reaches the age of 35 this can be over 50 percent. By the time she reaches 40, over three quarters of the embryos she creates are, in fact, chromosomally abnormal.
The female human body has a very sophisticated mechanism of recognising these fetal anomalies: the messages sent to the uterus from the growing baby result in one of two things happening: either, the uterus just lets the abnormal embryo pass through the body without allowing it to implant into the wall of the uterus, or if it is unsure, the uterus will allow it to implant. The body will then monitor the growth and development of the baby for a few days or weeks. If the baby is normal, the uterus will keep hold of the developing pregnancy. If it detects a significant abnormality, the uterus will let the pregnancy go or expel it.
Ninety seven per cent of all early miscarriages, i.e. those before 12 weeks gestation, are chromosomally abnormal.
If you think of it another way, the commonest chromosomal abnormality is Downs Syndrome.
It is estimated that for every one hundred Downs babies conceived, only one is ever born, the remaining ninety nine per cent will be lost through miscarriage.
As a general rule of thumb, up until twelve weeks of pregnancy, by far the commonest cause of miscarriage is through fetal abnormality. After twelve weeks of pregnancy, it becomes less likely that the baby is abnormal and more likely that there is a maternal component to the miscarriage.
It is for these reasons that if a pregnancy threatens to miscarry, it is often best to let nature take its course. There is very little a doctor can do to stop an early pregnancy from miscarrying. Giving lots of hormones is not the answer. If a pregnancy is normal, it will stay put and simple advice such as rest will suffice. If the pregnancy is abnormal, the chances are, it will not survive.
It is uncommon for a normal pregnancy to miscarry in the first twelve weeks.
One final point; it is a complete myth that you should not try for another baby immediately following a miscarriage. There is no scientific basis for this unless you have suffered a medical or psychological complication. As a matter of fact, it’s quite the opposite. Women tend to be more fertile following a miscarriage.
From a fertility doctor’s point of view, despite miscarriage being a very upsetting and unwanted complication of pregnancy, it’s an encouraging sign because if you've got pregnant once, you'll get pregnant again. Except this time - with a bit of luck - it will have a better, happier outcome.