Subsequent Fertility

A study published on BMJ.com concludes that the form of treatment a woman receives after early miscarriage does not affect her future fertility. Furthermore, 80% of all women who have this type of pregnancy loss go on to have a healthy baby within five years of suffering a miscarriage.

Wait And See

Miscarriage spells the end of a pregnancy 15% of the time. For many decades, the treatment of choice for a miscarriage that occurred early on in the pregnancy was the surgical removal of the parts of the pregnancy that were retained by the uterus. At some point, physicians changed their thinking about this practice and began to offer women a chance to wait and see if the miscarriage could occur naturally without surgical intervention. In other cases, women were offered medication to expedite the process.

Studies have shown that these methods all have similar rates of outcome in terms of infection. One such trial included a very large published trial known as the MIST trial. But none of these clinical studies explored the long-term effects of these methods on a woman's future fertility.

As a result of this lack of data on the subject, researchers in England's South West decided to compare the fertility rates of women treated for miscarriage according to the three standard managements methods: expectant (wait and see), medical (drug treatment), or surgical. To this end, the researchers tracked down 762 women from the earlier MIST trial that had been treated for early miscarriage or miscarriage that occurs before 13 weeks of gestation. The women filled out a questionnaire relating to pregnancies after miscarriage and their previous birth histories.

Live Birth

Researchers then analyzed the questionnaires and found that overall, 83.6% became pregnant after miscarriage and 82% were able to report a live birth. The length of time between miscarriage and subsequent pregnancy was around the same, no matter how the miscarriage was managed: 79% in the expectant management group, 78.7% of the medical group, and 81.7% of the surgical group managed a live birth five years post-miscarriage.

On the other hand, women in the upper range of their childbearing years as well as those women who suffered from recurrent miscarriages (3 or more miscarriages) had a significant decrease in the rate at which they succeeded in having a subsequent live birth. The study authors concluded that the method by which a miscarriage is managed doesn't affect future pregnancy or pregnancy outcomes. Four out of every five women have a live birth within five years after a miscarriage. The authors had reassuring words for women who have miscarried, "Women can be reassured that long term fertility concerns need not affect their choice of miscarriage, management method."