FROM OBSTETRICS & GYNECOLOGY

Couples who try to conceive shortly after an early pregnancy loss have a higher likelihood of a subsequent live birth than those who wait 3 months or longer to try again, according to a report published online Jan. 11 in Obstetrics & Gynecology.

“Our results indicate that there is no physiological basis for delaying pregnancy attempt after a nonectopic, nonmolar, less-than-20-week gestational age pregnancy loss. Recommendations to delay pregnancy attempts for at least 3-6 months among couples who are psychologically ready to begin trying may be unwarranted and should be revisited,” wrote Karen C. Schliep, Ph.D., of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Md., and her associates.

Couples who experience an early pregnancy loss often seek counseling about how long to wait before attempting to conceive again. Even though the optimal timing after a pregnancy loss that was nonectopic, nonmolar, and less than 20 weeks’ gestation has never been well studied, “many clinicians recommend waiting at least 3 months, with the World Health Organization recommending a minimum of 6 months,” the researchers wrote.

To assess pregnancy outcomes after a variety of such time intervals, they performed a secondary analysis of data from a multicenter randomized trial involving women with a history of pregnancy loss. For their analysis, the investigators focused on 1,083 women who had experienced pregnancy loss at 20 weeks or earlier.

Most women in the study (76.6%) tried again to conceive within 0-3 months, while 23.4% waited more than 3 months.

Compared with women who waited longer than 3 months to attempt to conceive again, those who didn’t wait were more likely to achieve pregnancy (68.6% vs 51.1%) and more likely to have a live birth (53.2% vs. 36.1%). Yet they were no more likely to develop pregnancy complications, including pregnancy loss, preterm birth, preeclampsia, or gestational diabetes (Obstet Gynecol. 2016;127:205-13. doi: 10.1097/AOG.0000000000001159 ).

While the study finds no physiological reason for couples to delay attempting to conceive after early pregnancy loss, emotional readiness is another matter. However, the researchers noted that previous studies have shown that “a speedy new pregnancy and birth of a living child lessens grief among couples who are suffering from a pregnancy loss.”

The study was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Dr. Schliep and her associates reported having no relevant financial disclosures.

obnews@frontlinemedcom.com

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