When does ovulation restart after a miscarriage?
Everyone's experience of pregnancy loss is different. Many need time and support to recover before they try to conceive again. Others may wish to become pregnant as soon as possible.
In this article, we discuss how miscarriage affects the menstrual cycle and the signs of ovulation.
We also cover when it is safe to conceive again, whether people are more fertile after pregnancy loss, and the chances of experiencing another miscarriage.
How does miscarriage affect ovulation?
How long it takes for ovulation to return after a miscarriage varies from person to person.
After a miscarriage, the menstrual cycle restarts, and many women will have their first period 4–6 weeks later. However, it can take several months for the menstrual cycle to return to how it was before pregnancy.
It is normal to experience some bleeding after pregnancy loss. The first day of bleeding is day 1 of the new menstrual cycle. Bleeding or spotting may continue for around a week after this.
Ovulation may occur around 2 weeks into this new cycle. Day 14 of the menstrual cycle is when ovulation typically occurs for women with regular periods.
According to the American College of Obstetricians and Gynecologists (ACOG), women can ovulate as soon as 2 weeks after a miscarriage, if it occurs within the first 13 weeks of pregnancy.
If miscarriage occurs in the later stages of pregnancy, their cycle may take longer to adjust.
However, exactly when ovulation occurs will vary from person to person. For example, women who had irregular periods before pregnancy may find that their periods remain irregular.
Signs of ovulation
There are many signs of ovulation. Some are quite easy to look out for, but their reliability can vary. These signs can include:
- vaginal discharge that appears clear, gloopy, and wetter than usual
- breast tenderness
- bloating and abdominal cramping
Other signs of ovulation require a little more effort to monitor. These can include measuring and recording basal body temperature and levels of luteinizing hormone (LH). We discuss both of these below:
Tracking basal body temperature
A person can purchase a basal body thermometer from their local pharmacy or online.
People can work out roughly when they are going to ovulate each month by tracking their daily basal body temperature. For most people, the temperature reading will be 0.5–1.0°F higher when ovulation occurs and will then return to normal 1–2 days before their period starts.
To use this method, a person needs to measure and record their temperature each day using a basal body thermometer. It is best to take the reading at the same time every morning, ideally before getting out of bed in the morning.
Rectal thermometers are usually more reliable than oral thermometers. Because the change in temperature is typically very small, it is important to use a thermometer with an accurate and easy to read scale.
Basal body thermometers are available in pharmacies, and a person can also purchase them online.
There are also many smartphone apps that allow people to easily record their basal body temperature and track their fertility cycles. Some thermometers even come with their own apps.
Tracking basal body temperature over multiple cycles can help a person predict when ovulation is likely to occur.
Testing for LH
Another way to predict ovulation is by testing for levels of LH in the urine.
When LH levels rise, it causes the ovaries to release an egg. LH levels typically begin to surge around 36 hours before ovulation.
A person can purchase ovulation predictor kits from drug stores as well as online.
The kits normally comprise a number of test sticks and a sterile container. To use, urinate on one of the tests strips and then place it in the container.
A change in the color or appearance of the plus symbol indicates a positive result. A person may need to test LH for several days before they detect a surge.
When is it safe to conceive again?
When a woman tries to conceive again is a personal decision. Some people try again straight away, but others prefer to wait.
However, one 2017 systematic review suggested that conceiving again within 6 months of pregnancy loss may actually lower the risk of:
- preterm birth
Also, the ACOG state that there is no medical reason to wait before trying to conceive again. However, they do explain that waiting until after a woman has her first period can make it easier to calculate the due date.
Are people more fertile after a miscarriage?
Scientists are not able to say with certainty exactly how miscarriages affect a person's fertility.
Every woman experiences a different level of fertility after a miscarriage, which makes it difficult to draw conclusions.
For example, a study from 2003 suggested that getting pregnant is easier than usual in the first cycle after an early miscarriage. However, another study from 2005 suggested that miscarriage may slightly reduce subsequent fertility.
How likely is another miscarriage?
A doctor can explore any underlying reasons for a miscarriage.
Although it is possible to have more than one pregnancy loss, multiple miscarriages are rare. According to the ACOG, around 1% of women experience repeated miscarriages.
Around 60% of miscarriages occur randomly, and there is no medical reason for why. Less commonly, certain genetic problems and medical conditions can increase the risk of repeated miscarriages.
Women who have experienced a miscarriage should discuss the possible reasons with a doctor, who can test for any underlying causes.
Having more than one miscarriage does not mean that having a baby is unachievable. In fact, around 65% of women who experience multiple unexplained miscarriages go on to have healthy babies.
Miscarriage restarts a woman's menstrual cycle, with the first day of bleeding being day 1 of the new cycle.
Ovulation tends to occur around day 14 of the menstrual cycle. However, the exact time of ovulation varies among women, and it may take several months for their cycle to return to normal after pregnancy loss.
Women who had irregular cycles before pregnancy may continue to experience irregular cycles after a miscarriage. Early miscarriage is less likely to impact the regularity of the menstrual cycle than miscarriages that occur later in pregnancy.
Signs that a woman is ovulating can include abdominal cramps, breast tenderness, and clear, gloopy vaginal discharge. However, testing for LH and tracking basal body temperature are more reliable ways to predict ovulation.
Knowing when ovulation is likely to occur can help people understand when in their cycle they are most fertile. This information is useful when trying to plan or avoid pregnancy.
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