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The Chances of Having a Second Miscarriage

One of the scariest things about attempting to get pregnant again after a miscarriage is a fear of miscarrying again. Early pregnancy loss is incredibly draining and disheartening—so much so, that some people shy away from trying again altogether.

However, certain factors can be evaluated to determine your risk of another miscarriage. While there are no definite guarantees, you may be pleasantly surprised to find out that the odds of a viable pregnancy are still in your favor. In fact, only about 1% of women will experience recurrent miscarriages.

First Trimester Miscarriage

Doctors believe that about half of all first-trimester miscarriages are due to chromosomal issues in the developing fetus. In fact, miscarriages are not uncommon during the early term. As many as 10% to 20% of all known pregnancies end in miscarriage, and 99% of those losses occur within the first trimester.

Thankfully, a first-trimester miscarriage is usually a one-time event. Most women who experience a first-trimester loss will have a successful pregnancy in the future (as many as 87%).

If the miscarriage is not related to chromosomal abnormalities and was instead caused by a treatable condition, receiving necessary medical treatment prior to attempting another pregnancy will improve your chances of success.

For instance, getting uncontrolled diabetes under control, or having uterine polyps or fibroids removed, can help fix the root cause of your first miscarriage and prevent the problem from happening again.

Loss Later in Pregnancy

Women who have had a second-trimester miscarriage or stillbirth have a higher risk of subsequent miscarriage or preterm delivery than those who miscarried in the first trimester. This may be related to advanced maternal age or other factors beyond random chromosomal abnormalities.

Conditions associated with a second-trimester loss include:

• Autoimmune conditions like lupus or antiphospholipid syndrome (which increases the risk of blood clots)
• Early pre-eclampsia
• Genetic or structural fetal abnormalities
• History of cervical surgery
• Illicit drug use
• Issues with the shape or condition of the uterus
• Physical trauma
• Poorly controlled diabetes, high blood pressure, or thyroid disease

If your doctor is able to identify the probable cause of miscarriage (which is possible about 50% of the time), you may be able to make lifestyle changes or receive treatment to improve your chances of a future viable pregnancy.

A second-trimester loss doesn't mean that you should avoid getting pregnant again. Despite the risk, it's still more likely than not that you'll deliver successfully. If you have had a previous miscarriage during the second or third trimester, you'll need to work closely with your doctor during prenatal care, which may include more frequent monitoring of you and your baby's condition.

Ectopic Pregnancy and Miscarriage

Ectopic pregnancies occur when a fertilized egg implants outside the uterus, typically in the fallopian tubes. Having an ectopic pregnancy places you at greater risk of having a second one, but your healthcare provider can be on the lookout for signs early on.

If you've ever had an ectopic pregnancy, advise your obstetrician as soon as you get pregnant again. Once it's confirmed that the fertilized egg has implanted in your uterus as it's supposed to, you can rest assured that the pregnancy has every likelihood of proceeding to term.

Coping With Recurrent Miscarriages

Sadly, a small percentage of women who have had a miscarriage will go on to have another one or multiple miscarriages. Speak with your doctor to see if further testing can reveal the causes of recurrent miscarriage before getting pregnant again. This will give you peace of mind and better control over your future pregnancy outcomes.

Evaluation of recurrent pregnancy loss may include:

• Blood tests: To check for lupus markers, thyroid function, and other factors
• Karyotype testing: To rule out chromosomal abnormalities
• Uterine evaluations: To detect issues with the uterus

It's possible that surgery, genetic counseling, or assisted reproductive technology can better your chances for a healthy pregnancy. Although there's usually no medical reason to delay trying to get pregnant again after a miscarriage, you may want to seek the support of a qualified therapist to deal with the emotions of miscarriage and address any anxiety or depression you may be experiencing.