Approximately half of all women who experience a miscarriage before the 13th week of pregnancy will require a procedure known as a D&C (dilation and curettage).
Most D&Cs are done between the 11th and 13th week of pregnancy. If you have to undergo the surgery, then you may be worried about your chance of getting pregnant after a D&C. However, full fertility should be restored once your body undergoes a period of healing.
Ovulation After a D&C
Your body will normally ovulate two to four weeks after a D&C. However, you should not try to get pregnant immediately after a D&C because your body needs time to heal. Most physicians advise waiting for at least three cycles before you try to conceive again.
Chances of Becoming Pregnant After a D&C
Research indicates that women who started trying to conceive within three months after their last miscarriage or D&C still had approximately 65% greater odds of becoming pregnant and giving live birth than women who waited, according to a research team from the National Institute of Child Health and Human Development in Bethesda, Maryland.
The higher rate of pregnancy in the early months could be attributed to the natural decline in fertility that women start to experience each month after they reach 30.
What is a D&C?
A D&C is a medical procedure that is usually performed in a hospital or surgical center. The entire operation is typically done under anesthesia, but on rare occasions, a local anesthesia is given.
- Dilation of the Cervix: It involves the dilation of the cervix to expand it.
- Curettage of the Uterus: Once the cervix is expanded, curettage of the uterus takes place. Scraping the Walls of the Uterus: Curettage involves scraping the wall so the uterus using a medical instrument known as a curette.
- Vacuum Curette: Sometimes a vacuum curette is also used to adequately clean all the tissue and lining from the interior of the uterus. You will normally be discharged a few hours after undergoing a D&C.
- Going Home: You will normally be discharged a few hours after undergoing a D&C.
What to Expect After a D&C
After release from the hospital, most physicians will advise you to go home and rest for a day or two before resuming your normal day-to-day activities or returning to work.
- Cramping: Initially, you may experience cramping for the first 24 hours following a D&C.
- Bleeding: You will normally have light bleeding for a few days up to a week or more. Doctors advise using pads and abstaining from tampon usage.
- Normal HCG Levels: The bleeding will not normally cease until your HCG (human chorionic gonadotrophin) levels have returned normal.
Birth Control and Sex Following a D&C
There is no way to know exactly when you will ovulate following a D&C. Most doctors advise against have sexual relations for the first two weeks after the medical procedure.
Then you should use some form of birth control to avoid getting pregnant during the first ovulation cycle after the D&C because your uterus needs to undergo a healing time in order to carry a healthy pregnancy.
When Will You Experience Your Period?
Most women experience their first period after a D&C within four to six weeks. However, it is not uncommon for your first period after a D&C to be even later. Remember, that you will not have your period until your body resumes ovulation. Your period typically occurs two to three weeks after ovulation resumes.
D&C Procedures Were Once Used to Increase Fertility
Approximately 40 years ago, physicians believed that a D&C would help increase a woman’s fertility by making the receptors in her uterus more receptive to the ovum and better able to carry a pregnancy to full term.
However, the practice was abandoned due to the lack of scientific evidence that indicated fertility was increased. However, some researchers believe there may be some merit to the outdated practice.
How a Type of D&C Procedure May Increase Pregnancy Chances
Fertility experts have been using what is known as an ‘endometrial scratch’ to spur fertility. The procedure involves lightly scraping the endometrial lining of the uterus to spur pregnancy.
Research has revealed a nine percent increase in pregnancy after the procedure which raises the percentages to between a 14 and 28 percent chance of achieving pregnancy, according to Sarah Lensen, from the University of Auckland, New Zealand.
What the Experts Say
“There’s some old wives’ tale about waiting for three cycles after a miscarriage to get pregnant again. There was also some old data that perhaps people are more likely to miscarry again if they try immediately after, but that’s all been debunked,” according to says Angela Chaudhari, MD, a gynecologic surgeon and assistant professor in the Department of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine in Chicago, Illinois.
“For example, let’s say you miscarried, you passed some tissue you didn’t pass at all, so they had to go in, you had a little infection in your uterus, so they did a D&C, and in the process of doing that D&C in a scarred, in an infected uterus, the uterus got scarred. And so that can be the cause of the secondary inability to get pregnant. But for the majority of people who are not old, and they got pregnant easily, and they miscarried, the majority of them, 85% to 90%, will be pregnant again within a year. So not getting pregnant is not normal,” according to Dr. Kirtly Parker Jones at the University of Utah Health and Sciences.
“We cannot really tell whether pregnancies conceived very soon after a miscarriage really do have better outcomes, or whether women (and couples) who conceive quickly following a miscarriage have better outcomes in a subsequent pregnancy than couples who take longer to conceive,” says Julia Shelley, Ph.D, an associate professor at Deakin University, in Burwood, Australia, who co-wrote an editorial accompanying the study.
“If a woman is over 30, then waiting another six months will reduce her chances of getting pregnant at all and increase her chances of having another miscarriage, simply because of the age difference. Our research shows that there is no justification in terms of health reasons for delaying,” according to Dr. Sohinee Bhattacharya, an obstetrician at the University of Aberdeen.
Your chance of getting pregnant after a D&C typically remains the same as prior to the procedure. Although, women who are in their thirties and older face a decline in fertility every month as their age advances towards menopause.
In such cases, waiting longer after a D&C may make it harder to conceive, but the inability to conceive because of advancing age is not caused from the D&C. A D&C is a medical necessity that does not appear to lower your chances of getting pregnant following the procedure.