Time to pregnancy after a previous miscarriage in subfertile couples

Abstract

Objective: To assess the time to spontaneous ongoing pregnancy after a previous miscarriage in subfertile couples.

Design: A prospective cohort study.

Setting: The study was conducted in 38 fertility centers in the Netherlands.

Patient(s): Subfertile couples who miscarried after completing their basic fertility work-up.

Intervention(s): Expectant management after a miscarriage.

Main outcome measure(s): Spontaneous ongoing pregnancy.

Result(s): We included 5,663 subfertile couples, of which 1,098 (19%) conceived spontaneously. Among these 1,098 couples, 199 (18%) miscarried and these couples were included in the present study. Follow-up was completed for 171 couples, of which 95 conceived again within 24 months of follow-up. Of these 95 pregnancies, 86 (91%) were ongoing. The cumulative spontaneous ongoing pregnancy rate (PR) after 24 months was 70% (95% confidence interval [CI] 59%-81%).

Conclusion(s): Subfertile couples, who experience a treatment-independent pregnancy resulting in a miscarriage, have very good prospects of a spontaneous ongoing pregnancy in the near future. This information is useful in counseling couples who had a miscarriage after a previous period of subfertility.