Miscarriage Symptoms After IVF (How To Know If It’s Happening)

Are you bleeding and wondering if you are having a miscarriage after IVF?

This post will cover:

  • Common symptoms of miscarriage
  • The most common causes of it after IVF
  • If miscarriage prevention is possible
Miscarriage Symptoms After IVF- cover image

What are the symptoms of miscarriage after IVF?

The most common symptom of a miscarriage after IVF is vaginal bleeding. Other symptoms include:

  • lower abdominal cramping
  • lower back pain
  • passage of clots and/or tissue

Loss of pregnancy symptoms (such as breast tenderness and nausea) is an unreliable indicator for miscarriage.

Does bleeding always indicate a miscarriage?

Vaginal bleeding in the first trimester is fairly common.

Some studies show that at least 25% of women will experience either spotting or heavier bleeding in early pregnancy.

The good news is, the majority of bleeding in the first trimester does not end in miscarriage.

That same study of over 4000 women found that only 12% of women with bleeding experienced a miscarriage.

What causes Them? (Common reasons)

It is difficult to pinpoint the exact reason for a miscarriage in many cases.

Here’s a list of the most common causes of miscarriage:

This is not an exhaustive list of all the causes of pregnancy loss.

It is possible to not have any of these issues, especially if you have done in vitro fertilization.

In situations where there is no obvious underlying cause, we don’t always know why it happens.

does IVF decrease The Risk?

IVF can decrease the risk of miscarriage through the use of preimplantation genetic testing.  

PGT allows us to analyze if an embryo is chromosomally normal or not. This is important because aneuploidy is one of the most common causes of pregnancy loss.

picture of the 23 pairs of chromosomes on a karyotype, showing an extra chromosome 21, which is down syndrome

The genetic screening process helps ensure that only embryos without a chromosomal abnormality are transferred.

What are the chances of miscarriage after IVF?

Approximately 10-25% of women will have an early miscarriage after IVF. Unfortunately, this data is true even after the transfer of a chromosomally normal euploid embryo.

This rate of miscarriage is pretty consistent with what we see in the general population.

Recent reports estimate that up to 1/3rd of all clinical pregnancies will result in miscarriage.

The real number may be higher as this does not include women who have had an early pregnancy loss before they even knew that they were pregnant.

can I prevent It?

Unfortunately, miscarriage prevention isn’t possible, even after IVF treatment. With that said, there are some things you can do to try and decrease the risk.

These measures include:

  • Avoiding harmful toxins like alcohol, tobacco, and drugs
  • Maintaining a healthy body fat percentage
  • Eating a well-balanced diet that includes plenty of fruits and vegetables;
  • Ensuring that your metabolic blood tests are under control (thyroid, glycemic control, etc)

There may be a small benefit of progesterone supplementation for miscarriage prevention in women who have had prior miscarriages or have early first trimester bleeding.

Can I still become pregnant after a miscarriage?

Yes! A miscarriage doesn’t mean you can’t conceive again. Many couples who have experienced a first-trimester loss go on to have a successful pregnancy after!

Other Related Questions

What week is a miscarriage most likely?

Miscarriages are most common in the first trimester within weeks 6-12.  On average, the further along you are, the less likely you will miscarry.

The risk decreases after 12 weeks of pregnancy and is very low in the second trimester.

Can you miscarry with a heartbeat?

Yes, it is possible to miscarry after a heartbeat. A heartbeat by itself does not guarantee an ongoing pregnancy, although it does make a miscarriage less likely.

Your doctor will usually check for a heartbeat around 6-7 weeks with a vaginal ultrasound scan.

image of fetal heartbeat on a doppler ultrasound

Can bad sperm cause It?

Sperm quality can play a role in determining whether or not fertilization takes place, and whether or not an embryo develops normally.

There is no evidence that sperm quality has any impact on the risk or likelihood of miscarriage.

Is a chemical pregnancy the same?

A chemical pregnancy is not the same as a miscarriage. A chemical pregnancy indicates that you have a positive pregnancy test, but no actual development of the embryo takes place.

A miscarriage entails that the pregnancy progressed and developed into a clinical pregnancy. This means that we see evidence of a gestational sac and at least a yolk sac on ultrasound in addition to a positive pregnancy test.

Is a failed IVF transfer considered a miscarriage?

A failed embryo transfer is not considered a miscarriage. A failed transfer generally refers to the embryo not implanting into the uterine lining.

A miscarriage indicates that the embryo implanted and developed into a clinical pregnancy seen on ultrasound.

What are the different types of miscarriage after IVF?

There are typically 3 different types of miscarriage after IVF.

Approximately 5% of women will experience two consecutive miscarriages, and 1% will experience three or more.

If you have recurrent miscarriages (aka recurrent pregnancy loss), you should work closely with a fertility specialist to learn about your treatment options.

What is the difference between a miscarriage and an ectopic pregnancy?

An ectopic pregnancy occurs when the embryo does not implant in the uterus but attaches and grows in another location.

The most common places where this ectopic implantation occurs are the fallopian tubes, cervix, ovaries, and abdomen.

Ectopics usually require some form of medical intervention to resolve them.

Conclusion

Miscarriages are a sad occurrence for many women and their partners.

There are many questions that may arise in the aftermath of a miscarriage, and many of them remained unexplained.

Be sure to speak with your doctor for any concerns that arise at this critical time point in your life.

Related Posts:


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alex robles

Alex Robles, MD

Dr. Alex Robles is a Spanish-speaking Latino-American Reproductive Endocrinologist and Infertility specialist in New York City, and a board-certified OBGYN. He has a special interest in health, lifestyle, & nutrition. Make an appointment with Dr. Robles to discuss your fertility options today!


References:

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  2. Irani M, Reichman D, Robles A, Melnick A, Davis O, Zaninovic N, Xu K, Rosenwaks Z. Morphologic grading of euploid blastocysts influences implantation and ongoing pregnancy rates. Fertil Steril. 2017 Mar;107(3):664-670. doi: 10.1016/j.fertnstert.2016.11.012. Epub 2017 Jan 6. PMID: 28069172.
  3. Coomarasamy A, Devall AJ, Brosens JJ, Quenby S, Stephenson MD, Sierra S, Christiansen OB, Small R, Brewin J, Roberts TE, Dhillon-Smith R, Harb H, Noordali H, Papadopoulou A, Eapen A, Prior M, Di Renzo GC, Hinshaw K, Mol BW, Lumsden MA, Khalaf Y, Shennan A, Goddijn M, van Wely M, Al-Memar M, Bennett P, Bourne T, Rai R, Regan L, Gallos ID. Micronized vaginal progesterone to prevent miscarriage: a critical evaluation of randomized evidence. Am J Obstet Gynecol. 2020 Aug;223(2):167-176. doi: 10.1016/j.ajog.2019.12.006. Epub 2020 Jan 31. PMID: 32008730; PMCID: PMC7408486.
  4. Dugas C, Slane VH. Miscarriage. 2021 Jun 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30422585.

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