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
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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.
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 early miscarriage in IVF? (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:
- Chromosomal abnormalities: Genetic problems like aneuploidy are the most common reason for miscarriage. Chromosomal problems usually prevent a fetus from developing into a healthy pregnancy, even after implantation.
- Anatomical Issues: Another potential cause is anatomical problems in the uterus. Uterine anomalies like fibroids, polyps, adhesions, and septums can all be associated with pregnancy loss.
- Endocrine Issues: Abnormalities in your thyroid levels such as an elevated TSH >4 can be associated with a higher risk of pregnancy loss.
- Environmental: Exposure to toxins like drugs and tobacco can also increase the risk of miscarriage. In addition, there is data emerging that endocrine disruptors (chemicals found in many consumer products such as BPA and phthalates) could also affect reproductive health.
- Trauma: Injury to your abdomen could also cause a miscarriage. Car accidents and even falls are common examples.
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.
How does IVF decrease miscarriage?
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.
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.
How can I prevent miscarriage after IVF?
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)
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.
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.
Can bad sperm cause a miscarriage?
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 as a miscarriage?
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.
- Spontaneous abortion: the embryo implants, but spontaneously miscarries with heavy bleeding and passage of tissue
- Missed abortion: the fetus develops normally with a heartbeat, but then the heartbeat stops. This miscarriage often has no symptoms (which is why it is called “missed”)
- Blighted ovum: In this case, the embryo implants and a gestational sac forms, but no fetus develops
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.
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.
Alex Robles, MD, FACOG
Alex Robles is a Spanish-speaking Latino-American Reproductive Endocrinologist and Infertility specialist in New York City, and board-certified OBGYN in his final year of fellowship at Columbia University Medical College. He has a special interest in exercise, lifestyle, & nutrition.
- Hasan R, Baird DD, Herring AH, Olshan AF, Jonsson Funk ML, Hartmann KE. Patterns and predictors of vaginal bleeding in the first trimester of pregnancy. Ann Epidemiol. 2010 Jul;20(7):524-31. doi: 10.1016/j.annepidem.2010.02.006. PMID: 20538195; PMCID: PMC2884141.
- 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.
- 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.
- Dugas C, Slane VH. Miscarriage. 2021 Jun 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30422585.