Sadly about a quarter of positive pregnancy tests after treatment end in pregnancy loss. Nearly all occur before the 7-8 week scan or impending loss is apparent from the scan.
Pregnancy loss occurs as frequently after natural conception as it does after fertility treatment, and nearly always is due to the embryo not growing as it should, therefore is not preventable.
Common signs of miscarriage are bleeding, cramping that feels like period pains, and the loss of pregnancy symptoms. If you have any of these symptoms or are concerned, ring your nurse at the clinic, and we can often arrange a blood test to give a better idea of what is happening.
Pregnancy loss early in pregnancy can be very hard to bear – it can be hard to tell people and they may not appreciate your grief from a loss that is very dear to you but which they may see as common and normal. This is a really good time to talk to or to see one of our counsellors, whether to talk about coping with how you feel or coping with other people.
Not pregnant this time
It is natural to feel sad, disappointed and upset that treatment hasn’t worked this time. If you are feeling sadder than usual, please call your nurse or arrange a time to talk with or see one of our counsellors. Don’t underestimate how long it may take to recover your emotional balance, so be gentle on yourself.
We strongly encourage you to make a review appointment with your doctor after each IVF cycle or have finished your ‘package’ of 4 clomiphene or IUI cycles. Even if you are not considering further treatment, it can be helpful to talk things over for a sense of closure. Doctors are often booked up 2-4 weeks ahead, so even if you don’t feel like it at the time, it is good to book an appointment soon after your pregnancy test result.
A review appointment is free for publicly funded treatment, and it is included in the cost of IVF treatment.
More about miscarriage
Losing a baby before 20 weeks of pregnancy is called a miscarriage. It can be a very tough time to go through and, with around one in five pregnancies ending in miscarriage it sadly happens relatively frequently. The likelihood of miscarriage also increases slightly with age. Although some women experience a late miscarriage, the majority happen within the first 13 weeks of pregnancy or first trimester, and in fact 90% occur within the first eight weeks of pregnancy.
What causes miscarriage?
The first thing to recognise is that miscarriage is usually a natural process. The whole process from conception through early gestation is complex. If anything about the pregnancy is abnormal then the developing fetus may not be viable and a miscarriage will occur.
If a woman endures three consecutive miscarriages, the miscarriages are considered recurring. A woman suffering recurring miscarriages may undergo medical tests to try and discover any underlying conditions that may be causing her to miscarry.
Signs of miscarriage
Some of the signs that you might be miscarrying often depend on how long you have been pregnant. Prior to six weeks of pregnancy the only sign may be bleeding that looks like a heavy period. Miscarriage later in the first trimester at six to eight weeks will include cramping as well as bleeding. You should contact your fertility or pregnancy care provider immediately if you are experiencing signs of miscarriage. Often an ultrasound can be carried out to see whether or not your pregnancy is proceeding normally or if you have miscarried.
Some women will have little or no sign that their pregnancy is no longer continuing. This type of miscarriage is referred to as a ‘missed miscarriage’. Often it is only at first ultrasound that the miscarriage is confirmed.
Women should then discuss with their Doctor whether to have an operation to remove any remnants of the pregnancy - this is called a D & C (dilation and curettage) - or whether to allow time to miscarry naturally.
Women who choose to wait for a natural miscarriage after being diagnosed with a pregnancy loss often wonder how long it will take for the bleeding to start if it hasn't already. Overall 70% of women who chose natural miscarriage miscarry within 14 days of diagnosis. However it is OK to change your mind at any time and choose D & C, or your doctor may recommend this method.
Suffering a miscarriage can be very traumatic. Not only is it taxing on you physically, but emotionally, the healing process can take much longer. As with any loss it is normal for people to feel grief after a miscarriage. It is important to remember that entering a grieving period after a significant loss is a perfectly normal emotion. On the other hand, some people cope more easily, and some people may suffer upset at a later date.
Miscarriage can make men nervous to talk to their partners. They can be upset about the pregnancy loss, but they can also be grieving for their partner. After a miscarriage a couple’s relationship may become significantly strained. Counselling can help to work through grief as well as improve the communication between you and your partner.
Contact your medical team if you are experiencing any symptoms that are causing you concern. Or to book a review appointment.
Fertility NZ is a charity which offers free support through informal groups around the country and virtually, and a helpline. www.fertilitynz.org.nz / 0800 333 306
• Other useful websites: www.miscarriagesupport.org.nz and www.kiwifamilies.co.nz