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Ovulation after a miscarriage

Mon Nov 04, 2013 8:15 am

HI all,

I just wanted to introduce myself and post a question with some information I found. I recently had a miscarriage 2 weeks ago, after 7 weeks 6 days (I think it was a blighted ovum, but I hate that term!) It was my first pregnancy and very devastating. I must say I did think something was wrong for a couple weeks. So I was sad, and disappointed but not too shocked.

I had a natural miscarriage after seeing on ultrasound the baby measuring at 5 weeks 2 days. As soon as I left the u/s, I started spotting then by the next day bleeding at least it was quick.

I have decided to TTC right away but see there are A LOT of misinformation on the internet and even with what ladies doctors are saying.

So the first question I have: Can you ovulate with HCG in your system?
After much searching and researching I have come to the conclusion that yes you can. It is the progesterone and estrogen concentrations that prevent ovulation while you are pregnant...not HCG. In fact HCG is used in both IVF and as trigger shots in women to help ovulation along. This is the number one misinformation I have found.

Also, many women say that ovulation usually doesn't happen the cycle after miscarriage...but then I found this article:

Return of ovarian function following spontaneous abortion.

Assays of first morning urine samples for oestrone-3-glucuronide, LH and pregnanediol-3-glucuronide, were used to study endocrine function and return to ovulation in 18 subjects following spontaneous miscarriage. On the basis of the endocrine data, ovulation occurred in all 18 women in the cycle prior to first menses at a mean of 29 days post-partum (range 13-103 days) with one subject conceiving in that cycle. Compared with the second cycle, the first cycle after spontaneous abortion had similar levels of follicular phase peak ovulatory oestrone excretion but lower levels during the late luteal phase (P less than 0.02), lower levels of peak LH (50.5 IU/g creatinine (C) cf. 68.8 IU/g C; P less than 0.04) and lower late secretory peak pregnanediol (4.6 mg/g C cf. 6.1 mg/g C; P less than 0.02). The mean luteal phase length of 12.9 days in the first cycle was shorter than the mean of 14.4 days in the second cycle (P less than 0.02). These data show that, although there is some disturbance of endocrine function in the first cycle after spontaneous abortion, the majority of women have a rapid return to ovulation, making the early use of contraception necessary for those wishing to avoid conception.

So it looks like MOST women do ovulate the cycle after a miscarriage, and I think most are assuming they don't because they know HCG is still in their system.

Very confusing!

I just wanted to get your thoughts on these findings, since I know a lot of you have researched extensively as well.

I am finding it hard to get the right answers. Some personal experiences would definitely help!

Re: Ovulation after a miscarriage

Mon Nov 04, 2013 8:36 am

Sorry, I also forgot to mention in my research, I found HCG causes the Corpus luteum to keep producing progesterone which does inhibit Ovulation (not HcG directly) however, this is only in doses above 100IU. In doses such as 60IU, it does not cause the CL to produce progesterone, which then means you are free to ovulate. There fore after a miscarriage when your HCG levels get to be about 50-100iu (still testing positive on HPT) you could actually ovulate. In case folks are scientific and would like to see the study :
Clin Endocrinol (Oxf). 2000 Sep;53(3):345-50.
Corpus luteum response to exogenous HCG during the mid-luteal phase of the menstrual cycle.
Tay PY, Lenton EA.

It showed levels of 140iu and above, demonstrated prompt increases in progesterone secretion. However 60iu did not have the same effect.

Re: Ovulation after a miscarriage

Mon Nov 04, 2013 9:26 am

Hi gwtw, I was unsure as well. I had a stillbirth over 10 weeks ago and no cycles since. when I called my ob on thurs she wanted me to go in for u/s and blood work to see why I haven't ovulated to have my cycle return. I do believe now that we ovulate after mc/stillbirth before our cycles return. I rried to research this as well b/c I had no idea what was happening with my body. There's conflicting stories online.

Re: Ovulation after a miscarriage

Mon Nov 04, 2013 10:04 am

Thank you for the information. I have heard so many times that people were told to wait at least one cycle and I also heard that this was actually because the doctor wanted a last period date to go by.
My plan is to not try to prevent this month but start temping and using opk's again next cycle. I just want to be able to count the cycle days accurately as now I really don't know what cycle day I would be considered to be in. Of course, I hope that I don't have to even get to that point and that I am pleasantly surprised sooner than that! I have read that some take a long time before their cycles get back on track. I really hope that my body bounces back quickly!
I took a hpt this morning and there is barely a faint line left on it. My MC started on 10-26 (started spotting then bleeding heavily) and on 11-1 had a D&C. I am not sure where my levels are but I think that in a couple of days, there will not be any line anymore.

Re: Ovulation after a miscarriage

Fri Nov 15, 2013 10:56 am

You definitely CAN ovulate with hcg in your system, but it has to be pretty low. I researched this like crazy after my miscarriage. It took 7 weeks for my hcg to drop to zero, but I did ovulate while my hcg was above 0 but below 25. I had blood tests weekly.

My doctor said waiting is "old" advice and that you can TTC right away.

After my hcg returned to 0 I had a period two weeks later. A heavier than normal period but it only lasted a few days. Now I am having an issue - I am not ovulating. I am on CD21 with no ewcm and no ovulation.

It's frustrating TTC after a loss, because you want to know what's going on with your body, but because everyone is so different, there is no "normal" to look for. Some people ovulate right away, some people get their cycles back right away, for others it can be a few months. For me I think my body is still kind of whack. :/ It's so hard to be patient.

Re: Ovulation after a miscarriage

Thu Jul 19, 2018 9:26 pm

LOL I know right!! :rofl:

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