The type of treatment a woman
receives after an early miscarriage does not affect subsequent fertility, with
around 80% of women having a live birth within five years of their miscarriage,
concludes a study published on bmj.com.
Fifteen per cent of pregnancies end in early miscarriage. For decades the standard management of early miscarriage was surgical evacuation of retained products of conception. But this was increasingly questioned and now women are usually offered expectant (watch and wait) and medical management as well.
Previous studies, including the largest published trial (the MIST trial), have suggested that all three methods are probably equivalent in terms of gynaecological infection, but their long term effects on fertility are not known.
They surveyed 762 women who had taken part in the original MIST study, and who had randomly received surgical, medical or expectant management for an early miscarriage (less than 13 weeks gestation).
These women completed a questionnaire about subsequent pregnancies and live births after this miscarriage. The effects of age, previous miscarriage and previous birth history were taken into account.
Among the survey respondents, 83.6% reported a subsequent pregnancy, with 82% having a live birth.
Time to subsequently giving birth was very similar in the three management groups: 79% of those randomised to expectant management, 78.7% of the medical group and 81.7% of the surgical group all had a live birth five years after their miscarriage.
However, older women and those suffering three or more miscarriages were significantly less likely to subsequently give birth.
The authors conclude that method of miscarriage management does not affect subsequent pregnancy rates, with around four in five women having a live birth within five years of a miscarriage.
"Women can be reassured that long term fertility concerns need not affect their choice of miscarriage, management method," they say.