How Soon Can You Do IVF After A D&C (REI Doc Explains)
By Alex Robles MD / January 4, 2023 January 4, 2023
How long do you need to wait to do in vitro fertilization (IVF) after a dilation and curettage (D&C)?
factors that can influence the timing of IVF after a D&C,
risks and benefits of starting a cycle soon after a recent miscarriage, and
if there are any significant differences in success rates in either direction.
How Soon Can You Do IVF After A D&C?
Generally speaking, you will need to wait at least six to eight weeks after a D&C procedure before starting an IVF cycle. The timing largely depends on how quickly your beta hCG (the pregnancy hormone) returns to undetectable levels.
The further along you were at the time of D&C, the longer it will take.
Once the b-hCG levels are back to normal and you've had a natural period, your doctor may recommend trying IVF with that cycle or the next full cycle.
What Are The Risks and Benefits Of Starting a Cycle Soon After The Procedure
Thankfully, there are only a handful of medical reasons that would require you to delay an IVF cycle after a D&C.
Possible reasons to delay include:
Needing more time to recover from the procedure emotionally,
Needing more time to recover from the surgery physically (especially if you had a complication such as a post-operative infection or heavy vaginal bleeding),
Giving your uterus more time to heal.
Thankfully, the latter two are very rare. In the absence of these factors, there is no risk of trying for a new pregnancy soon after.
The main benefit of starting a cycle soon after the procedure is that it can help maximize efficiency and reduce the time it takes to achieve a successful pregnancy.
How Soon Can You Do A Frozen Embryo Transfer After A D&C?
The earliest you can do a frozen embryo transfer (FET) after a D&C is six to eight weeks. We must ensure that your beta hCG levels have returned to normal and that your natural period has resumed.
In addition, it is also important that we evaluate your uterine cavity in the following cycle to look for any adhesions or retained products that may interfere with the frozen transfer.
The most common cavity evaluation is a saline infusion sonogram (SIS), which we do between days 5 through 12 of your menstrual cycle.
Are You More Fertile After A D&C?
No, there is no evidence that you are more fertile after a D&C.
Your chances of conceiving largely depend on your age and whether or not you have any underlying medical conditions that could affect fertility.
Is It Harder To Get Pregnant After D&C?
Getting pregnant after a D&C is no more difficult than before the procedure.
However, if you have had multiple D&C procedures, you may have intrauterine adhesions or scar tissue inside the uterus that may interfere with the implantation of an embryo.
Your doctor can do a saline ultrasound or a hysteroscopy to check for any abnormalities with your next period.
Why Are D&Cs Done in IVF?
The most common indication for a D&C procedure in the setting of IVF is to treat an early miscarriage. These can be in the form of the following:
A missed miscarriage (when the fetus's heart stops beating)
An early pregnancy failure (the embryo stops growing)
A blighted ovum or anembryonic pregnancy (when the sac grows but nothing develops inside)
This short procedure can also help us to determine if you have an ectopic pregnancy, which is when the embryo implants outside of your uterus.
With that said, there are risks to a D&C procedure.
All surgical procedures carry three main risks.
These risks include:
Bleeding (the procedure may cause heavy bleeding for a few days after)
Fever or infection (there is a small risk of infection at the surgical site)
Injury to adjacent organs
D&Cs also have a few other risks that are much less common.
Incomplete removal of tissue
Scarring and adhesion formation inside the uterus
Uterine perforation
Lastly, you will get anesthesia (sometimes light sedation and occasionally general anesthesia) during the procedure.
It is important to discuss these risks with your doctor before proceeding with the procedure.
What Are The Alternatives?
Depending on the individual case, you may be eligible for medical management of the miscarriage.
Medical management typically involves taking medications that cause the uterus to expel the tissue.
The other option is expectant management, which involves waiting for the body to expel the tissue naturally.
The primary disadvantages of medical and expectant management are:
There is uncertainty on how long it will take for the tissue to be expelled,
Your body may not expel all of the tissue (aka an incomplete miscarriage), which might necessitate a D&C anyway,
You might experience abdominal pain, cramping, and abnormal bleeding for a prolonged time,
There is a higher risk of infection with these approaches if the body does not expel the tissue quickly.
Lastly, we might be unable to recuperate the pregnancy tissue to perform genetic testing on the fetus.
For these reasons, your doctor may recommend that you have a D&C procedure instead.
How Long Do You Have To Wait To Do IVF After A Natural Miscarriage?
We recommend waiting for your natural menstrual cycle to resume after a spontaneous miscarriage before starting IVF treatment. For most patients, it can take two to four weeks for the pregnancy hormones to return to zero and an additional four weeks or so to get your next menstrual period.
How Long Does It Take For The Uterine Lining To Rebuild After A D&C?
The endometrium (the lining of the uterus) regrows with each menstrual cycle. As such, most women will have a normal uterine lining within four to six weeks following the procedure.
In rare cases, women who develop Asherman Syndrome after the procedure might experience difficulty in achieving a standard endometrial thickness.
A Quick Word On Recurrent Miscarriage (AKA Recurrent Pregnancy Loss)?
Recurrent miscarriages are defined as three or more consecutive pregnancy losses. However, many fertility doctors will start a workup if you have had two consecutive miscarriages.
In these situations, your doctor may recommend a series of blood tests to look for underlying causes like hormonal imbalances, genetic abnormalities, and other medical abnormalities. Depending on the results of these tests, your doctor may suggest delaying treatment until the workup is complete.
The good news is that your next pregnancy is always more likely to be healthy, regardless of your prior losses.
A first trimester miscarriage is devastating. Although you may want to start an IVF cycle soon after the loss, it is important to consult your reproductive endocrinologist for guidance on the specific timing for trying to conceive after a D&C procedure.
Every patient is unique, and there is no one-size-fits-all answer.
Your fertility doctor can evaluate your situation and determine the best next steps for you.
Blighted Ovum After IVF: What It Means & What To Do About It
The IVF Cycle Timeline: How Long Do IVF Cycles It Take?
The Frozen Embryo Transfer Timeline: What To Expect