According to the American College of Obstetricians and Gynecologists (ACOG), miscarriage is the most common reason for a pregnancy loss. It is estimated that 10-25% of all clinically recognized pregnancies are lost, most within the first 13 weeks of pregnancy. Women that experience a miscarriage in early pregnancy may receive surgical, medical, or "watch-and-wait" management. Recent long-term follow-up analysis of the miscarriage treatment (MIST) clinical trial finds that the type of miscarriage treatment does not affect a woman's chance of conceiving and delivering a baby in the future.
Types of Miscarriage Treatment
Early pregnancy loss can be caused by a variety of factors, including:
- Chromosomal abnormality
- Hormonal problems
- Maternal health issues
- Lifestyle choices (e.g., drug use and/or smoking)
- Improper implantation of the egg into the uterine lining
- Maternal age
- Maternal trauma
There are many types of miscarriages, many of which do not require medical treatment. In cases where the body is not able to expel the fetus, surgical or medical intervention may be necessary. Doctors may advise that one of three approaches be taken:
- No active intervention ("watch-and-wait")
- Surgical evacuation of the retained products of conception
- Use of medications like mifepristone (Mifeprex) and misoprostol (Cytotec)
Chances of Conception and Successful Pregnancy After Miscarriage
The miscarriage treatment (MIST) clinical trial was conducted to evaluate the incidence of infection among women who received surgical, medical, or "watch-and-wait" management after a first-trimester miscarriage. Chances of developing gynecological infection were similar among all women, and did not appear to differ based on the miscarriage treatment strategy selected.
Researchers also wanted to determine whether the specific type of treatment a woman had for a miscarriage affected her chances of giving birth in the future. Participants of MIST were surveyed after five years. Approximately 82% of respondents had given birth, and the type of miscarriage treatment did not appear to affect the time it took for women to achieve a successful pregnancy.
The study found that women under the age of 25 were more likely to give birth in the future, when compared to women ages 35 to 39 and women over the age of 40. In addition, women with a previous history of miscarriage were less likely to give birth in the future when compared to women with no miscarriage history.
Results from the miscarriage treatment (MIST) trial indicate that women who receive surgical, medical, or "watch-and-wait" management after a first-trimester miscarriage have similar rates of live birth within five years. This study provides encouraging news for women who have suffered a miscarriage and are unsure of the impact surgical or medical treatments may have on their future fertility.
References
American Pregnancy Association. "Miscarriage"
Smith L, et al. "Incidence of pregnancy after expectant, medical, or surgical management of spontaneous first trimester miscarriage: long-term follow-up of miscarriage treatment (MIST) randomized controlled trial." BMJ 2009.
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