Pregnancy does not always end in childbirth. Sometimes the development of the embryo in the fertilized egg stops and it dies, causing a miscarriage. According to statistics, most often a frozen pregnancy is diagnosed at 6-8 weeks.

A woman either has a natural miscarriage or is referred for an artificial termination of pregnancy if the fertilized egg, which is regressing in development, still remains in the uterus.

Most often, the expectant mother does not notice the moment of death of the embryo and may still notice signs of pregnancy: soreness and heaviness of the mammary glands, toxicosis, drowsiness. This is due to the fact that the hCG hormone is still present in the blood, although in much smaller quantities.

Determining causes and risks

Many women planning a pregnancy after a frozen pregnancy are concerned with the question: how likely is the embryo to die next time? To assess the risks, you need to know the factors that led to the regression of the development of the fertilized egg. Specialists need to examine the aborted material and establish the reasons why it died:

• Genetic disorders of fetal development. Scientists have found that about 80% of pregnancies that fail before 8 weeks have chromosomal abnormalities. The number of chromosomes is either changed or their structure is disrupted.
• Hormonal disorders. About 20% of pregnancies fail due to excess testosterone, or prolactin, or lack of progesterone, or a combination of these factors. The vast majority of pregnancies that are miscarried due to hormonal disorders die due to insufficient luteal phase of the mother's menstrual cycle.
• Immune causes. Pregnancy can die due to the incompatibility of the spouses, as well as due to the presence of antibodies in the mother’s blood, which cause either thrombus formation in the placental circulatory system or the occurrence of inflammation in the chorion.
• Infectious factors. The most common cause of embryo death due to infections is infection in the early stages of gestation. This provokes pathological measurements in the circulatory system between mother and fetus.
• Insufficient blood supply to the placenta. It is a common cause of spontaneous fetal death in the 2nd and 3rd trimesters. Impaired blood flow can occur for two reasons: due to abnormalities in the structure of the vascular system of the placenta, or due to the formation of blood clots in it, which can be caused by genetic factors (for example, thrombophilia in the mother).

A study of aborted material during a non-developing pregnancy will determine what caused the death of the embryo and the attending physician will either prescribe treatment for the woman or continue to study her body to understand whether it is possible to prevent a frozen pregnancy in the future.

If the aborted material has not been examined, then before planning the next child, the woman must undergo a series of examinations to find out whether the death of the embryo was caused by a spontaneous genetic failure or was a consequence of pathological processes in the body of the expectant mother.

If in the first case no treatment is required, then in the second, doctors will have to think not only about the scheme for correcting pathological disorders in the woman, but also about what kind of drug therapy to carry out in the event of a new pregnancy.

Genetic testing– involve visiting a geneticist who will take the necessary blood tests and determine the presence of hereditary genetic mutations in a couple who is preparing to conceive a child.

Hormonal study– involves taking blood on certain days of the cycle to study the concentration of hormones in a woman’s body. Estrogens, prolactin, FSH, LH and testosterone are released on days 3–5 of the menstrual cycle. 17-OH-progesterone, DHEA sulfate, SHBG - from 8 to 10 days of the cycle. Progesterone - on the 7th day after ovulation.

Research into autoimmune disorders– involve a visit to a gynecologist-immunologist, tests to determine the compatibility of spouses, the presence of antisperm antibodies in a woman and pathological changes in the functioning of the immune system. The main study will be to test to rule out antiphospholipid syndrome (APS), which contributes to embryo rejection.

Standard examinations when planning: ultrasound of the uterus and appendages, analysis for STDs, gynecological examination, snapshot of the sella turcica, visit to a therapist.

It is problematic to provide a complete list of necessary tests - each specialist, having examined the clinical picture of a frozen pregnancy, can prescribe examinations that are necessary only in a specific case.

Planning after a missed pregnancy

You can start planning for a child only after the reproductive system has been fully restored after a missed pregnancy. The gynecologist will determine the body’s readiness to conceive, based on several factors:

1. Normalization of the menstrual cycle;
2. Healing of the uterine cavity after curettage;
3. Normalization;
4. The absence of STDs, or the presence of some of them in inactive phases;
5. The fullness of the luteal phase of the menstrual cycle.

Your doctor may recommend taking a course of vitamins and folic acid before planning a pregnancy.

Despite the fact that visiting a geneticist and gynecologist-immunologist is recommended only after several missed pregnancies, you need to understand that the embryo never stops developing for no reason. Therefore, you should not wait for the child’s death to happen again and start planning the next pregnancy only when doctors have carried out the necessary research.

Perhaps, during planning and in the first weeks after conception, they will prescribe drug therapy that will help the child circumvent the threat from the mother’s body and allow him to develop correctly and at a normal pace.

How long until the next planning?

After the loss of a desired pregnancy, a woman may be depressed for a long time and her only desire will be to drown out the pain of loss by conceiving another baby. Therefore, at an appointment with a gynecologist, the question invariably arises: when can you get pregnant after a frozen pregnancy? Doctors advise starting planning no earlier than six months after curettage or miscarriage.

This period was not determined by chance:

• The examinations that need to be completed will take a lot of time. Therefore, the woman will have to wait several months before the cause of the death of the embryo becomes clear.
• After curettage of the membranes of a frozen pregnancy, the uterus should heal, and the endometrium should fully restore its structure. If this does not happen, the next pregnancy will also be in danger of regression, only now due to insufficient functioning of the endometrium.
• A woman’s body needs to be saturated with folic acid in order to reduce the possibility of developmental abnormalities in the child during subsequent pregnancy. It will take several months for full saturation.
• If the cause of the lost pregnancy was the improper functioning of the endocrine system, then it will take time to correct the concentration of hormones in the blood to normal limits.

Of course, pregnancy after a frozen pregnancy can occur after 1 to 3 months. But in this case, the baby’s life will be at constant risk of not only a repeat case of regression in development, but also a miscarriage due to a weakened uterus after curettage.

How to get pregnant and carry a child to term after a frozen pregnancy?

Depending on what caused the death of the fetus, treatment regimens will be determined that, firstly, will help to conceive a child without genetic disorders, and secondly, will help the pregnancy develop correctly.

Genetic factor– if the analysis of the abortive material showed that the embryo died due to genetic pathologies that have a chance of appearing again in subsequent pregnancies - the conception of a genetically healthy child becomes most likely only with IVF, where preimplantation genetic diagnosis (PGD) will be performed before embryos are transplanted into the uterus .

Getting pregnant in the usual way, with the hereditary genetic factor of a frozen pregnancy, is dangerous - the risk of giving birth to an unhealthy child is too great or, most likely, the risk of a second frozen pregnancy.

If an analysis of the abortive material showed that the genetic mutation was spontaneous and the genetic set of chromosomes of the father and mother allows them to have healthy offspring, it is possible to become pregnant after removal of a non-developing pregnancy naturally.

Hormonal factor– assumes that from the first days of the next pregnancy, regular monitoring of the concentrations in the blood of the expectant mother of hormones that caused the death of the embryo last time will be carried out. The frequency of checks is determined by the doctor.

At the slightest deviation from the norm, emergency hormonal correction is carried out to stabilize the functioning of the organs of the reproductive system and maintain the vital activity of the fetus.

In addition, menstruation after a frozen pregnancy caused by a hormonal factor may be irregular for about six months. Therefore, a new pregnancy will become possible only after correcting the functioning of the endocrine system.

Autoimmune factor– the next pregnancy after a frozen one should be monitored by an immunologist. If possible, he will prescribe a treatment regimen that will, firstly, allow the woman to conceive a child, and secondly, temporarily weaken the woman's immune system to increase the chances of survival of the embryo.

Preliminary drug therapy before conception, with an autoimmune factor, is very important, since pathological changes in homeostasis occur soon after implantation of the fertilized egg into the uterine wall.

Infectious factor- suggests that a new pregnancy should be planned only when the infection that led to the death of the previous embryo can be cured. The main barrier to pathogenic flora in the female body is the cervical canal.

If it is affected by chronic diseases, then it is much easier for infections to penetrate into the uterine cavity and cause pathological changes in the structure of the fertilized egg. Therefore, before a new pregnancy, it is necessary to pay attention to the condition of the cervix.

A frozen pregnancy is not a death sentence - it signals that there are certain problems in the mother or father’s body that have prevented the embryo from bearing. In most cases, with the proper level of treatment, these problems can be overcome and the woman can carry her next pregnancy safely.

Specialist help

Feel free to ask your questions and our staff specialist will help you figure it out!

“I can’t get pregnant after a frozen pregnancy.” These words can be heard from many women who are faced with this problem. Why doesn’t conception occur? And what needs to be done for the desired pregnancy to occur.

Problems with conception after a woman has suffered a frozen pregnancy can be different. Sometimes they are associated with the causes of fetal death, and sometimes with the consequences of what happened or incorrectly provided medical care.

Factors that may interfere with successful fertilization:

• Chromosomal abnormalities or developmental pathologies of the unborn child. Most often, they lead to a halt in the development of pregnancy. The death of the fetus is a natural selection carried out by nature itself. Such anomalies can be associated with a variety of negative factors: fragmentation of a man’s sperm (that is, a break in DNA chains), chronic diseases of the mother or acute infections suffered by her after conception or shortly before it, poor ecology, unfavorable working conditions for women, taking certain medications, chemical influences and so on. All this can, in subsequent attempts to conceive a child, not only lead to a missed abortion, but also interfere with fertilization.
• Inflammatory diseases. Unfortunately, a frozen pregnancy can lead to the development of serious inflammatory diseases of the female reproductive system, and this often happens. There are several reasons for this. The first and most common is late or inaccurate diagnosis. If the specialist has not determined that the fetus is no longer developing, then it will begin to decompose in the uterine cavity, and this will certainly provoke inflammation. The second reason is unsuccessful cleaning. If the fertilized egg is not completely removed, then, remaining in the uterine cavity, it will begin to decompose and provoke inflammation of the endometrium and deeper layers. When diagnosing complications, repeated curettage will be required, as well as the use of antibiotics and other drugs.
• Violation of the integrity of the endometrium after rough or unsuccessful cleaning. Curettage is often a necessary manipulation performed after a diagnosis of “frozen pregnancy” has been made. It is required if the fetus has not left the uterine cavity. But even if it comes out, fragments of the fertilized egg or placenta may remain on the endometrium, which will subsequently begin to decompose and rot, which will lead to serious inflammation.
• Hormonal disorders. They can also lead to the fading of pregnancy, since some hormones have a direct effect on its development. And if there is a shortage of them, the fetus may die.

When is it allowed to plan conception after a missed pregnancy?

In general, a subsequent pregnancy after the first one has died can occur in the very near future, namely after the complete restoration of the cycle and the onset of ovulation. But, as a rule, the death of the fetus becomes a serious burden and a real shock for the female body, which often leads to hormonal disruptions and disruption of the genital organs. And in such cases, conception is impossible.

Even if the cycle has been restored, this does not mean that the woman and her body are ready to conceive. If pregnancy occurs in the near future, it may end just as tragically as the first. That's why it's worth waiting. Typically, experts advise their patients to resume planning 4-6 months after the incident, but the rehabilitation period may well drag on.

You should start trying to get pregnant again only after the body has fully recovered, as well as after finding out the reasons for the death of the fetus in the womb and their complete elimination. The condition of the reproductive system organs should be monitored by a specialist using ultrasound.

What to do if you can't get pregnant?

What to do if you can’t conceive a child after a missed pregnancy? Don’t despair and don’t give up, this definitely won’t help. Ask your gynecologist to prescribe a more thorough examination, and both partners must undergo it, since the man may have problems. If the doctor refuses you or assures you that everything is fine, try to find another specialist: more competent, experienced and qualified.

If no problems have been identified that could prevent conception, then try to change your attitude towards planning a new pregnancy. Don't obsess over it, don't blame yourself, just relax and enjoy life. This really helps a lot of people.

Finally, I would like to wish all women planning pregnancy a speedy onset.

Video from a specialist

Necessary tests and treatment after a frozen pregnancy. Preparing for pregnancy after a frozen pregnancy.

Sometimes it happens that a long-awaited pregnancy ends in a terrible tragedy - the death of the fetus. When a woman has a frozen pregnancy, as a rule, she undergoes a curettage procedure - freeing the uterine cavity from dead cells by removing the top layer of the endometrium. This operation is performed under general anesthesia.

The rehabilitation process after curettage can last several months. After a woman recovers from such a strong shock and grief, she quite often wants to get pregnant again and still give birth to the desired baby.

But when can she get pregnant again? How long will it take for her body to recover? How to make sure everything goes well this time? We will try to understand all this in this article.

Menstruation after a frozen pregnancy

• The menstrual cycle after curettage of pregnancy should normally return within a month. That is, in 25-35 days the woman should begin her first period after the operation. However, there are cases when menstruation is restored only after a couple of months. There's nothing wrong with that
• Each woman's body is completely individual. The process of restoring the monthly cycle after a missed pregnancy is influenced by hormonal levels, emotional state and the ability to heal the genital organs themselves.
• The fact is that during curettage, one might say, the top layer of endometrial tissue is torn off. In other words, it turns out to be a living wound. The rehabilitation period for women’s health will depend on how quickly this wound heals.
• Immediately after surgery, the patient may experience minor bleeding. They do not pose any danger, but are only evidence that the endometrium is being restored. However, a woman will need to be wary if such discharge becomes abundant, produces an unpleasant odor and causes severe pain. In this case, it is better to inform your doctor about the presence of such symptoms. They may be signs of infection and infection in the uterine cavity
• The first menstruation may have slightly different manifestations compared to the usual menstruation. Bleeding is sometimes less intense and shorter lasting
• And sometimes, on the contrary, the discharge is more intense and lasting. All these deviations are quite understandable. The female body has suffered so much stress that it is still very difficult for it to fully recover to its normal state.
• Pain during the first menstruation after curettage can be many times stronger than during menstruation before surgery, or may not be accompanied by pain at all. If the pain is unbearable, of course, it is better to consult a doctor
• The nature of the first menstruation in general can also be influenced by the period at which the life inside the woman ended. The longer the period, the more difficult and longer the recovery will be.

To identify the causes of fetal fading and when planning the next pregnancy, a woman will need to undergo a number of laboratory tests:

1. Fetal histology analysis
2. Hormonal tests. Such studies are carried out if hormonal changes in a woman’s body are suspected.
3. Vaginal flora smear. This analysis allows us to exclude the presence of such dangerous sexually transmitted infections as genococcus and group B streptococcus
4. Genetic or chromosomal studies of the fetus for karyotype. Such tests make it possible to find out whether the reasons for the failure to carry the pregnancy to term were any inherited disorders of the fetus
5. Analysis for hidden infections such as chlamydia, papillomavirus, herpes, cytomegalovirus, ureaplasma or mycoplasma
6. An immunogram is a study that allows you to determine the state of a woman’s immune system
7. Coagulogram and hemostasiogram - tests for blood clotting
8. Test for the presence of an autoimmune disease such as antiphospholipid syndrome
9. Typing for second class histocompatibility antigens for both parents is a study that allows us to identify immune forms of frozen pregnancy

It is worth noting that some of the above studies are quite expensive, and they are prescribed only if there are very good reasons to suspect a certain disease.

Histology after frozen pregnancy

• Histological studies after a frozen pregnancy make it possible to roughly determine what was the cause of fetal death
• To carry out this analysis, tissues scraped from the uterine cavity are taken. Sometimes, by order of the doctor, a thin ball of epithelium from the uterine cavity or fallopian tube is also given for analysis.
• When all the materials are collected, they are sent to the laboratory for careful examination under a microscope and to identify the causes of pregnancy loss.

In the course of such studies, the following factors can be determined that influence the interruption of fetal development:

• sexually transmitted infections
• diabetes
• pathologies of uterine development
• viral infectious diseases (hepatitis or rubella)
• chronic diseases of the female genital organs
• disturbances of hormonal processes in a woman’s body

All of these diseases can be detected using histological examination of the fetus. However, such research only gives the direction in which to look for the cause.

To accurately identify the disease and its effect on pregnancy, you will need to undergo other tests. They will give a clearer picture, help decide on treatment and prevent a recurrence of the situation.

First of all, when it is established that the fetus is frozen in a woman’s uterus, she is prescribed a cleansing, that is, getting rid of dead foreign cells. Today, world practice knows three ways to cleanse the uterine cavity from a dead fetus:

1. Medical abortion. This type of cleansing involves taking special medications that provoke a miscarriage. As a rule, this method is used for a period of no more than eight weeks.
2. Mini-abortion or vacuum aspiration. This procedure involves removing unnecessary contents of the uterus using a special vacuum. It is performed under general anesthesia
3. Spontaneous abortion. Foreign experts in the field of gynecology consider this method the most humane and gentle. They simply wait until the uterus itself begins to reject the foreign body and pushes it out. Spontaneous abortion is carried out under regular medical supervision. If a woman shows signs of inflammation, she undergoes a mini or vacuum abortion.

In addition to cleaning, a woman may be prescribed a course of antibiotics. As a rule, such drugs are prescribed when there is an infection in the uterus.

• As mentioned above, after a frozen pregnancy, a woman will need to undergo a series of tests. It is based on the results of these tests that adequate treatment is prescribed.
• If the cause of fetal death is hormonal imbalances in a woman’s body, she is prescribed hormonal medications. The same drugs can be prescribed in case of prolonged absence of menstruation to restore them. Taking hormonal medications can also serve as an excellent contraceptive.
• If a woman has been diagnosed with sexually transmitted infections or other diseases, the doctor will first take care of their treatment
• It is very important during the rehabilitation period to protect the unhappy woman from additional negative emotions and experiences.
• The best medicine for her will be care and guardianship. In some cases, when a woman’s mental-emotional state is at its peak, the doctor may prescribe her a course of sedatives and tranquilizers

What to do if there are already 2, 3, 5, 7 missed pregnancies?

• After the first frozen pregnancy, in almost ninety cases out of a hundred, women manage to carry and give birth to healthy children. For those families who have suffered such a tragedy not for the first time, the chances of a positive outcome only decrease
• In order to prevent such a sad event, future parents first need to undergo all the necessary research. Do not ignore referrals for tests prescribed by the doctor
• The doctor must have complete information about the reasons for not carrying a child to term in order to prescribe the correct treatment. Sometimes a small difference in diagnoses can lead to another fetal death. Why should both partners take the tests seriously?
• When undergoing the prescribed treatment, there is no need to rush into a new pregnancy. It is better to listen to the doctor’s recommendations and wait until the causes of previous miscarriages are completely eliminated
• In some cases, doctors advise abandoning further attempts for the benefit of the woman’s physical and mental health.
• After all, every failure entails a number of consequences and aggravation of the situation. Sometimes a doctor may recommend that a couple consider surrogacy or adoption

How long after a missed miscarriage can you plan your next pregnancy?

• A woman can become pregnant immediately after her previous pregnancy has died. Her cycle can be restored very quickly and fertilization is possible already at the very first ovulation
• However, this does not mean that pregnancy will be desirable. The fact is that the woman’s body has not yet gained strength and has not recovered from the severe stress of a miscarriage
• The endometrium of the uterus may not fully heal, hormonal levels may not yet stabilize, and all metabolic processes in the body may not return to normal activity. In such conditions, a new pregnancy is completely unwelcome
• Doctors usually recommend taking a break from six months to a year. This time will be enough for the woman to fully recover
• In addition, if during the tests any diseases of the partners are named as the reasons for the previous interruption, then before planning a new pregnancy, these reasons will need to be excluded
• It happens that after a single miscarriage, a woman becomes pregnant within a couple of months and safely carries a second pregnancy. However, such cases are the exception rather than the rule. It's always better to play it safe and follow your doctor's advice
• The length of time the second pregnancy is delayed is also influenced by the period at which the fetus froze. The larger it was, the more time it will take for the woman to recover and gain new strength.

• When preparing for your next pregnancy, you should take into account all the mistakes made during your first unsuccessful pregnancy. Expectant parents should give up bad habits (alcohol, smoking) at least three months before conception.
• Ideally, it would be if they switched to a healthy diet, began to actively engage in sports and spend more time in the fresh (clean) air
• It is advisable for the expectant mother to take multivitamin complexes at the same time. Mandatory elements required in sufficient quantities at the time of pregnancy are folic acid and iodine. There are special preparations containing only such microelements (for example, Iodomarin)
• It is advisable for women working in hard work or hazardous enterprises to moderate the load on their body. The same applies to the emotional background. During such a crucial period, they should not worry and experience stress. Expectant mothers need to be positive, forget about previous failures and believe in the best
• A prerequisite is to undergo all tests prescribed by doctors, and, if necessary, treatment
• As a rule, most subsequent pregnancies after fetal death end successfully. Exceptions, of course, happen, but very rarely
• In addition, establishing the cause of frequent miscarriages with the modern level of medicine will not be a problem at all. Having been treated and prepared for a new pregnancy, future parents have every chance of a positive result

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