Miscarriage During IVF: Causes, Signs, and Emotional Impact
In vitro fertilisation (IVF) offers hope to countless individuals and couples struggling with infertility. However, miscarriage during IVF, while devastating, is not uncommon. Understanding why it happens, how to recognise the signs, and how to cope emotionally and medically is crucial for those on the IVF journey.
Understanding IVF and Pregnancy Loss
IVF involves fertilising an egg outside the body and implanting it into the uterus. Although it has given rise to millions of successful pregnancies, IVF doesn’t eliminate the risk of miscarriage. In fact, some studies suggest the miscarriage rate in IVF pregnancies may be slightly higher than natural conception, especially in certain age groups or underlying conditions.
How Common Are Miscarriages During IVF?
According to the American Pregnancy Association:
- Approximately 15%–25% of all pregnancies result in miscarriage.
- Among IVF pregnancies, miscarriage rates vary between 10% and 30% depending on age, embryo quality, and other factors.
The risk increases with maternal age, with women over 40 facing a higher likelihood due to chromosomal abnormalities.
Common Causes of IVF Miscarriage
Several medical and lifestyle factors can lead to pregnancy loss during IVF:
- Chromosomal Abnormalities: Account for nearly 50% of early miscarriages. Even embryos that appear normal can carry unseen genetic issues.
- Uterine Conditions: Fibroids, scar tissue, or an abnormally shaped uterus can make implantation or growth difficult.
- Hormonal Imbalance: Low progesterone or thyroid dysfunction can impact embryo survival.
- Autoimmune Disorders: Conditions like lupus or antiphospholipid syndrome may interfere with fetal development.
- Lifestyle Factors: Smoking, excessive alcohol, obesity, and chronic stress may also elevate risk.
Signs and Symptoms of Miscarriage After IVF
If you're pregnant after IVF, it’s important to know the warning signs of a possible miscarriage:
- Vaginal bleeding or spotting
- Cramping or abdominal pain
- Loss of pregnancy symptoms (nausea, breast tenderness)
- Lower back pain
However, light spotting or mild discomfort can be common in early pregnancy. Always consult your fertility clinic before assuming the worst.
When Do Miscarriages Happen During IVF?
Most IVF-related miscarriages occur during the first trimester (up to 12 weeks), often due to chromosomal abnormalities. In some rare cases, second-trimester miscarriages may occur due to infections, placental issues, or cervical insufficiency.
How IVF Clinics Monitor Pregnancy
After embryo transfer and a positive beta-hCG test, most clinics schedule early ultrasounds at 6–7 weeks to confirm heartbeat and gestational development. Ongoing hormone support (progesterone) continues through the first trimester to maintain a viable pregnancy.
Emotional Toll of IVF Miscarriage
Miscarriage at any stage is emotionally draining, but after the time, cost, and physical effort of IVF, the loss may feel even more heartbreaking. Common emotional responses include:
- Grief and hopelessness
- Guilt or self-blame (even though the miscarriage is almost never your fault)
- Fear of future IVF cycles
It’s vital to seek emotional support—through therapy, support groups, or fertility counselors.
What Happens After an IVF Miscarriage?
Depending on the stage and medical situation, your doctor may recommend:
- Watchful waiting: Letting the miscarriage pass naturally.
- Medication: To induce uterine contractions and complete the miscarriage.
- D&C (dilation and curettage): A minor procedure to remove tissue.
After a miscarriage, your clinic may perform additional tests such as:
- Karyotyping (genetic testing of fetal tissue)
- Uterine scans or hysteroscopy
- Blood work for hormonal or autoimmune conditions
Can You Try IVF Again After Miscarriage?
Yes. Many people go on to have successful pregnancies after an IVF loss. Your doctor will typically recommend waiting one to three cycles before attempting a new round, depending on physical and emotional readiness.
Preimplantation Genetic Testing (PGT-A) may be considered in the next IVF cycle to improve the odds of selecting a healthy embryo.
Expert Insight
“A miscarriage does not mean the end of your fertility journey. With improved embryo testing and personalised protocols, your chances of success can increase,” says Dr. Anjali Mehta, IVF specialist at Delhi Fertility Centre.
Frequently Asked Questions
- Is miscarriage more common in IVF? Slightly, particularly in older women or when using donor eggs/embryos.
- How soon can I try again after a miscarriage? Usually after one or two menstrual cycles, depending on your doctor’s advice.
- Can stress or guilt cause miscarriage? No—most miscarriages are due to chromosomal or medical causes.
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Final Thoughts
Miscarriage during IVF can be an incredibly painful experience. But with proper medical care, emotional support, and the right strategies moving forward, many women and couples find hope again. Speak with your fertility team about next steps, and don’t hesitate to prioritise your mental health as you continue the journey toward parenthood.