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Miscarriage - Symptom, Treatment And Causes

A Miscarriage usually occurs when the fetus dies before the 20th week of pregnancy. In medical terminology, a Miscarriage is also called a spontaneous abortion. Miscarriages are very common, according to a study, approximately 50% pregnant women can experience a miscarriage. Signs of a Miscarriage include severe back pain, weakness, fever, abdominal pain, acute cramps and mild to heavy bleeding. It is important to consult your obstetrician if you experience such symptoms.

What causes miscarriages?

  • Dangerous genetic problems which the unborn baby can develop.
  • Infection
  • Medical conditions existing in the mother like thyroid diseases and diabetes.
  • Hormonal problems
  • A very weak immune system.
  • Physical problems experienced by the mother.
  • Abnormalities or problems in the uterus

Risk factors which can lead to a Miscarriage:

  • If a woman’s age is over 35.
  • If a woman has medical conditions such as thyroid problems or diabetes.
  • If she has had three or more Miscarriages in the past.
  • A woman can also experience a Miscarriage is she has a weak cervix. This is also known as incompetent cervix, in such cases the woman’s cervix cannot hold a pregnancy. A Miscarriage caused due to cervix insufficiency occurs during the second trimester.

    Symptoms of a Miscarriage caused by cervical insufficiency:

    • A sudden pressure in her uterus.
    • A woman’s “water” can break all of a sudden.
    • Tissue from the placenta and fetus gets expelled from the vagina without any pain.

    What happens after a Miscarriage?

    The health care provider or an obstetrician will perform some blood work, ultrasound test and a pelvic exam to confirm if there has been a Miscarriage. Sometimes, during a Miscarriage the uterus usually gets empty and no treatment is required. But in case the uterus isn’t empty a procedure called dilation and curettage (D & C) procedure is carried out. In this surgery the cervix is dilated at first and then the remaining placental or fetal tissue is removed from the uterus. Most of the times, certain medications are prescribed so that your body can expel the remaining tissues out of your uterus. This is an ideal option for some women who want to avoid a surgery and have a stable condition during the Miscarriage.

    Medications, genetic tests and blood tests are mandatory for women who have had more than three miscarriages in a row so that the doctor can diagnose the root of the problem and avoid further Miscarriages in future.

    Treatable by medical professional Require medical diagnosis Lab test always required Short-term: resolves within days to weeks
    Fluid, blood or tissue passing from the vagina Pain in the belly or lower back

    Popular Health Tips

    Recurrent Pregnancy Loss - What Things Should You Avoid?

    Dr. Yuthika Bajpai Sharma 85% (38 ratings)
    MBBS, MD - Obstetrics & Gynaecology
    Gynaecologist, Kanpur
    Recurrent Pregnancy Loss - What Things Should You Avoid?
    Recurrent pregnancy loss is termed as the occurrence of three or more miscarriages. Recently, the American Society for Reproductive Medicine has altered the definition and limited the number of miscarriages to two. A pregnancy loss can only be termed so if the pregnancy is clinically recognized and is ends involuntarily before 20 weeks. The pregnancy loss must be identified by a registered doctor to term it as pregnancy loss. What are the major causes of Recurrent Pregnancy Loss? There could be a lot of reasons behind recurrent pregnancy loss. Most of the pregnancy failure happens from reasons such as abnormalities of the genes, chromosomes and other random events. It is estimated that close to 15 percent of the pregnancies end up in miscarriages. While 30-60 percent of the pregnancies expire within the first 12 weeks, fifty percent of the women are believed to be not aware of the pregnancy in the first place. The risk of miscarriage, however, is less than 50 percent. An advanced maternity age is another crucial factor towards recurrent 2pregnancy loss. The risk of miscarriage dramatically increases among these women owing to their poor quality of egg, abnormalities in the chromosome etc. At a time, it has been observed that either the father or the mother might have irregularities in the gene leading to early miscarriage. An abnormality in the uterus might also be a reason for a miscarriage. Poor blood supply and inflammation of the uterus are two of the topmost reason for miscarriages among many women. While some women born with a defective uterus, some develop uterus anomalies due to lifestyle and unhealthy life practices. Last but not the least, a woman s immune system might also play a pivotal role towards a miscarriage. Certain hormonal irregularities, diabetes and thyroid diseases might lead to a miscarriage. Then there are the environmental factors such as stress, occupational factors, lifestyle practices etc that contributes towards a miscarriage. What are the tests conducted? To evaluate the exact reason for repeated miscarriages, a doctor performs a detailed physical and surgical examination. Some other areas where a doctor sneaks into include family history, genetic history etc. A karyotype test might also be prescribed in case a doctor feels the need of doing so. The uterus cavity and the uterus are closely monitored to understand any potential lack in the anatomy. This is followed by a list of imaging tests that a doctor might prescribe. These include MRI, X-ray, hysteroscopy etc. What are the treatment options? The treatment options are decided based on the finding of the tests. Sometimes plain medicines along with antibiotics can cure the condition, while sometimes surgery might be required to fix any potential threat within the uterus. In any case, the probability of future pregnancy after treatment goes as high as 77 percent.

    Repeated Miscarriage- A Painful Experience for the Couples

    Dr. Sujoy Dasgupta 89% (10379 ratings)
    MBBS (Gold Medalist, Hons), MS (Obst and Gynae- Gold Medalist), DNB (Obst and Gynae), Fellow- Reproductive Endocrinology and Infertility (ACOG, USA), FIAOG, MRCOG (London, UK)
    Gynaecologist, Kolkata
    Repeated Miscarriage- A Painful Experience for the Couples
    Pregnancy gives a woman completeness by turning her into mother from a simple woman. It is the thing which makes the couple parents, the dream which they nurture right time from their marriage. Of course, there are many couples who are not fortunate enough to achieve pregnancy and they are usually termed infertile and we have discussed it in separate post. But there are other couples who may or may not (as this is the usual case) find difficult to conceive but the pregnancy does not continue to the age of viability. Age of viability means the age, when a baby born can survive. Thanks to the improvement in neonatal care by leaps and bounds and availability of NICU which made it possible to survive even a baby born at 22 weeks. For example, last month we delivered a baby at 28 weeks of pregnancy, who is fine now. But if the baby is 'born' before 20 weeks, it is called MISCARRIAGE. This is because these babies who weigh less than 500 grams cannot survive outside the uterus. It is seen that 10-15% couples who conceive successfully may not be able to carry pregnancy beyond 20 weeks. Thus, the miscarriage rate for a single pregnancy is 10-15%. But in most of the time this mishap does not recur in future. We call it 'sporadic miscarriage' and often the cause is not known. But almost 1% of the couples who want to get pregnant may suffer from repeated miscarriage. That means the unfortunate events can repeat. These are called 'RECURRENT MISCARRIAGE' or 'REPEATED PREGNANCY LOSS *RPL) CAUSES So, what's the reason for RPL which is equally frustrating for the patients as well as the doctors? First of all let me honestly confess that in most of the cases the cause is not known (50-60%) and this is called 'UNEXPLAINED RPL'. Again, we have to admit that despite tremendous advancement in science, the knowledge behind RPL is limited. Many theories and causes have been proposed but most of them could not withstand the taste of time. That means if a problem is found in husband or wife, we are not certain whether the treatment of that problem will prevent future miscarriage. This should be explained properly to the couples to have realistic expectations and avoid unnecessary frustration s in future. Only factors which are definitely associated with RPL are only two- anti-phospholipid antibody syndrome (APS) and chromosomal problem of either of the couples. Detection and treatment of these problems are often rewarding as after treatment pregnancy continuation rate us very high. The other causes have been proposed but as mentioned above the link between RPL and these causes are not yet very clear and need further scientific research. Please remember according to the timing, RPL may be divided into two categories- the 1st trimester RPL (occurring before 12 weeks in each pregnancy) or second trimester RPL (12-20 weeks in each pregnancy). 4-5% cases may be due to genetic or chromosomal problem of the couples. These problems can affect the egg (ovum) and/or the sperms. Even if the couples are normal, the baby may have abnormal chromosome.It is blessing that a genetically abnormal baby is miscarried by the nature, otherwise if it survives there is high chance that it may be mentally or physically handicapped. The reason may be increased age of the mother (above 35 years especially), exposure of mother to some environmental pollutants or sometimes increased age of the father (the latter is controversial). The diagnosis is done by chromosomal analysis of the couple by Karyotyping or FISH from blood samples. If the baby has been miscarried, it may be rational to send the tissue of the baby for chromosomal analysis to find out the cause. The treatment option in next pregnancy in such cases is genetic counselling by an expert and in most cases unfortunately only one option remains- that us IVF and PGD (pre implantation genetic diagnosis) where only genetically tested normal embryos are transferred by IVF ('test tube baby'). Anatomical factors are responsible for 12-15% if RPL, in most cases the second trimester RPL. The most common cause is 'CERVICAL INCOMPETENCE'. The cervix is the mouth of the uterus which should remain closed in pregnancy to support pregnancy and should only open during delivery. But in some cases, it can open prematurely leading to miscarriage. Usually this causes apparently painless miscarriage. In many women fibroid is found as a tumour of uterus. Whether fibroids cause RPL is again very controversial among the scientists and doctors. In some women who had repeated abortion or surgery to uterus and even tuberculosis (TB) there may be adhesion (binding together) between the walks of uterus. This is called Asherman Syndrome which causes scanty or absent periods and RPL. In few women there may be Congenital Anomaly of the uterus- that is where is some abnormalities inside uterus from birth. Therecan sometimes cause RPL, although controversial. These anatomical problems are diagnosed by proper examination, some tests like HSG (hysterosalpingogram), SSG (sonosalpingogram), 3D ultrasonography (USG), MRI, hysteroscopy and/or laparoscopy, depending on the women and test results. The treatment should be done cautiously as treatment may not always prevent RPL. For cervical incompetence usually, we put stitch in the cervix in pregnancy or sometimes before pregnancy. Operation can be done, before pregnancy for fibroids, Asherman and congenital anomalies. In many cases (more than 70%) cases hormonal problems may be there and these may cause both 1st and 2nd trimester RPL. However, whether treatment us beneficial or not, is again controversial. The commonest pattern is Luteal Phase Deficiency (LPD) due to deficiency of hormone progesterone. PCOS (Polycystic Ovaries) is also associated with RPL. The other causes are uncontrolled diabetes, thyroid problems, high prolactin and high testosterone, high insulin and low ovarian reserve. As mentioned earlier, it is not clear whether they all need testing and treatment but usually tests advised for these are blood for progesterone, TSH, Prolactin, FSH, LH, AMH, Insulin, Testosterone, sugar, HbA1C etc. Treatment is usually progesterone supplement along with correction of hormonal imbalance. It is to be mentioned that these patients need high dose of thyroid drugs (TSH normal for other people may be considered abnormal for RPL) and more tight control of blood sugar in diabetes. In 60-70% cases the cause is Thrombolphilia, that is tendency to thrombosis or blood clotting. The most common is anti phospholipidantibody syndrome (APS) which may or may not be associated with thrombosis in other sites but can cause thrombosis if blood supply to the baby and thus causes stoppage of its heart and miscarriage. Although more common in the Western World, some Hereditary Thrombolphilia may be found in other family members and commonly cause miscarriage and thrombosis. Deficiency of folic acid and vitamin B12 rarely can cause thrombosis and RPL. The APS testing is often successful, so as the treatment with aspirin and heparin injection throughout pregnancy. With this 80% women can expect full term pregnancy. Folic acid and B12 vitamin supplement is commonly given to RPL patients. Whether testing for hereditary thrombophilia is needed in our country or not is controversial. But treatment is like APS- that is aspirin and heparin injection. Diseases of mother like diabetes, epilepsy, liver or kidney diseases, SLE etc can cause miscarriage. Exposure of mother to harmful substances like environmental pollution, radiation, chemotherapy and some toxic drugs, smoking, alcohol, cocaine, cannabis etc are also responsible but the latter usually cause sporadic miscarriage rather than RPL. So, these drugs should be stopped and replaced by safer drugs and the diseases must be treated properly. Even exposure of father to some drugs can cause RPL. Again, some abnormalities of sperms may cause RPL. So, semen analysis of the husband is usually done as a test for RPL. The most controversial topic for RPL is the infections. But it is the fact proved by scientific studies that only infection in current pregnancy causes miscarriage. So, infection is a cause of sporadic miscarriage, not RPL. In the past TORCH testing was very much popular but nowadays it is obsolete test and there is no scientific ground for tests or treatment of TORCH. Only test we recommend is rubella testing. If rubella IgG is negative that means you may get infection in pregnancy so we advise to take rubella vaccine and avoid pregnancy for one month. On the other hand, rubella IgG positive means you are already immune and thus you can never get rubella. So vaccine is not useful in those cases. If any genital infection is found in husband or wife, both of them should be tested and treated aggressively. TESTS REQUIRED First of all, we need to know when we should advise tests. Assuming that most cases of miscarriages are SPORADIC, we usually do not advise investigation after single miscarriage unless the couple insists or there is some reason by the doctor to suspect some abnormalities that might cause future miscarriage. In the past testing was started after 3 miscarriages. But nowadays we do not want to give the couple, especially the woman a third trauma. So, we usually advise tests after 2nd miscarriage. The tests usually start with checking for chromosome of the baby. It is followed by chromosome analysis of both the partners along with proper history taking and physical examination. Semen analysis is done for the husband. The wife is advised ultrasonography, routine blood, thyroid testing, testing for APS and blood group. These are tests usually done everywhere. Further tests are done depending on the results if initial tests and especially if no cause is found after initial tests. It should be mentioned to the couples that the 2nd group if tests often do not have scientific grounds and are done only on benefit of doubt. They may not change the management plan. TORCH test is not done in modern era. TREATMENT The basic treatment is support if the couples, reducing stress as stress can be responsible for RPL. When a cause is found this should be treated. While an optimistic approach should be taken with expectations for normal pregnancy in future but this should be based on scientific and realistic approach to avoid future frustration. The treatment may not be 100% effective and most treatment may not have scientific base but are usually not harmful. Treatment may not guarantee a successful future pregnancy but a positive attitude is necessary. This is called TENDER LOVING CARE (TLC) where proper support and discussion can help more than explanation if mere statistics. Treatment should be continued both before and after pregnancy confirmation, as mentioned above. This is to be mentioned that even after 6th miscarriage, the chance that future pregnancy will be normal is more than 50%. So, the message should be not to give up hope.
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    Understanding The Reasons Behind Recurrent Miscarriage!

    Dr. Shiva Singh Shekhawat 94% (100 ratings)
    MBBS, DGO, DNB, CIMP, Fellowship In Minimal Access Surgery, Diploma In Minimal Access Surgery, Fellowship In ART
    Gynaecologist, Chennai
    Understanding The Reasons Behind Recurrent Miscarriage!
    Recurrent pregnancy losses happen to a very small fraction of the population. Only 1% of couples are affected by it. Nevertheless, it is a very difficult and serious process to deal with due to the sensitivity of the issue. A woman is said to have recurrent pregnancy losses if she has lost 3 or more of her pregnancies. Although the exact reason for recurrent pregnancy losses are not known, there are several suggested reasons. Reasons why it may happen Anomalies in the uterine lining such as polyps (abnormal tissue growth, usually in the cervix), or fibroid tumors can result in miscarriages if left untreated. Hormonal factors such as thyroid malfunctions or pituitary problems can cause an imbalance in the luteinizing hormone (a hormone which triggers ovulation) resulting in miscarriage. Age is also an issue one must keep in mind while addressing pregnancy losses. Women over the age of 35 are more likely to experience recurrent pregnancy losses. As women get closer to menopause, their bodies produce reduced levels of hormones and eggs which cater to a pregnancy. Therefore, due to the reduced levels of hormones, an older woman is susceptible to losing a baby as they have elevated levels of hormones and therefore are more fertile. Lifestyle factors also have been linked to recurrent pregnancy losses. Constant exposure to toxic chemicals can result in pregnancy problems. Along with that, constant drug use, smoking and excessive consumption of alcohol are some of the lifestyle choices that can cause recurrent pregnancy losses. Infections such as syphilis, malaria, measles, herpes simplex etc. can cause recurrent pregnancy symptoms if left untreated as they can obstruct and complicate the growth of the baby, resulting in premature development or pregnancy loss. Management of Pregnancy Loss Polyps and fibroid tumors are complicated disorders which should be given immediate medical attention. Although surgical methods are available, the best way to treat polyps and fibroid tumors is through the intake of progestin hormone pills which shrink the size of the polyps/cysts. Eating a healthy diet to ensure the prevention of diabetes is highly recommended. Fruits, leafy green vegetables and whole grain cereals are a prerequisite for the complete growth of the baby as well as arming the body with the necessary strength it needs for pregnancy transitions as well as a stronger immune system. A regular workout routine is also advised for pregnant women as it ensures a healthier and stronger immune system. Although recurrent pregnancy loss is very emotionally debilitating for a woman and her partner, there are several means and measures to overcome this tragedy. One should not be disheartened by such an occurrence and get the required help needed.

    Can Endometriosis Cause Infertility & Miscarriages?

    Dr. Seema Jain 89% (53 ratings)
    MBBS, MD - Obstetrtics & Gynaecology, DNB (Obstetrics and Gynecology), Royal College of Obstetricians and Gynaecologists (MRCOG)
    Gynaecologist, Pune
    Can Endometriosis Cause Infertility & Miscarriages?
    There can be a number of reasons that lead to infertility in women. Endometriosis is one of them. It is a benign condition where the endometrium, which includes the tissues that form the lining inside the uterus, grows outside the uterus. Apart from infertility, it may also cause pelvic pain in women. There are no such symptoms of endometriosis apart from pelvic pain and it cannot be detected without surgery. Thus, it is very difficult to diagnose this disease and state how common it is. However, research says that the prevalence of this disease in women in their reproductive age is between 3 to 10 per cent. It is found that endometriosis sometimes leads to infertility. Here is how: Abdominal Adhesions and Infertility Normally, the endometriosis implants develop in the abdomen. Then the body surrounds them with connective tissues. The reason for doing so is isolating the implants, so that they cannot harm your body. Now, sometimes these adhesions can create a blockage in the opening of the fallopian tube or may also pinch off the fallopian tube. This will result in obstruction in the fertilisation of egg and the sperm and thus fertilization will not take place; so there are no chances of conceiving. These obstructions when diagnosed can be treated with surgery. Secretions from implants Endometrium plays a vital role in conception where the tissues secrete a wide variety of hormones and nutrients. Now, the endometrial implant also functions in the same way and secretes those hormones. The difference is that it does not deposit them in the lumen of the womb, and it is released in the abdominal cavity. In these substances, there may be some hormones that are responsible for infertility. Prostaglandins Prostaglandins are other hormones that are secreted by the endometrium normally. It helps in a lot of body processes that include various stages of menstrual cycle and pregnancy. This hormone is required for a lot of functions such as ovulation, sperm mobility, and regression of corpus luteum, immune interaction, menstrual cramps and contraction of the uterus at birth. Just like the endometrium, the implants also secrete these hormones. And the problem that is caused by the implant secreted prostaglandin hormone is that they are released in the abdomen and not in the womb. Moreover, they are not secreted at the right time, thus sending a wrong message to the brain. A woman with a few days of pregnancy may face a miscarriage because the ovary will get a signal to start the menstrual cycle, and the womb lining where the egg is implanted will be expelled. If you too are fearing of getting this disease, it's better to visit your Gynecologist soon.
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    5 Ways to Prevent Recurrent Miscarriages

    Dr. Madhumita Das Mazumdar 94% (79 ratings)
    MD - Obstetrtics & Gynaecology
    Gynaecologist, Guwahati
    5 Ways to Prevent Recurrent Miscarriages
    Natural therapies are a great option to support your body and prepare it for pregnancy. As with any approach trying to decrease the chance of miscarriage, these steps will help to nourish and support the body, inviting a healthy pregnancy to occur. Preparing ahead of time for your pregnancy is also important for decreasing the chance of a miscarriage, these steps must be practiced for at least 3 months before you become pregnant again. If you are currently experiencing a miscarriage contact your doctor or midwife right away. Prepare for conception: The first step is to prepare your body with fertility cleansing. Fertility cleansing helps you to support the liver in cleansing the body of old toxins and excess hormones while encouraging the uterus to cleanse itself of old contents, increasing uterine circulation and tone. Eat a nutrient dense fertility diet: The next step is to nourish and build up your body to be a healthy, baby friendly body. This can be done through eating a well balanced and nutritious diet. What you eat has a strong impact on: The health of your eggs Your hormonal balance Creating a healthy placenta Decreases chance of a miscarriage Building nutrient storage for baby Creating a healthy reproductive system Build a healthy foundation: One of the major foundational steps to increase your chance of having a healthy pregnancy is to take some basic vitamins, minerals, and EFA s. There are specific vitamins and minerals that are necessary for a healthy reproductive system, hormonal balance, and ovulation. Essential fatty acids are also extremely important for miscarriage prevention. Apply fertility or abdominal massage: Another important element of promoting a healthy conception is to increase circulation to the uterus. Through applying a simple massage method called self fertility massage you are able to increase the circulation to the uterus, clear adhesions and congestion.
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    Popular Questions & Answers

    Sepia dilution 200 and gossypium Q drops daily use to cause miscarriage at 5-6 months of pregnancy?

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    Yes it can but sometimes it fails also,,soo if if u doesn't bleed within 7-8 days after using this u should consult with a gynecologist
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    Meri wife ki uterus bicornuate Hai. Ek bar miscarriage bhi ho chuka Hai. Kya kre btaynge please.

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    Pt with bicornuate uterus have a slightly increased chance of abortion ,but most pt either have preterm delivery or have caeserian sections. You can try for one more time ,if you have abortion again then go for surgical correction of bicornuate uterus (metroplasty). Fetal outcome is good after surgery.
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    What is the difference between late period and miscarriage. How is it possible to differentiate between late period and miscarriage by observations. Also please answer what are the symptoms of miscarriage. Thank you.

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    Hi, I had 2 miss miscarriage happened .and my baby developed only six week in both pregnancy .So my doctor suggest me do a torch test here in the reports toxoplasma igg is 1.34 ,cytomeglavirrus igg is 1.71 and rubella igg is 1.74 so the results is positive .just tell me it is reason of miscarriage and baby is not develop. Please tell me.

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    intrauterine growth restriction: Intrauterine growth restriction (“IUGR,” for short) is a term for a baby who is smaller than normal during pregnancy. The baby is not growing inside the uterus at the normal rate. These babies usually have a low weight at birth. Most of the causes of IUGR are beyond your control. Usually, nothing the mother did causes IUGR in her baby. But if you smoke cigarettes, drink alcohol or abuse drugs, you can cause IUGR in your baby. Pregnant women who are infected with CMV rarely have symptoms, but rather their developing baby may be at risk for congenital (meaning from birth) CMV disease. ... For a woman who has a recurrent CMV infection during pregnancy (meaning this is not a primary infection), the rate of newborn CMV infection is about 1%. A rubella infection can cause miscarriage, preterm birth, or stillbirth, as well as a variety of birth defects, but it depends on how far along you are when you contract the virus. ... If you get rubella during the first 12 weeks of pregnancy, there's a high chance (up to 85 percent) that your baby will develop CRS. If you are newly infected with Toxoplasma while you are pregnant, or just before pregnancy, then you can pass the infection on to your baby. You may not have any symptoms from the infection. ... Occasionally infected newborns have serious eye or brain damage at birth.
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    Hello everyone, This is regards of small clarification just need yours support and advice. I got married last year feb. My wife got conceived and miscarriage within 2 months, and after taken for D&C procedure. After the time duration of 6 or 7 months from D&C we planned for baby as advised. However it was not success thereof. We can face the same problem. Her cycle stopped and continue on the same month following after 7 days delay. Could you please advise us what is the exact problem. Is travel could affect baby growth or any other health issues Thanks,

    Dr. Richika Sahay Shukla 91% (326 ratings)
    DNB (Obstetrics and Gynecology), MBBS
    IVF Specialist, Delhi
    Hello Lybrate user you should try atleast for 6 month now. After D&C some patient conceive late sometime because of blood loss and thinning of endometrium. Try during ovulation period and advice your wife to eat healthy diet and do regular exercise. Avoid tension and any type of stress. If,further remain same then visit to Doctor personally for better management. All the best.
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