Women who have experienced fetal arrest and abortion are often encountered clinically, who are anxious about future fertility problems and are very worried that the same thing will happen again.
I've written about fetal arrest many times before. Fetal stoppage in the first trimester is the normal programmed screening of human embryos in nature, just like the quality control screening of defective products in the factory, which should be thrown away, and if it is a defective product, it cannot be sold, which harms consumers. The truth is exactly the same.
Therefore, I have always agreed with first-trimester fetal preservation, and I am also extremely disgusted by the frequent monitoring of HCG and progesterone in the first trimester. Many people have created the concept of low progesterone because they are worried about fetal arrest. If progesterone is low, tire preservation begins. In the end, whether this fetus was saved, or whether the people themselves were strong enough, no one could say whether they survived. The most aggrieved is the child, who knows that he can survive, and finally has to owe you human affection: "You see, if I hadn't seriously protected the fetus back then, where would you still be now..." Such a scene has no feeling of déjà vu.
China has a very large tire protection industry chain. It is said that there are such god-level fetal protection hospitals in several cities in China, and it costs hundreds of thousands of dollars to keep a fetus in this hospital, which is actually a naked scam, but patients from all over the country are still in an endless stream. It is no wonder that Chinese like to protect the fetus since ancient times, and in the palace costume dramas we are familiar with, there are two things that cannot be stopped, the harem fight cannot be stopped, and the concubine's anti-fetal medicine cannot be stopped.
In fact, most human pregnancies are phased out.
If all pregnancies are included in the statistics, most human pregnancies are phased out. Pregnancy is divided into biochemical pregnancy and clinical pregnancy. Biochemical pregnancies must be blood tested for hCG to be detected. If you do not pay attention to it deliberately, just get stuck to the point to draw blood to check hCG, biochemical pregnancy belongs to pregnancy that will not be discovered, usually manifested as a normal menstruation, this matter is over. Clinical pregnancy refers to pregnancy that has menopause, has pregnancy symptoms, and can detect the existence of pregnancy through tests such as color ultrasound. In reality, the proportion of biochemical pregnancies occurs at about 70%, that is, human pregnancies are actually 70% of biochemical pregnancies that have not been detected. So biochemical pregnancy has no meaning. And these 30% of clinical pregnancies are not all pregnant with full-term delivery, and about 20% of them will have fetal abortive abortion in the early stages of pregnancy. Whether it is biochemical pregnancy or fetal abortion in the first trimester, it belongs to the normal procedure of nature to control the total quality of human reproduction.
Although it is a normal quality control procedure, it is still very frightening for women who have experienced fetal arrest and abortion. They are very afraid that the same thing will happen again. I hope that through preliminary preparation, through sufficient preparation, similar things can be avoided. As a result, many people will receive contraception under the guidance of a doctor, or decide on their own. There is nothing wrong with short-term contraception, but many people will stick to contraception for three months, half a year, a year, or even longer. They hope to find reliable ways to avoid planning a pregnancy after a fetal abortion.
Wrong! All wrong!
Whether it's a patient who decides to stay on contraception without permission, or a doctor who recommends contraception for 3 months to six months, it's all wrong.
There is no evidence that prolonged contraceptive duration reduces the incidence of adverse pregnancy outcomes.
Dr. Guo has several golden sentences to recommend to everyone, I hope you will remember. These words have also been repeatedly mentioned in my popular science creations in the early years:
1. Pregnancy is trial and error. If you want good results, you can only keep trying and making mistakes, perseverance, and not afraid of failure! If you stop trial and error, you don't even have the opportunity to make mistakes, will there still be a chance of success?
2. Children are screened out of the harsh natural elimination, not carefully designed by you. No amount of experts can design a healthy fetus for you.
……
Based on the above two core theories, the appropriate time to get pregnant again after fetal cessation does not have any requirements for the length of contraception. As long as the basic conditions for pregnancy are met, it is OK.
What are the basic conditions?
First, the ovaries have ovulation.
Second, the uterus can get pregnant.
Ovarian ovulation is almost always restored within 1 month of termination of pregnancy. Whether the uterus can get pregnant depends on the recovery of the uterus, the color ultrasound prompts that there is no tissue residue in the uterus, and the uterus can menstruate normally, which proves that the uterus has recovered.
So, basically, after a re-examination of the ultrasound after the miscarriage, no abnormalities were found in the uterus, and after the resumption of 1 menstruation, you can plan your pregnancy again.
Many people can't accept it, thinking that miscarriage is very harmful to the body, and they need to fully recover their body, and they need to use some conditioning to feel solid. Regarding the "conditioning" thing, I am very opposed. There is no objective evaluation standard, all the content is subjective, you feel that the body is hurting, you feel that the body is not recovering, you feel that you need conditioning, so how far do you have to feel that the body has recovered, to remember that you are well conditioned? Can you tell it yourself? You obviously can't say it clearly, and your reasoning is "I'm not a doctor, the doctor must know." "I tell you, no doctor knows. Even if someone suggests that you regulate for half a year, three months, or how long, they don't actually know, but it just caters to your desired conditioning mentality. And before and after the conditioning, you do not feel a significant gap in your body. Oh no, you may feel the gap before and after the conditioning, because before and after is what you feel, good or not depends entirely on whether you believe it or not, the so-called faith is the spirit, unbelief is not the spirit.
Readers who still insist on the appeal after I have written these are please take it! Dr. Guo can't cure your disease.
Why is there such a special issue of science popularization. Because I recently contacted a lot of elderly women in the outpatient clinic, I was more impressed by a 32-year-old woman, who had two fetal arrests 8 years ago, and since then she has been afraid to get pregnant because of fear, and there was another biochemical pregnancy half a year ago, and then contraception has been used so far. According to her, the doctor of the previous biochemical pregnancy suggested that she use contraception, saying that she was afraid that she would be pregnant again and that she would stop the fetus, saying that she wanted to recover. I'm not sure if her previous doctors really gave her advice like that. If it is true, I would like to ask, she is 32 years old this year, 33 years old next year, with her reserve status of ovarian function, is the probability of fetal arrest and miscarriage at the age of 32 years old, or after 1 year of cultivation, the probability of fetal arrest and miscarriage at the age of 33 is higher?
A woman's ovaries are like a granary, and the eggs in the ovaries are like grain in a granary. The total amount of food in the granary is already constant at birth, and when a woman is born, the total number of oocytes in the ovaries is about 2 million. After birth, these oocytes remain there, dormant. It is not until puberty that ovulation begins, and only one egg is activated for each batch of eggs. From birth to adolescence, a long period of more than 10 years of dormancy, will the quality of egg cells change? The grain in the granary has been stored for more than 10 years, will the quality of the grain change? Will definitely change. Even if you don't eat a grain for 10 years, the grain will still decrease, because if you don't eat it, the bugs will eat, the rats will eat it, and the grain itself will be moldy and pregnant. The same goes for the eggs in the ovaries. Although there are 2 million eggs at birth, only 200,000 to 300,000 are left during puberty, and the rest are naturally locked. And the remaining two or three hundred thousand are not moldy, whether there are natural defects, not necessarily.
The eggs you ovulate at the age of 16 are young eggs that have been stored for 16 years, and the probability of mold or defects is relatively low. The probability of fetal abortion after conception is also relatively low.
The egg you ovulated at the age of 32 is a middle-aged egg that has been stored for 32 years, and the probability of mold or defects is significantly increased compared to the 16-year-old egg. The probability of fetal arrest miscarriage after conception is also significantly increased.
So you say that the probability of an embryo formed after the conception of your ovulated egg at the age of 33 will be lower or higher than that of the 32-year-old?
On the issue of fertility, there are no risk factors, which are more harmful to fertility than age.
There will always be young girls of twenty-four or five years old who tell me what she is "fertile constitution", which is the "fertile constitution", purely because of youth. You let her try it in 10 years to see if she dares to say that she is "fertile"!
How long does it take to get pregnant again?
How long does it take to get pregnant again?
How long does it take to get pregnant again after a biochemical pregnancy?
How long can I get pregnant again after tubal pregnancy?
It's all the same logic of thinking.
How long does it take to get pregnant after conservative treatment for ectopic pregnancy?
This should be the time node of healing. Blood hCG is measured weekly to normal levels, even if it is cured, and then you can plan to become pregnant.
How long after molar and chorionic carcinoma can I get pregnant?
There are strict follow-up requirements for this, and the usual follow-up standard at the end of treatment is 1 year. After the blood hCG drops to normal, it is also necessary to repeat the blood hCG every month for 1 year. Therefore, it is necessary to complete this 1 year of monitoring, and the indicators do not rebound before you can plan pregnancy.
On the issue of molar, choriocarcinoma contraception.
Many experts on the Internet say that they cannot use contraceptives, they cannot use rings, and it is recommended to use condoms. It is right not to be able to use the ring, but it is wrong not to be able to use the pill. Guidelines recommend that the preferred contraceptive measure is short-acting oral contraceptives. Because it is safe and reliable. Although condoms are also safe, they are not reliable enough and there is a risk of contraceptive failure. The risk of contraceptive failure with short-acting oral contraceptives is minimal.
After a caesarean section, strict contraception is usually recommended for 18 months before becoming pregnant. But that doesn't mean you have to terminate your pregnancy early if you get pregnant early. You just increase your risk of terminating your pregnancy.
As for the interval between contraceptives after uterine fibroid surgery, it depends on the location of the specific fibroid and the degree of destruction of the uterine structure. Contraception is required for up to 18 months or more, and the shortest can be unaffected.
How long after ovarian cyst surgery can I become pregnant?
There are no specific requirements, and ovulation can be restored. For patients with chocolate cysts, pregnancy should be obtained as soon as possible after surgery, and the sooner you conceive, the better. If there is no short-term birth plan, medication maintenance therapy is recommended for a period of time.
Here are two articles for reference.
A 2019 Lancet article argued that re-pregnancy within 12 months of a miscarriage did not increase the risk of adverse outcomes for another pregnancy.
Conception within 12 months of a stillbirth was common and was not associated with increased risk of adverse outcomes in the subsequent pregnancy. These findings could be used when counselling women who are planning future pregnancies after a stillbirth and for informing future recommendations for pregnancy spacing in a high-income setting.
Does short birth spacing lead to an increased risk of placental implantation? However, from the data in this article, it is not.