The time following a miscarriage or dilation and curettage (D&C) can be both physically and emotionally challenging. It is crucial that you are attuned to your body’s health and response over the next several weeks as it outlines how you are recovering and what your next steps in surrogacy will be.
In general, doctors will monitor your blood hormone levels to ensure that your HCG levels return to zero on their own. Your body will typically experience a slow bleed for up to a week following the miscarriage or procedure. The cessation of the bleed is generally an indication that the HCG levels have returned to zero.
Your first period will generally return within 4 weeks of your HCG levels returning to zero. However, it is not uncommon for some women to experience prolonged return to ovulation and menses, sometimes up to eight weeks. You should note that, for many women, ovulation will not occur during your first cycle, as your body is still recovering.
In most cases your IVF doctor will want to wait for your body to experience one or two cycles before starting medications for a repeat medical cycle and transfer. During this time your cervix will remain soft and open, and may make intercourse painful.
In the cases of natural miscarriage especially, you’ll want to pay special attention to how long your initial bleed lasts and how frequently you experience a recurrence of bleeding. In these cases it is possible that some tissue may have been retained in the uterus and is preventing your body from healing. If you continue to experience light spotting over an extended time it could be possible that your body is having trouble returning to regular hormone levels. In any case of extended bleeding you will want to speak with your doctor.
Prolonged Absence of Menses
A prolonged return of menstruation is not normal. While it can take up to eight weeks for your body to properly recover and return to having regular cycles, some women will experience an even longer delay. This is typically experienced after a D&C as opposed to a natural miscarriage and may indicate the presence of new scar tissue or fibroids inside of the uterus. If you have not experienced a menstrual bleed by ten weeks following the miscarriage or procedure, it is important to mention this to your doctor as well.