{'fraction_non_alphanumeric': 0.013870967741935483, 'fraction_numerical': 0.005483870967741935, 'mean_word_length': 5.104330708661418, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Waiting to Conceive After an Early Pregnancy Loss.

Spontaneous early pregnancy loss is one of the most common, stressful life events that obstetrician–gynecologists help couples to endure. Traditionally, many clinicians advised patients to wait 3 months before trying to conceive after an early pregnancy loss. A common belief is that this reduces the risk of another early pregnancy loss. Traditions are hard to change, and many clinicians continue to advise waiting at least 3 months for this reason despite numerous studies showing no relationship between attempts at conception within 3 months of a previous loss and repeat early pregnancy loss. However, the recommendation to delay subsequent conception for 3 months is not without merit. A number of studies have found that a short interval between any pregnancy (including spontaneous or induced abortions) and a subsequent pregnancy is associated with increased risk of pregnancy complications, including preeclampsia, premature rupture of membranes, low birth weight, and preterm delivery. In this issue, Schliep and co-authors (see page 204) give us additional reassurance that trying to achieve pregnancy shortly after a spontaneous abortion is not associated with an increase in the risk of a subsequent spontaneous abortion. The authors performed a secondary analysis of data from a prospective study examining the effects of taking low-dose aspirin during early pregnancy. This previous prospective study found that taking low-dose aspirin before and during pregnancy did not decrease the risk of spontaneous abortion but actually increased the absolute chance of becoming pregnant and having a live birth by as much as 5%. In the secondary analysis by Schliep and co-authors, rather than examine the interval from the previous early pregnancy loss to the next pregnancy as previous studies have done, the investigators chose to examine the interval recalled by the patient between her last early pregnancy loss and when she began trying to get pregnant again. They found that women who recalled starting to try less than 3 months from the previous loss were no more likely to have an early pregnancy loss than those who recalled starting to try more than 3 months afterward. Surprisingly, they also found that recollection of starting to try within 3 months of a loss was associated with a 17% increase in the absolute chance of live birth compared with those who recalled waiting. Although it is intriguing to imagine that patients can dramatically increase their chances of having a child by trying to get pregnant sooner after an early pregnancy loss, this information should be taken with a grain of salt for a number of reasons. In the absence of any biologically plausible explanations, alternative explanations for this apparent increase in fecundity are certainly more likely. Similar to all retrospective studies, selection bias likely played a role in the findings. The group of patients who recalled attempting pregnancy less than 3 months from their previous early pregnancy loss were more See related article on page 204.