Trying to Conceive After a Miscarriage: Timing & Advice

Question
hi

I am 29 have 2 healthy children one is 2 years and the other 7 months.  I  had a d&c Thursday November 10 for a miscariage at 12 weeks (first m/c), at the moment I am still spotting slightly and charting my cycle looking for signs of Ovulation.  

I have 2 questions

We would like to try to conceive as soon as possible but have had conflicting advice about the issue, I have been told wait 3 months, wait 1 full cycle and it's ok to try straight away. What do you usually recommend?  

Also, I would like to ask my doctor for a progesterone test, what part of the cycle do they usually perform this test at, can it be performed in the cycle where the d&c is cycle day 1 or do you need to wait for a period and have the test in that cycle?  Finally can the test be preformed in early pregnancy?

Thank you so very much  

Answer
After a miscarriage, you can start trying to conceive again after your next period. We ask that you wait for your next period only in order to "date" the pregnancy. YOu probably will ovulate around 2 weeks following the start of your next period. If you had a miscarriage on November 10, you probably will get your next period in 2-4 weeks.  Once you get your period, you can safely start trying to conceive. We used to tell patients to wait 3 montus, but have found that it does not make any difference.  I doubt that you have a progeterone deficiency due to your two previous pregnancies. However, If you find that you have a cycle that is shorter than 21 days, you may have a luteal phase defect due to lower progesterone.  If you think the miscarriage was due to low progesterone, you certainly can take a test. The value will be different at different times of the cycle. I would take it after mid-cycle.I would not take a pregesterone test until arter your next period. Your hormones are a bit out of wack at this time. Most of the time, we check the progesterone level once you have confirmed a pregnancy. Then, if it is low, you can start progesterone supplementation and take it up to 12 weeks gestational age. We do not recommend progesterone after 12 weeks gestation. Finally, you should realize that miscarriages occur in 15-20% of every pregnancy. There is nothing you can do to cause a miscarriage and there is nothing you can do to prevent a miscarriage. Progesterone supplementation is though to help but there are very few studies to prove that it prevents miscarriage. Good luck.