Conception rates after medical versus surgical evacuation of early miscarriage

Abstract

Objective: To compare short-term fertility rates after medical and surgical management of early miscarriage.

Design: Observational cohort study.

Setting: Academic tertiary-care medical center.

Patient(s): A total of 203 patients were enrolled between June 2017 and May 2018, comprising 106 surgical evacuations and 97 medical evacuations.

Intervention(s): Either surgical or medical evacuation of the uterine cavity.

Main outcome measure(s): Conception rates 6 months after miscarriage.

Result(s): Conception rates 6 months after miscarriage among women who had attempted to become pregnant were similar between the medically and surgically evacuated groups (68.0% vs. 65.1%). There were no significant differences in background characteristics between the groups, apart from younger age and earlier gestational age among the medically treated group. There was no difference in the proportion of women using assisted reproductive technologies between the medically and surgically managed groups (15.5% vs. 12.6%, respectively). The median time-to-conception was 4 ± 2 months in both groups. Cumulative pregnancy rate 12 months after pregnancy loss, live birth rate, and repeat miscarriage rate also were similar between groups.

Conclusion(s): Modality of uterine evacuation after early miscarriage does not affect short-term fertility outcomes.

Keywords: Miscarriage; conception rate; fertility outcome; medical evacuation; surgical evacuation.