A Dilation and Curettage (D&C) is a brief surgical procedure often performed following a miscarriage, an incomplete abortion, or to address abnormal uterine bleeding. The process involves dilating the cervix and gently removing tissue from the uterine lining. Many individuals turn their attention to future family planning, wondering how easily they can conceive again. For most, the medical consensus is reassuring: the procedure itself does not negatively impact the ability to achieve a future pregnancy.
Physical Recovery and Return of Menstruation
The body begins its recovery immediately after the D&C, including a hormonal reset that clears pregnancy hormones. Most individuals experience mild cramping and light bleeding or spotting for several days. To prevent infection, it is recommended to avoid placing anything into the vagina, such as tampons or having sexual intercourse, for one to two weeks.
The return of the regular menstrual cycle is the next significant physical milestone, signaling the body’s readiness for conception. The first period typically returns between four and eight weeks post-procedure. This timing depends on how quickly the pregnancy hormone human chorionic gonadotropin (hCG) returns to zero and the body’s cycle status before the D&C.
The uterus needs this time to rebuild its endometrial lining. A predictable period indicates that ovulation is occurring again and reproductive hormones have restabilized. If a period has not returned eight weeks after the procedure, seeking medical consultation is advised.
Understanding Fertility Rates After the Procedure
Undergoing a D&C does not diminish long-term fertility. Studies show that a high percentage of individuals who begin trying to conceive (TTC) after the procedure achieve pregnancy within a year. The ease of getting pregnant is restored to the individual’s baseline fertility level prior to the D&C.
Historically, medical professionals advised waiting for two to three regular menstrual cycles before attempting a new pregnancy. This waiting period allowed for emotional recovery and ensured accurate dating of the subsequent pregnancy. Calculating a due date relies on the last menstrual period, which is difficult without a preceding normal cycle.
Recent research suggests that waiting may not be physically required for a successful outcome. Attempting conception soon after an early pregnancy loss, even before the first period returns, may not be associated with higher complications and might lead to a higher chance of a live birth compared to waiting longer than three months. The decision of when to start trying again rests with the individual and their partner, once they feel physically and emotionally prepared.
Recognizing and Addressing Scar Tissue Risk
While the outlook for future fertility is good, a rare complication of a D&C is the formation of intrauterine adhesions, known as Asherman’s Syndrome. This condition involves scar tissue inside the uterus, which can cause the uterine walls to stick together. The risk of scarring is higher after a D&C following a later miscarriage or if the procedure must be repeated.
The adhesions can interfere with the normal growth of the endometrial lining, potentially leading to infertility or recurrent miscarriages. A primary symptom prompting medical investigation is a significant change in menstruation following the D&C, specifically very light periods (hypomenorrhea) or the absence of a period (amenorrhea). These symptoms suggest the uterine cavity may be partially or fully obstructed.
Asherman’s Syndrome is treatable, often through a minimally invasive surgical procedure called hysteroscopy. A surgeon uses a small camera and specialized instruments inserted through the cervix to visualize and remove the scar tissue. Treatment often includes temporary placement of a balloon or stent to keep the uterine walls separated while they heal, sometimes combined with estrogen therapy to encourage healthy regrowth of the uterine lining.