Can You Ovulate With HCG in Your System? What To Expect

| Reviewed By Kimberly Langdon, M.D.

If hCG levels remain high in the body, it is unlikely for ovulation to take place, as elevated hCG levels impede the process of ovulation.

After a miscarriage, hCG levels need to drop below 5 mlU/ml before the menstrual cycle, which includes ovulation, will resume as normal. 

Healthline explains:

“Your hCG levels don’t need to drop to zero before you can try getting pregnant again. They just have to be low enough so that they can’t be detected in a blood or urine test.

Higher levels of hCG can interfere with figuring out when you’re ovulating or give you a false positive on a pregnancy test.”

Although some women ovulate as soon as two weeks after a miscarriage, most women will resume ovulation 4-6 weeks after a pregnancy loss.

How HCG Affects Ovulation

Human Chorionic Gonadotropin (hCG) is a hormone that plays a crucial role in pregnancy.

It is produced by cells that form the placenta shortly after a fertilized egg attaches to the uterine lining.

While its primary function is to support the corpus luteum (a temporary endocrine structure in the ovaries) during early pregnancy, hCG can also indirectly affect ovulation.

Here’s how it works:

Supporting the Corpus Luteum

After ovulation, the follicle that released the egg transforms into a structure called the corpus luteum.

The corpus luteum produces progesterone, which helps prepare the uterine lining for a potential pregnancy.

If fertilization occurs, the developing embryo releases hCG, which helps maintain the corpus luteum.

This is important because the corpus luteum continues to produce progesterone until the placenta is developed enough to take over this function.

Preventing Further Ovulation

The presence of hCG in a woman’s body can signal that pregnancy has occurred.

In response to hCG, the body generally suppresses the release of additional eggs during the same menstrual cycle.

This helps ensure that only one embryo implants and develops, reducing the likelihood of multiple pregnancies.

Timing of Ovulation in Fertility Treatments

In some cases of fertility treatments, a controlled dose of hCG may be administered to trigger ovulation.

This is particularly relevant for procedures like in vitro fertilization (IVF) where the timing of egg retrieval is crucial.

The hCG injection is timed to induce ovulation, allowing for the collection of mature eggs for fertilization.

Ovulation After Miscarriage

The presence of hCG in your urine is what triggers a positive pregnancy test and is how doctors determine if you are or are not pregnant. 

After a miscarriage or pregnancy loss, the body stops hCG production, but it takes time for levels to return to zero.

This is why a woman may still get a positive pregnancy test soon after a miscarriage.

After a miscarriage, hCG levels will start to decline.

The rate at which hCG decreases can vary depending on how far along the pregnancy was at the time of the miscarriage. 

In early miscarriages, hCG levels may return to non-pregnant levels relatively quickly, but in later miscarriages, it may take longer.

Ovulation can resume once hCG levels have returned to non-pregnant levels. 

This is because the decline in hCG signals to the body that the pregnancy has ended, and the reproductive system can begin to prepare for a new menstrual cycle.

When Do You Ovulate After Miscarriage?

According to the American College of Obstetricians and Gynecologists, you can resume ovulation as little as two weeks after a miscarriage.

However, most women find that it takes about 4-8 weeks to ovulate after pregnancy loss and, sometimes it takes a few months for your cycle to return to normal. 

The timing of ovulation after a miscarriage can vary widely among individuals.

Some women may ovulate within a few weeks after a miscarriage, and for others, it may take longer. 

There is no strict timetable, and individual factors, such as hormonal balance and the woman’s overall health, can influence when ovulation resumes.

Can You Get Pregnant Right After a Miscarriage?

It is possible to ovulate and become pregnant within two weeks after a miscarriage.

However, this timeline varies from person to person depending on their miscarriage timeline and how long it takes for their cycle to return to normal. 

Most medical experts recommend waiting at least a few cycles after a miscarriage before trying to conceive again.

While soon becoming pregnant after a miscarriage is physically possible, both your body and your emotions go through a lot during a miscarriage.

Depending on the severity, it may be beneficial to wait a few cycles to recover.

HCG Levels After Miscarriage

It can take anywhere from one to nine weeks for hCG levels to return to zero following a miscarriage.

Once a miscarriage happens, hCG levels should begin to drop, usually decreasing at an average rate of 50% every 48 hours.

HCG Levels After Miscarriage at 4 Weeks

If you experience a miscarriage at 4 weeks gestation, your hCG levels will be between 5 and 426 mlU/ml.

It will likely only take a few days for your hCG levels to return to their normal, pre-pregnancy measurement of less than 5 mlU/ml. 

If you are 4 weeks post pregnancy loss, you can expect to see your hCG levels decreasing rapidly and getting closer to their normal range of less than 5 mlU/ml. 

HCG Levels After Miscarriage at 5 Weeks

At 5 weeks gestation, the normal hCG range is 18-7,340mlU/ml.

If pregnancy loss occurs at this stage of pregnancy, it may take several days for levels to return to normal but usually not much longer than a week. 

If you test your hCG levels 5 weeks after a miscarriage, they are likely to be very close to the normal range.

It is possible that levels will be low enough for you to test negative on a pregnancy test 5 weeks after a miscarriage. 

HCG Levels After Miscarriage at 7 Weeks

At 7 weeks gestation, hCG levels should range from 7,650-229,000 mlU/ml.

They are closer to reaching their peak, which occurs around the 12th or 13th week of pregnancy.

Therefore, it may take a little longer for the levels to return to normal after a miscarriage, but they should be back to normal within a couple of weeks at the most. 

By seven weeks post-pregnancy loss, your HCG levels should be back to normal, and you should not test positive on a pregnancy test.

Experiences of Women Who’ve Been There

One woman shared: “I ovulated 4 weeks exactly after my loss at 21w6d as tracked by temping and OPK’s and had my first cycle start exactly two weeks after that.”

Another woman explained: “My midwife thinks that I ovulated a few days after my HCG levels returned to zero after my 1st mc.”

A heartbroken woman’s experience: “I have had two miscarriages where it took over a month for the levels to drop to zero, they were very slow in going down.”

Signs of Ovulation After Miscarriage

After a miscarriage, the signs of ovulation can vary from woman to woman, and they may not be as noticeable or regular as they would be in a typical menstrual cycle.

However, some common signs of ovulation that women may experience following a miscarriage include:

  • Changes in Cervical Mucus: As a woman approaches ovulation, her cervical mucus may become more abundant, clear, and slippery. This type of mucus facilitates sperm movement and is an indicator that ovulation is near.
  • Mild Pelvic Pain or Mittelschmerz: Some women may experience a mild, dull ache or twinge on one side of the lower abdomen. This is known as mittelschmerz and can be an indication of ovulation.
  • Heightened Libido: Some women report an increase in sexual desire around the time of ovulation. This may be a hormonal response to the body’s preparation for potential pregnancy.
  • Breast Tenderness: Some women may experience mild breast tenderness or sensitivity around the time of ovulation due to hormonal changes.
  • Increased Basal Body Temperature (BBT): BBT is the body’s resting temperature, measured in the morning before any activity. After ovulation, a woman’s BBT may rise slightly and remain elevated until the start of her next menstrual cycle.
  • Ovulation Pain: Some women may experience a brief, sharp pain or cramp on one side of the lower abdomen during ovulation. This is referred to as mittelschmerz and is thought to be caused by the release of the egg from the ovary.
  • LH Surge on Ovulation Predictor Kits: Ovulation predictor kits (OPKs) measure the surge in luteinizing hormone (LH) that precedes ovulation. A positive OPK result indicates that ovulation is likely to occur within the next 24-48 hours.
A sad woman in pajamas sitting on the couch in dimly lit room.

What To Expect After a Miscarriage

A miscarriage is not just a singular-moment event like some may believe it to be.

A miscarriage is a process that causes both physical and emotional change and hardship. 

Physical Symptoms

Once a pregnancy loss has occurred, you can expect bleeding as the body expels the pregnancy tissues, which are called the products of conception.

Depending on how far you were into your pregnancy, the bleeding may be similar to or heavier than a period.

You can also expect some mild pain and cramping that may be slightly worse than menstrual cramps.  

You will notice a decline in your pregnancy symptoms as your hCG levels decrease and your body returns to its normal state. 

Return of Menstrual Cycle

Since you are no longer pregnant, your menstrual cycle will resume its normal cycle in order to prepare for conception again.

Once the miscarriage has ended, bleeding has stopped, and hCG levels have returned to normal, your body will begin to get back on track naturally.

Most women get their first period about four to six weeks after experiencing a miscarriage.

The exact timing may vary by several weeks and largely depends on when the miscarriage is “finished,” meaning the uterus has shed all of the tissues from the pregnancy.

Many women who experience pregnancy loss later in their pregnancy may find that it takes longer for their period to return due to elevated hCG levels. 

Some have found that their first few periods are worse or heavier than they were before they were pregnant.

This is normal as your body is still adjusting and recovering. 

Emotional Recovery

A miscarriage can be just as hard (or harder) emotionally as it is physically taxing.

Experiencing a pregnancy loss can trigger a lot of challenging emotions for everyone involved.

Some women or their partners may experience bouts of depression or anxiety after a miscarriage.

It is important that you take time to recover emotionally just as you would physically.

Turn to loved ones, friends, support groups, and specialists to get the help and support that you need.

11 Ways To Boost Your Odds of Getting Pregnant After Miscarriage

  1. Wait Until You’re Emotionally and Physically Ready: Take the time you need to grieve and heal both emotionally and physically after a miscarriage. This can vary greatly from person to person, and it’s important not to rush the process.
  2. Nutrition: Eat a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Consider taking a prenatal vitamin to ensure you’re getting essential nutrients.
  3. Exercise: Engage in regular, moderate exercise to help maintain a healthy weight and overall well-being. Avoid excessive or strenuous exercise, as it may affect fertility.
  4. Avoid Harmful Substances: Minimize alcohol consumption, quit smoking if you do smoke, and avoid illicit drugs. These substances can negatively impact fertility.
  5. Track Ovulation: Monitor your menstrual cycle and look for signs of ovulation. This can help you identify your fertile window and time intercourse accordingly.
  6. Consider Ovulation Predictor Kits (OPKs) or Fertility Monitors: These tools can help predict when you are likely to ovulate by detecting hormonal changes in your body.
  7. Maintain a Healthy Body Weight: Being either underweight or overweight can affect fertility. Aim for a healthy BMI (body mass index) by maintaining a balanced diet and engaging in regular exercise.
  8. Manage Stress: High levels of stress can affect fertility. Practice stress-reducing techniques such as meditation, yoga, deep breathing exercises, or activities that you find relaxing.
  9. Limit Caffeine Intake: Some studies suggest that high caffeine intake may be associated with a higher risk of miscarriage. Consider reducing your caffeine consumption if it’s high.
  10. Seek Support: Don’t hesitate to reach out for emotional support from friends, family, or a support group. Counseling or therapy can also be beneficial for processing your feelings.
  11. Regular Check-Ups: Schedule regular check-ups with your healthcare provider. They can provide guidance, monitor your reproductive health, and address any concerns you may have.

If you’ve been trying to conceive for an extended period without success, consider consulting a reproductive endocrinologist or fertility specialist.

They can conduct tests to identify any underlying issues and recommend appropriate treatments or interventions.