At least one in five pregnancies end in miscarriage and this can be an incredibly upsetting time for all involved. However, a new study has found that women are more likely to suffer major psychological trauma if they conceived the child following assisted reproduction.

According to scientists in Hong Kong, miscarriage is the most common complication of pregnancy. They set out to assess the psychological impact of a miscarriage in the first 12 weeks of pregnancy.

They followed the progress of 75 women who had conceived naturally and 75 who had required assisted reproduction, such as IVF (in vitro fertilisation).

The scientists noted that the women in the assisted reproduction group tended to be older. They had an average age of 37 compared to 31 in the natural conception group.

The women in the assisted reproduction group also tended to miscarry slightly earlier than the other women.

All of the women who miscarried were assessed for mental wellbeing one week, four weeks and 12 weeks after their miscarriage.

The study found that all of the women, regardless of how they conceived, scored high for stress and anxiety one week after the miscarriage.

However, while mental wellbeing improved in both groups over time, those in the assisted reproduction group still scored significantly higher for stress and anxiety 12 weeks after the miscarriage.

They were also almost twice as likely to experience serious psychological morbidity (distress) after a miscarriage compared to those who had conceived naturally.

"Our results identified significantly higher stress, anxiety and depression levels in women who conceived after assisted reproduction, leading us to conclude that miscarriage resulted in greater psychological trauma to these women,"

"Elevated emotional stress after miscarriage could therefore be associated with the duration of subfertility (reduced fertility) and the need of assisted reproduction," the scientists from Queen Mary Hospital said.

They added that ‘timely support and intervention' are important for these women and called for more research in this area.

Details of these findings are published in BJOG: An International Journal of Obstetrics and Gynaecology.

Commenting on the study, BJOG editor-in-chief, Pierre Martin Hirsch, noted that while miscarriages are common, ‘women are often unprepared for the loss'.

"They suffer a range of psychological reactions from grief, to anxiety and depression. The findings of this study emphasise the importance of early identification and appropriate management processes to help improve the psychological wellbeing of women who miscarry," he said.