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Implications of chemical pregnancies

Posted on Dec 04, 2019

Like so many times in medicine, the one thing one should never do, is to generalize things. In this case this means that the meaning of a chemical pregnancy is not always the same and, therefore, must be appropriately interpreted: For a young and healthy woman in her 20s who just started trying to conceive, there, likely, is no clinically actionable meaning attached to experiencing a chemical pregnancy.

However, for a 39-year-old who was never pregnant before and just experienced a chemical pregnancy in her first IVF cycle, there is a very distinct meaning attached to this diagnosis:

  • First, it demonstrates that she can create embryos that can implant;
  • Second, this fact alone, as studies have demonstrated, improves her prognosis for conceiving and delivering a healthy baby through IVF in comparison to women who did not experience a chemical pregnancy in her first IVF.

A chemical pregnancy may have a completely different meaning in a woman who had a previous clinical miscarriage and, now, in her next pregnancy, experiences the chemical pregnancy. As noted earlier, for us here at CHR, this sequence of events represents a warning sign that this patient may be entering a repeat abortion pattern. We attach the same meaning to repeat chemical pregnancies since we consider them with the same seriousness of purpose as repeat clinical miscarriages. Any suspicion that a couple may exhibit a repeat pregnancy loss pattern, whether primary (without a prior pregnancy and delivery) or secondary (with usually one prior pregnancy and delivery), deserves an appropriate investigation to either discover a chromosomal cause in one of the parents (a so-called balanced translocation) or  an immunologic cause in the mother.

What is important here is to interpret the chemical pregnancies on an individual basis.

This is a part of the December 2019 CHR VOICE.

Norbert Gleicher, MD, FACOG, FACS

Norbert Gleicher, MD, FACOG, FACS

Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.

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