The sad news is that there is no time to treat a chemical pregnancy. Most women don’t even know when they experience a chemical pregnancy, with the only potentially recognizable sign being a heavier than usual menses and/or a slightly delayed period, by a few days. The only exception is in IVF cycles, where we do know when a chemical pregnancy occurs because every patient undergoes early hCG testing via blood tests.
What we are left with is to attempt to reach a correct diagnosis for what causes chemical pregnancies in a patient: If the cause can be presumed to be chromosomal abnormalities in embryos, then the event can be viewed as a random event (i.e., “bad luck”) and no further intervention is required.
If, however, one of the parents carries a balanced translocation that becomes unbalanced with fertilization, then two alternative solutions exist: Most balanced translocations do not always cause miscarriages. In other words, if one is willing to endure a few more of these early miscarriages, sooner or later, a pregnancy will be normal and reach delivery.
For those with less patience, embryos can be tested with great accuracy and examined for unbalanced translocations. In other words, patients affected by this rare cause of repeat chemical pregnancies have the option of having their embryos’ chromosomes examined prior to embryo transfer. As readers of these pages know, CHR is not a big fan of chromosomal investigations of embryos to improve IVF outcomes (PGT-A; as also discussed elsewhere in this issue of the VOICE); but for this clinical purpose such testing is accurate and recommended.