The expert: Dr. Véronique Bied Damoin, gynaecologist
If miscarriage is a well-known term in everyday language, chemical pregnancy is far less so. However, we can be made to encounter it, especially when we are in the process of medically assisted reproduction (PMA).
Definition of a chemical pregnancy: what is it?
Chemical pregnancy, or more precisely “biochemical pregnancy”, is an assisted reproductive term used to describe a very early miscarriage. “We have discovered the existence of chemical pregnancies through assisted reproduction. This includes doing beta HCG testing very early because women are in a hurry to find out if it worked or not., explains Dr. Véronique Bied Damon, gynecologist specializing in reproductive medicine and couple fertility, in a center for medically assisted fertilization. A biochemical pregnancy is therefore an extremely early pregnancy diagnosed by a beta-HCG biological test, but the reality of which has not been seen on ultrasound. The pregnancy test is sensitive to the level of the beta-HCG hormone which is quite high in early pregnancy. The beta-HCG level is positive, which indicates that pregnancy is present but fails to occur very early, earlier than miscarriage. In fact, if there was a miscarriage, we had time to do an ultrasound and determine the presence of an embryoe. A chemical pregnancy usually lasts from fifteen days to three weeksand in any case ends before the fifth week of pregnancy.
Biochemical pregnancy: what are the symptoms?
In the case of a chemical pregnancy, the woman may have felt all the minor symptoms of a classic early pregnancy: Late bleeding, nausea, abdominal cramps similar to those of menstruation… However, these signs are rather moderate and disappear with the return of the rules. “Apart from a PMA, in addition to a slight delay in menstruation, a biochemical pregnancy can go completely unnoticed because the termination of pregnancy occurs very early. It simply corresponds to a menstrual cycle a little longer than the others »says Dr. bied damon The positive pregnancy test is now negative.
Positive then negative pregnancy test: early miscarriage or period?
It is the dosage of the beta-HCG hormone that indicates whether pregnancy has occurred. If the pregnancy test was initially positive, but a few days later the second line is clearer or has disappeared on the new pregnancy test, cis that this one is negative. Usually the period occurs every 28-30 days. If they occur after 35 days and a first positive pregnancy test has been performed, there may have been a few days of gestation and therefore a chemical pregnancy. The only way to find out is with a beta HCG test. through a blood test. It can still be positive during menstruation, depending on how long the pregnancy has lasted.
What are the causes?
In most cases, no particular cause explains the premature termination of pregnancy. But the risk factors for chemical pregnancy can be the same as for miscarriage. The embryo is not programmed to develop due to chromosomal abnormalities, hormonal problems, malformations... Advanced age, i.e. over 35 years of age, can also be a risk factor for the standstill of embryonic development.
Why do some women have repeated chemical pregnancies?
If a woman has repeated chemical pregnancies, that is, three or more chemical pregnancies in a row, medical professionals will perform a miscarriage exam to look for possible causes. “It can be one of the most common causes a genetic or hormonal abnormality with lack of luteal phase support, or uterine abnormalities that prevent proper embryo implantation. It can also be due to an immune disorder, but that’s usually later in the pregnancy.remarks the gynecologist.
What treatment after one or more biochemical pregnancies?
Nothing needs to be excreted after a chemical pregnancy as the embryo has barely implanted. Of course it will be evacuated. No special treatment is required. Woman has her period again indicating the absence of pregnancy. She can very well get pregnant again in the next cycle.
When biochemical pregnancies recur, treatment varies depending on the cause. If it is genetic, there is no specific treatment. If the cause is hormonal, we give progesterone in the second part of the cycle. “Most of the time we can’t find a cause. Despite everything, an empirical treatment is then attempted. B. by administration of progesterone and often also aspirin. Low-dose aspirin has vasoconstrictive effects that can improve blood flow and facilitate placental implantation. If it doesn’t work, at least it doesn’t hurt.”recognizes Dr. bied damon
Getting pregnant again after a chemical pregnancy
Although a chemical pregnancy can be quite anxious and sometimes cause great sadness, most of the time when the miscarriage test is negative, no cause is found, it is an accident with no impact on fertility. The couple can try again for a baby. After twelve weeks of amenorrhea, after the first ultrasound, the pregnancy is said to be ongoing.