Chemical Pregnancy After IVF And IUI: Is It A Good Sign?

Pregnancy may, at times, be difficult to attain for some couples. In such cases, couples may consider IVF and also hear of the term chemical pregnancy. It may lead you to wonder about the difference between a chemical pregnancy and IVF.

Those couples with concerns about infertility can go for fertility treatments like in vitro fertilization (IVF) and intrauterine insemination (IUI)i, two medically approved techniques that assist in artificial conception. However, chemical pregnancy after IVF and IUI is common.

A positive pregnancy test can be an instant source of joy in most families. Unfortunately, many couples suffer from infertility issues that compel them to resort to medical assistance to fulfill their dream of having a baby.

These processes are often tedious and involve an array of diagnostic tests, different hormonal medications, or surgical interventions. However, in the end, these medical techniques may not be a fool-proof solution to a successful pregnancy and come with their own share of adversities. One such phenomenon is referred to as “Chemical Pregnancy.” Continue reading this post as we tell you in detail about this condition, what may cause it, the diagnosis and how it can be prevented.

What Is IVF?

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Before we tell you about chemical pregnancy, let’s understand IVF a little better.

IVF or In Vitro Fertilization is a type of assisted reproductive technology (ART) involving hormone therapy, which encourages the development of numerous eggs in a woman’s ovaries.

These eggs are then collected and fertilized in a test tube using healthy sperm received from a man. These fertilized eggs make embryos that are allowed to grow for 2-5 days. The most vigorous of these embryos are transferred to the uterus. Pregnancy typically begins when these embryos nestle nicely in the uterine lining (implantation). According to the Centers for Disease Control and Prevention, approximately 2.3% of all babies born in the United States are conceived through Assisted Reproductive Technology (ART) annually (1).

What Is A Chemical Pregnancy?

Now that you know, in brief, what IVF is, let’s move on to a chemical pregnancy. What exactly is a chemical pregnancy? How is it different from a miscarriage?

A chemical pregnancy is a practical name given to a pregnancy loss. Here’s a brief account of what a chemical pregnancy entails (2):

• A chemical pregnancy is an early miscarriage, a rather early miscarriage. In fact, more women than you can imagine have a chemical pregnancy but don’t even know about it.

• It usually occurs around the time or a little after your period is due. That is when you are technically four to five weeks pregnant.

• A chemical pregnancy implies that your body did make the hCG (human chorionic gonadotropin) hormonei, a sure shot indicator of pregnancy.

• Most women experience their periods within days of a positive pregnancy test when they have a chemical pregnancy.

• A chemical pregnancy usually does not have differentiating symptoms. It feels like a period that came a little late.

Women who suffer from reproductive health issues such as infertility, especially those undergoing IVF, experience a chemical pregnancy more often than others.

Women who conceive naturally, in most cases, treat a chemical pregnancy as a late period because they have no clue they were even pregnant in the first place! On the other hand, women using artificial reproductive techniques like IUI and IVF, test (whether HPT or a blood test) a maximum of 14 days after transfer, which allows them to realize an early pregnancy.

Blogger Kimberly Currie observed a second line on the home pregnancy test kit seven days post-embryo transfer, but it faded after ten days. She recounts, “Ten days past transfer, the line was drastically lighter. They (the healthcare team) wanted me to continue the progesterone and come back in two days to see if that number would rise. I went in for my final blood draw ( on the 12th day after embryo transfer). That afternoon, the nurse called me and said she was sorry, but I had a chemical pregnancy and to stop all my medications and that I should expect a period in the next week or so (i).”

Chemical Pregnancy And IVF – Causes

Many women experience chemical pregnancy while undergoing IVF. Here are the major causes of a chemical pregnancy after IVF:

1. Embryo Abnormalities:

The biggest cause of a chemical pregnancy and miscarriage is embryo abnormality. What exactly does embryo abnormality mean? Well, a normal embryo consists of many chromosomes. But an abnormal embryo contains a disproportionate number of chromosomes. Other factors that can cause the growth of abnormal embryos include structural, chromosomal, epigeneticⁱStudy of the impact that one’s behavior and environmental factors can have on the way their genes work , and metabolic factors. Older women and women with PCOS (polycystic ovarian syndrome)ⁱA hormonal disorder causing ovaries to produce more than usual male hormones in women are more likely to experience embryo abnormalities during IVF too (3).

Quick fact

Around 50% of miscarriages in the first trimester occur due to chromosomal abnormalities in the fetus. The risk of this abnormality keeps increasing in future pregnancies (11).

2. Implantation Dysfunction:

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Several chemical pregnancies occur due to implantation failure or dysfunction. Some of the causes of implantation dysfunction include (4)

• Endometrial polypsⁱ Finger-like overgrowth of uterine tissue that occurs in the inner wall of the uterus
• FibroidsⁱAbnormal non-cancerous growth tissue in the uterus during child-bearing years
• Surgical scarring
• Advanced maternal age
• PCOS

3. Autoimmune Issues:

Sometimes, a woman’s immune cells are wired in such a way that they attack a growing embryo instead of nurturing it. This happens because the immune system is unable to differentiate between embryo cells and disease-causing cells (5).

4. Other Issues:

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Other possible causes of chemical pregnancy can include (2):

• Infections (especially sexually transmitted infections)
• Thyroid issues
• Hormonal imbalance
• Endometriosis
• Unbalanced embryo chromosomal translocationsⁱGenetic mutation that may cause rearrangement of genetic material

Point to consider

Environmental factors such as exposure to chemicals, drugs, x-rays, passive smoking, and excessive alcohol or caffeine may increase the risk of pregnancy loss (3).

Testing To Avoid A Chemical Pregnancy

If you are experiencing repeated chemical pregnancies, it may be time to dig a little deeper.

Some tests that can help unearth the real cause of repeated chemical pregnancies are:

1. Sonohysterogram, Hysteroscopy Or A Pelvic MRI:

Any of these tests can help evaluate the condition of your uterus and pinpoint any abnormalities. It makes sense to undergo these tests before you embark on IVF so that you can avoid chemical pregnancies and early pregnancy losses (6).

2. Ultrasound Scan:

An ultrasound scan determines the thickness of your endometrial wall lining. If your lining measures less than 8mm, it makes sense to wait till it is thicker before embryo transfer.

3. Natural Killer Cell aActivity (NKa) Test:

This primary immune test can help your doctor to find out if it is your immune system that is causing the chemical pregnancies.

4. Blood Tests:

Image: S: iStock

If you are undergoing IVF, the chances are high that you would have undergone a plethora of blood tests, including those measuring levels of hormones, such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH). But something may have changed in your body since your last series of tests. So, it is better to take new tests to learn more about your recurring chemical pregnancies.

5. Molecular And Biochemical Testing:

Your doctor can also check the molecular and biochemical factors in your endometrium. These tests can help discover your chances of implantations.

6. Chromosome Testing:

Thanks to the development of medical science, your doctor can now choose the healthiest embryo to transfer! Tests like using Comparative Genomic Hybridization (CGH) can help identify chromosomally healthy and normal embryos (7).

Research finds

Women undergoing a second IVF treatment after the first chemical pregnancy are more likely to be successful than those who were unable to conceive in the first attempt (12).

IVF And Chemical Pregnancy – Prevention

Once the exact cause is clear, your doctor can go on to treat the condition. Some of the treatment options for recurrent chemical pregnancies are:

1. Progesterone:

If your body is not making enough progesterone and that is causing your early pregnancy losses, your doctor may prescribe oral or vaginal progesterone use (8).

2. Baby Aspirin:

Baby Aspirin acts as a blood thinner and can help prevent chemical pregnancy in certain women (9).

3. Antibiotics:

Image: S: iStock

If an infection is causing you to lose your pregnancies, a course of antibiotics can do the trick.

4. Surgery:

As mentioned above, abnormalities in the uterus can in many cases cause chemical pregnancies. In such a case, your doctor may prescribe surgery to fix the problem.

Infographic: What You Should Know About A Chemical Pregnancy?

A chemical pregnancy is early pregnancy loss that occurs even before a woman knows she is pregnant. It is not possible to prevent chemical pregnancy in most cases when the causes are not known. Go through the infographic to learn more facts about a chemical pregnancy.

Illustration: Momjunction Design Team

Image: Dalle E/MomJunction Design Team

Chemical pregnancies can have serious implications for couples trying to conceive. Learn more in this video about the effects of chemical pregnancies, the signs, and what to do next.

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Reviewer Author Editor Fact Checker

Dr. Karla S. Sanchez-BanosMD

Dr. Karla S. Sanchez-Banos is a board-licensed Ob/Gyn in Mexico, specializing in Adolescent Gynecology. She is also trained in Gynecological Endocrinology, granted by AMEGIN (Gynecological Endocrinology Mexican Association).

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shreeja pillaiMSc

Shreeja holds a postgraduate degree in Chemistry and diploma in Drug Regulatory Affairs from the University of Mumbai. Before joining MomJunction, she worked as a research analyst with a leading multinational pharmaceutical company.

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Rebecca MalachiBSc

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU).

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Dr. Joyani DasM.Pharm, PhD

Dr. Joyani Das did her post-graduation from Birla Institute of Technology, Mesra and PhD in Pharmacology. Previously, she worked as an associate professor, faculty of Pharmacology, for two years. With her research background in preclinical studies and a zeal for scientific writing, she joined MomJunction as a health writer.

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