Many couples struggling with fertility issues choose IVF after a lot of consideration. However, not all IVF cycles are a success. In some cases, despite a positive pregnancy test result after the embryo transfer, there may not be a viable pregnancy. The embryo can implant successfully but fail to develop, resulting in a Biochemical pregnancy. Want to know more? Read on to know all about Biochemical pregnancy in IVF.
A Biochemical pregnancy is when an embryo successfully implants in the uterus and starts producing the pregnancy hormone hCG, but fails to develop. As a result, the pregnancy tests will be positive, but the embryo will not grow. This leads to a very early miscarriage that usually happens within the first 5 weeks.
In a Biochemical pregnancy, the pregnancy ends even before the embryo is big enough to be detected in an ultrasound. During these initial days, the only way to confirm a pregnancy is through a home pregnancy test or blood test, both of which will show positive results as the hCG levels will be increasing steadily.
Unlike natural pregnancies, where the sperm goes up the fallopian tube to enter the egg during ovulation for fertilisation, fertilisation happens under clinical conditions, outside the body, in IVF. The fertility specialist will transfer only the well-developed embryos for the best possible outcomes. However, even after the successful formation and transfer of the embryo, miscarriages or chemical pregnancies can happen due to the following reasons –
1. Poor Embryo Quality – The fertility specialist or embryologist will transfer only those embryos that seem healthy. There is no scientific method to determine the quality of the embryos being transferred. So, if the quality of the embryo is not good enough or has chromosomal abnormalities, the embryo may not develop any further after implantation, resulting in a Biochemical pregnancy.
2. Uterus Not Receptive – After the embryo transfer, the implantation is left to the uterus. If the lining of the uterus is not receptive enough, implantation may not occur or may not last, thus resulting in an early miscarriage.
3. Hormonal Imbalance – During IVF, the doctor will inject the woman with different hormones, including hCG, to aid in egg maturation and ovulation. This surge in hormones can influence the pregnancy test result when taken a few days after the embryo transfer, but the embryo may not develop as required.
4. Immune Response – In some cases, the mother’s immune system can attack the embryo, thus leading to a miscarriage in the early days.
In many natural conceptions, the woman may not even realise she had a Biochemical pregnancy, as the miscarriage happens very early. So, she could easily mistake it for delayed periods.
In IVF, since the embryo is transferred for implantation, and the fertility specialist will take a pregnancy test within a few days of transfer, detecting a Biochemical pregnancy is possible. The common symptoms are –
● A positive pregnancy test result
● A sudden decline in hCG levels can give negative test results a few days later.
● Unable to detect any viable embryo on the ultrasound
● Mild cramps, very similar or slightly more intense than regular period cramps
● A delayed period where bleeding is heavier than usual.
Unfortunately, there is no way to prevent a Biochemical pregnancy. Since the main cause of chemical pregnancies is chromosomal abnormalities in the embryo, there is no sure way to know about it before the embryo transfer in IVF.
The embryo forms outside the body, in a Petri dish, when sperm and eggs are combined. However, the embryo can start developing only after it attaches to the uterus and starts receiving blood and nutrients. Though the embryo does not grow, it cannot result in a miscarriage or a Biochemical pregnancy without embryo transfer and implantation.
However, if you have experienced chemical pregnancies before, you can reduce the risk in the upcoming IVF cycles by taking a PGT-A – Pre-implantation Genetic Testing. Maintaining a healthy lifestyle, following or altering hormone protocols, and managing underlying health conditions can also help reduce the risk of chemical pregnancies in IVF.
A Biochemical pregnancy in IVF can be tough on the couple. Choosing IVF as a solution to their fertility struggles can be a difficult choice for many. To lose the pregnancy after a successful embryo transfer and a positive test result can be emotionally testing, not to forget the financial implications as well, as they may need another round.
Here are some ways to deal with chemical pregnancies in IVF –
● Acknowledge the Loss – Though the pregnancy did not progress or last very long, it is indeed a loss. Acknowledge it and give yourself the time and space to grieve as you go through the loss and disappointment. Emotional health is also an essential factor to consider in IVF.
● Consult Specialist – Have a detailed discussion with your fertility specialist to determine and understand the possible causes for the Biochemical pregnancy. This will also help you decide on your next course of action.
● Healthy Lifestyle – Despite the reason behind your Biochemical pregnancy, a healthy lifestyle can help reduce the risk of another Biochemical pregnancy. If you are not eating healthy and being active yet, it is time to start right away. Improving your overall health can improve your chances of a successful IVF.
● Genetic Testing – In the case of advanced maternal age or repetitive chemical pregnancies, genetic testing to check for chromosomal abnormalities can be very helpful. If chromosomal abnormalities are a possibility, the embryologist can take greater care in choosing the healthiest embryos for transfer in the next cycle.
● Counselling – If dealing with the loss or repetitive loss is difficult for one or both partners, seeking professional help is advisable. Yes, it can be an added expense, but it is a much-needed investment. You need to be emotionally ready to go through the next IVF cycle and also meet the demands of pregnancy when your IVF succeeds.
Chemical pregnancies are not uncommon in both natural conceptions and IVF. It can happen to anyone for various reasons. While you cannot prevent a Biochemical pregnancy, you can reduce the risk level. Consult a good fertility specialist to know your options.
Yes, sleep deprivation can affect hormonal balance, which in turn can negatively impact one’s fertility. Sleep deprivation can affect both male and female fertility. When the body’s natural circadian rhythm is affected, the reproductive system suffers.
Yes, if the embryo is of poor quality or has chromosomal abnormalities, it may not develop, resulting in a very early miscarriage or a Biochemical pregnancy.
In an IVF cycle, the embryo is formed outside the body under clinical conditions. The best embryo is then transferred into the uterus for implantation. So, in an IVF, the formation of an embryo and transfer into the uterus is certain. The fertility specialist will check for pregnancy every few days. If the first test result is positive but the subsequent test is negative, or no embryo is visible on ultrasound, it indicates a Biochemical pregnancy.
In an IVF, one or more healthy embryos are transferred into the uterus. After 2 weeks, the fertility specialist will take a test to check for pregnancy. When there is a positive test around week 4, but the next test is negative, or if the ultrasound scan taken within the first 8 weeks is unable to detect any embryo, a Biochemical pregnancy or very early miscarriage has happened.
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