Biochemical pregnancy after IVF: causes, symptoms, forecasts, reviews

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

Biochemical pregnancy after IVF is common. In this case, the embryo is attached to the wall of the uterus, but is rejected very soon. What is the reason for early interruption of gestation? And how to avoid this situation at the next attempt of in vitro fertilization? We will consider these issues in the article.

Definition of concept

In obstetrics and reproductive medicine, there is the concept of "biochemical pregnancy" (BCP). This condition is not considered a pathology. This is the name of a pregnancy that was interrupted at an extremely short time, shortly after the attachment of the fetal egg to the wall of the uterus. Spontaneous abortion occurs in the first 4 weeks after conception.

According to medical statistics, BHB occurs in 50% of women. However, the vast majority of patients do not even suspect that they were pregnant. Indeed, at such a short time, there are no clinical signs of gestation. Pregnancy is still impossible to detect during a gynecological examination or ultrasound. To find out that the process of fertilization of the egg and implantation of the embryo has taken place, it is possible only with the help of an analysis for chorionic gonadotropin or a highly sensitive pharmacy pregnancy test.

Fetal rejection at such an early stage looks like regular periods that come on time or with a very short delay (no more than a few days). Therefore, during natural conception, BCB most often goes unnoticed.

Reproductive techniques and BCB

Obstetricians and gynecologists began to talk widely about BCB after the introduction of in vitro fertilization and other assisted reproductive techniques into medical practice. These technologies have helped many patients to conceive a child, even with complex forms of infertility.

However, cases of biochemical pregnancy after IVF are quite common. What does this mean? Such statistics do not indicate that reproductive techniques adversely affect the bearing of the fetus. With natural conception, such a pregnancy occurs no less often, but in most cases it is not detected.

After IVF, the patient must take a blood test for hCG. This test is done no later than 2 weeks after the procedure. This allows you to determine the presence of pregnancy at a very short time. Therefore, it is possible to track its interruption in the first weeks. BCP after in vitro fertilization is much more likely to be detected due to early diagnosis.

Next, we will look in detail at the causes and treatmentbiochemical pregnancy after IVF. The prognosis for the success of a repeat procedure is not as unfavorable as many patients mistakenly assume.

Etiology

It is very difficult to establish the exact causes of fetal rejection shortly after implantation. After all, cases of BCP are also observed in absolutely he althy women with natural fertilization. This phenomenon is currently understudied due to difficulties in diagnosis.

Doctors suggest that the following circumstances may serve as the causes of biochemical pregnancy after IVF:

• hormonal disruptions;
• fetal genetic disorders;
• use of ovulation inducing drugs;
• autoimmune reactions;
• blood diseases in a woman;
• impact of external unfavorable factors.

Next, we will look at the above causes of BCB in more detail.

Hormonal disorders

The hormone progesterone is responsible for carrying a pregnancy, especially at the initial stage. If a woman's body develops a deficiency of this substance, then this can cause the rejection of the embryo shortly after its implantation. Doctors prescribe progesterone-based drugs to many patients after IVF, but such therapy does not always help to successfully bear the fetus.

An excess of androgens in a woman's body can also be the cause of early termination of pregnancy. Male hormones suppress progesterone production.

Chromosomal abnormalities in the embryo

Reproduction doctors believe that genetic disorders in the fetus are the mainthe cause of spontaneous interruption of gestation in the initial stages. This can happen against the background of the complete he alth of the patient. The body recognizes and rejects an embryo with defective chromosomes.

Currently, doctors use pre-implantation genetic diagnosis. This study allows you to identify the presence of chromosomal abnormalities in the embryo even before transferring it to the uterus. However, this test is very expensive and is often refused by patients.

Ovulation Stimulation

Quite often, when applying a long protocol, there are cases of biochemical pregnancy after IVF. What it is? Protocol refers to a drug regimen for ovulation induction. Indeed, for successful IVF, it is necessary to obtain several mature eggs.

With a long protocol, the patient is prescribed high doses of drugs with follicle-stimulating hormone. Therapy lasts about 3-5 weeks. This can affect the natural hormonal balance in the body and provoke BCB. Therefore, at present, doctors use the long protocol only under strict indications. In most cases, short stimulation with hormonal drugs is used, which lasts 12-15 days.

Other reasons

The immune system in the female body can f alter. She can perceive the embryo as a foreign object and begin to produce antibodies against its cells. As a result, the fertilized egg is rejectedshortly after implantation. Such a reaction often occurs with chronic autoimmune pathologies in women, but can also be triggered by random failures.

Biochemical pregnancy after IVF is often observed in patients with blood diseases. For example, increased thrombosis (thrombophilia) can cause interruption of gestation. With such a pathology, the vessels that feed the embryo are clogged with blood clots. This causes rejection of the ovum in the first weeks.

Influence of external factors

Biochemical pregnancy after IVF can also be triggered by adverse external influences. The following factors can lead to interruption of gestation at an early stage;

• stress;
• malnutrition;
• unhe althy lifestyle of the patient;
• general weakened state of the woman's body;
• work in harmful conditions.

Therefore, doctors strongly recommend preparing for pregnancy in advance. Before the IVF procedure, it is necessary to cure chronic diseases, eat well and give up bad habits in advance.

Symptomatics

What are the symptoms of biochemical pregnancy after IVF? This condition is almost impossible to notice by external manifestations, it is determined only with the help of laboratory diagnostics. After all, the fetus is rejected at such an early stage, when there is still no delay in menstruation and other classic manifestations of pregnancy (breast engorgement, morning sickness, etc.).

Miscarriage in BCB occurs during menstruation. The fertilized egg comes out with blood. The discharge may be more profuse than usual and contain dark red clots. Sometimes there is a slight soreness in the lower abdomen. However, in many patients, the rejection of the embryo proceeds without features, and they mistake an early miscarriage for normal menstruation.

Diagnosis

HCG blood test is the only method for diagnosing biochemical pregnancy after IVF. What it is? Chorionic gonadotropin is a hormone that begins to be produced in the body a week after conception. If its indicators are more than 5 units, then this indicates pregnancy.

If the embryo has taken root and develops, then the level of chorionic gonadotropin is constantly increasing. In the first weeks of gestation, the concentration of hCG increases daily by 2 times. This is considered normal.

After in vitro fertilization, the hCG test is taken several times. This is necessary to monitor the implantation of the embryo and its further development. If the hormone level was initially high and then dropped, then this is a sign of a biochemical pregnancy after IVF. Usually, shortly after the decrease in the concentration of hCG, the patient begins menstrual bleeding, and the rejected embryo comes out.

During the IVF procedure, the patient usually receives two fertilized eggs. In this case, there may be jumps in the level of hCG. Hormone levels may fall and then rise again. This suggests that one of the embryos died, and the second took root. If the patient successfully develops bothfertilized eggs, the concentration of human chorionic gonadotropin is constantly increasing.

You can also find out about pregnancy in the early stages with the help of pharmacy tests that respond to an increase in the concentration of chorionic gonadotropin. However, this does not replace the analysis for hCG. After all, tests do not show the exact level of the hormone. Therefore, they cannot be used to diagnose BCB.

Do I need therapy

Patients often ask about the prevention and treatment of biochemical pregnancy after IVF. Its causes are often associated with random failures that may not be repeated during subsequent conceptions. BCP itself does not require special therapy. After its spontaneous interruption, there is no need to scrape the endometrium and take any medications. The embryo at this time is very small and completely leaves the uterus.

If gestation is interrupted at a very early date, then it is necessary to undergo a comprehensive examination. This will help to identify the etiology of biochemical pregnancy after IVF. Treatment is necessary if, during the diagnostics, the patient is diagnosed with pathologies that prevent the successful bearing of the embryo.

Forecast

Biochemical pregnancy is not always a sign of recurrent miscarriage. This also does not indicate that a woman will have problems conceiving in the future and infertility will begin. In many patients, after a spontaneous interruption of CCB, a normal cycle occurred already in the next menstrual cycle.pregnancy, which was safely carried to the end.

If BHB occurred after IVF, then doctors recommend re-in vitro fertilization after 3 months. This interval is necessary to restore the reproductive system. If the interruption of gestation occurred under the influence of random factors, then the chances of successfully carrying subsequent pregnancies are quite high.

If a biochemical pregnancy occurred after the transfer of cryopreserved (frozen) embryos, then a second IVF protocol is carried out in the next menstrual cycle. In this case, a three-month break is not required.

When BHB occurs again, IVF attempts are temporarily stopped. The patient must be carefully examined, determine the cause of miscarriage and undergo a course of treatment. Only after that you can start a new in vitro fertilization procedure.

In medical practice, there are often cases when a natural conception occurred during a three-month interval between BCB and a new IVF protocol. This was observed in about 25% of women. Most likely, this is due to the fact that in the process of preparing for artificial insemination, strong ovarian stimulation is carried out. In some cases, this starts the process of spontaneous ovulation. The cause of long-term infertility is eliminated and the woman conceives naturally.

Preparing for a second procedure

In order for the subsequent IVF attempt to be successful, it is necessary to undergo a comprehensive diagnosis, which includesthe following examinations:

• consultation of an immunologist and a hematologist;
• analysis for various types of antibodies;
• determination of chromosome set (for both spouses);
• coagulogram.

If any pathologies were identified during the diagnostics, they must be eliminated before embryo transfer. In some cases, a course of therapy is required not only for the woman, but also for her husband.

During the following protocol, the patient's hormonal background is closely monitored. Before embryo transfer, a detailed blood test for progesterone and estrogen levels is done. After IVF, the test for hCG is taken much more often than in the previous protocol. Doctors also strongly recommend pre-implantation genetic diagnosis. These measures help to prevent repeated interruption of gestation in the early stages.

Opinion of patients and doctors

A fairly large number of women have had cases of biochemical pregnancy after IVF. In the reviews, some patients report that the subsequent attempt at artificial insemination was successful and they managed to safely bear the fetus.

However, often the situation was repeated, and BHB constantly came with several attempts at artificial insemination. In these cases, the patients were prescribed an examination and a course of treatment. Many women note that a successful IVF attempt took place after therapy with special drugs that improve the quality ofeggs.

Reviews also report cases of natural conception after BCB. Many women have successfully endured pregnancy. However, some patients noted cessation of fetal development and miscarriages in the first trimester. This suggests that after BCB it is necessary to undergo a comprehensive examination and identify the causes of miscarriage.

Doctors-reproductologists consider the very fact of successful implantation of the embryo as a positive prognostic sign, even if subsequently gestation was interrupted at the initial stage. If the attachment of the fetus took place, then this indicates a good condition of the endometrium in the patient. This means that the chances of a successful pregnancy are quite high and there is no reason to refuse further IVF attempts.