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I’m TTC for a second child, but I’ve had multiple chemical pregnancies. Any data on how best to assist implantation?
— Anonymous
Let me say first that I’m sorry for your losses.
The term “chemical pregnancy” generally refers to a case in which a pregnancy is detected on a pregnancy test but miscarriage occurs before the pregnancy can be seen on an ultrasound. This generally means a loss before about five weeks of pregnancy (which is one week after your missed period). In the era before sensitive pregnancy tests, many of these pregnancies would never have been detected at all.
At least 25% of all pregnancies end in miscarriage, and pregnancy loss is more common early on. In nearly all of these cases, the cause is a chromosomal abnormality that is incompatible with further development. This could be an extra chromosome, a missing chromosome, or more complex genetic issues.
These genetic abnormalities are largely random, and most people who have early pregnancy losses go on to have healthy pregnancies.
To get to your question, though, in a case in which someone has multiple miscarriages, even early on, it makes sense to do some additional testing to learn more about what might be going on. This testing is likely to focus on genetic issues.
For example, in some cases, one parent has a balanced translocation, where two genes have switched chromosomes. This is fine for the adult, since they have both genes, but when only one copy of each chromosome is passed to the baby, this can cause problems.
Although this testing may be a good idea, in most instances, it will turn out that there isn’t an obvious explanation, and repeated miscarriages are just bad luck and are more likely with advanced maternal age.
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