Prevention of Chemical Pregnancy Based on Cause

hello I'm Norbert Gleichcher MD and I'm the medical director and chief scientist here at the Center for Human Reproduction in New York and it's a pleasure being with you again and this is the third in a series of three talks about the subject that we have gotten a lot of questions on over the last few weeks and month and that is chemical pregnancies and today I want to address treatment or should I say really prevention of chemical pregnancies because treatments really kind of do not exist because there's not enough time to treat the chemical pregnancy by definition the chemical pregnancy is very short-lived and therefore there's little for us to do but shouldn't surprise even with threatened miscarriages at much more advanced pregnancy stages real clinical pregnancies frankly we do not have many treatments because once a miscarriage starts it is very difficult to stop the process so we really have no treatment per se for early implantation that don't go on but these chemical pregnancies still at least in our opinion here at CHR do have a meaning and that meaning is that they must have an underlying cause so what I mean by that miscarriage is in general a frequent the data show that about 15% on average of all pregnancies get miscarried earlier later at all stages and the number is obviously much lower than that average in younger years and can go as high as 50% if a woman gets pregnant in her late forties so miscarriages are age dependent and to a degree that also applies to chemical pregnancies and whenever we see something being age dependent like miscarriages we need to think what the potential causes can be and when it comes to miscarriages the overwhelming cause not the only but the overwhelming cause a chromosomal abnormalities as the eggs and the woman's ovary age in parallel with that woman aging so do the chromosomal abnormalities in those eggs and with it unfortunately the number of chromosomal abnormalities in embryos and as a consequence of that increasing miscarriages at every stage including at very early stages in so-called chemical pregnancies now nobody wants to try to prevent miscarriages of abnormal pregnancies and that obviously also applies to those early chemical pregnancies or miscarriages whatever you want to call them but one needs to be cognizant of the fact that their occurrence relates with age and so if you have a chemical pregnancy and or early very very early miscarriage at a very young age if you have one it's no deal it is within the statistical probability of this happening but in our opinion it becomes a big mistake just because we don't count chemical pregnancies as real pregnancies to ignore if a young woman has two or three of those in a row there's a very different statistical meaning to having two or three early chemical pregnancies in a row than just having one at random which can really be bad luck once you get to two and certainly once you get to three then you really need to look for a deeper meaning there may be something else going on here than just chromosomal abnormalities pictures obviously different if you are dealing with a 45 year old woman they're chromosomal normalities are expected so the possibility that even two or three chemical pregnancies may be due to chromosomal abnormalities is much higher the point we're trying to make here is that while chemical pregnancies are not counted or shouldn't be counted and we agree with that we had CHR do not agree with ignoring chemical pregnancies chemical pregnancies send messages they send messages within the context of who the patient is and just as repeat miscarriages once they become clinically visible on ultrasound have great importance clinically so do repeated chemical pregnancies or very early miscarriages in other words if even a young woman suddenly has a whole series of very early miscarriages chemical pregnancies think about other possibilities and if it's not chromosomal abnormalities that lead to repeated pregnancy loss then it is usually not always there are other possibilities too but it is usually the maternal immune system and that's very important because there we can intervene if it's chromosomal abnormalities that lead to the termination of a pregnancy we don't want to intervene but if it is the immune system that is causing these pregnancies to be lost we have at least some potential treatments with which we can prevent those repeated losses from happening so everything must be viewed in an individualized way within the context of who a given patient is that's one of the things we pride ourselves here on here at CHR and I think it's one of the things that differentiates our Center from so many other IVF centers I hope I have told you and given it told you some information that will be useful for you in the future it was a pleasure visiting with you thank you very much

Channel: Center for Human Reproduction

Views: 49,760

Keywords: Chemical pregnancy, what is a chemical pregnancy, chemical pregnancy prevention, how to prevent a chemical pregnancy, clinical pregnancy, pregnancy statistics, ivf, ivf New York, ivf ny, chemical pregnancy and clinical pregnancy, infertility

Id: joXGfYBED0A

Length: 7min 53sec (473 seconds)

Published: Thu Jan 16 2020