Biochemical pregnancy: Clinical significance in assisted reproduction

Abstract

Objective: To study the subsequent reproductive performance of assisted reproduction (AR) patients with a previous biochemical pregnancy in the first cycle compared with those that did not get pregnant or had a miscarriage in that first cycle. Design: Retrospective study performed at an infertility clinic. Materials/Methods: We reviewed 927 cycles of AR patients who did not achieve a viable pregnancy in the first cycle and divided them into three groups: lack of pregnancy (n=513), biochemical pregnancy (n= 207) and miscarriage (n= 147). The reproductive outcome of the next three cycles was analyzed. Serum levels of -hCG were determined on day 16 after hCG injection and a vaginal ultrasound evaluation was performed weekly. Results: The subsequent pregnancy rate was similar irrespective of the outcome achieved in the first attempt (no pregnancy/biochemical pregnancy/miscarriage). However, the proportion of ongoing pregnancies in the next cycles was different (p <0.03) depending on the previous outcome of the first cycle: lack of pregnancy (73.4%), biochemical pregnancy (60.5%) and miscarriage (65.9%). Statistically significant differences were found only when comparing those who did not get pregnant versus those who had a biochemical pregnancy in the first attempt (p <0.006). Conclusions: A previous biochemical pregnancy does not seem to affect the chance of getting pregnant but it worsens the probability of having an initial ongoing pregnancy in the next cycles. Supported by: Instituto Valenciano de Infertilidad.