Published on 19, Dec 2022

Rejuvenating Fertility Center’s Dr. Merhi Talks About Chemical Pregnancy and Early Miscarriages

Rejuvenating Fertility Center (RFC) founder and medical director Dr. Zaher Merhi, a board-certified Reproductive Endocrinology and Infertility specialist, is passionate about education and research - and he combines both these drives on the various social media platforms for RFC, the first non-conventional fertility clinic in the U.S.

During one of his popular “Whiteboard with Merhi in 3 Minutes” segments on Instagram, Dr. Merhi talked about chemical pregnancy - a term that many are unfamiliar with, at least until they begin to encounter unknown fertility issues, such as multiple early miscarriages and/or the inability to become pregnant (or so they think).

Dr. Merhi shares that chemical pregnancy is, by definition, an extremely early miscarriage, occurring within the first few weeks after conception. What happens is that the egg is fertilized, an embryo forms, and it’s even possible that implantation happened (the embryo embedding in the uterine lining). However, it then stops developing. Chemical pregnancies and subsequent miscarriages occur so early in the process that many who miscarry don’t even realize it.

“This happens very early, before anything shows on the ultrasound,” says Dr. Merhi. He adds that it’s so common that up to 75% of fertile women will undergo a chemical pregnancy at some point during their childbearing years. As many as one-third of all pregnancies may be chemical pregnancies, and over 20% of IVF pregnancies turn out to be chemical pregnancies.

It’s nearly impossible to prevent a chemical pregnancy. It’s not known exactly why the embryo stops developing during a chemical pregnancy, but when it stops developing, it ceases to produce hCG (the pregnancy hormone that shows up on a positive pregnancy test). Sometimes an embryo stops growing when there’s an issue in its DNA; or sometimes it doesn’t implant.

Dr. Merhi breaks down the causes for chemical pregnancy into three main points:

1.Abnormal embryo

Preimplantation Genetic Testing (PGT) during the process of IVF (in vitro fertilization) can reveal embryonic abnormalities that is causing the embryo to stop growing and thus causing the body to reject the embryo via miscarriage. In fact, chemical pregnancy is actually the most common form of miscarriage. If the embryo has a chromosomal abnormality in the embryo, it either cannot implant or cannot grow to maturation.

2. Scars inside the uterus

Dr. Merhi states that C-sections can cause scarring that interferes with healthy embryo implantation and development - because, as he reminds viewers, blood does not flow within scar tissue. Scarring can also occur from prior abortion, prior miscarriage, prior normal pregnancy, retained placenta post-delivery for a previous pregnancy, infections like endometritis (inflammation of the lining of the uterus) or any previous procedures that involve entering and manipulation of the cavity of the uterus.

Dr. Merhi says that even if this is a factor, there is still hope for future healthy pregnancies leading to successful births. In cases where the scar tissue is what is preventing a healthy pregnancy, surgery can be performed to cut out and remove the adhesions (scar tissue) via hysteroscopy which is a minor same-day procedure, done via the vaginal route.

2. Fibroids and polyps

Uterine polyps and fibroids affect up to one-third of women. When these grow near the fallopian tubes, it can prevent conception; or if conception does occur, they significantly increase the risk of chemical pregnancy and early miscarriage.

Polyps and fibroids can be removed via hysteroscopy, and while this treatment is typically effective, it’s possible for them to return. Depending on their location, fibroids do not always need to be removed.

Dr. Merhi states that like any other fertility issue, chemical pregnancy is something that should be discussed with - and diagnosed by - a trusted team of professionals. He states that the staff and doctors at RFC are well versed in the treatment of and prevention of chemical pregnancies. “We are passionate about research and we’re the only fertility clinic to specialize in hysteroscopy in addition to offering 10 different types of IVF,” Dr. Merhi states. “Every woman deserves the chance to become pregnant with her own eggs. At RFC we will do everything possible to make that dream a reality.”

To learn more, please call (203) 557-9696 or e-mail info@rejuvenatingfertility.com