Tuesday, May 13, 2008

Biochemical Pregnancy

Have you heard of this term?

I didn't like it from the first time I heard. I mean, the term is both demeaning and confusing.

Demeaning because the affected woman feels like she's being treated like an experimental subject. Confusing because we are neither confirming or denying that she is pregnant.

Ok, background info. Decades ago, our grandmas realized they were pregnant when they began to experience 'morning sickness'. A doctor would then look for Hegar's sign and confirm the pregnancy. Then came in the urine pregnancy tests. Then, these tests became more sensitive. And we are now finally in an era where serum beta-hCG assay is easily available. To that, you add an anxious lady with fertility problems and an equally anxious doctor who wants to see the success of his/her fertility treatment.

And you get biochemical pregnancy.

These pregnancies are real, except when you have choriocarcinoma or hCG-secreting ovarian tumour. The more commoner culprit is hCG injections that are sometimes given to aid ovulation and / or provide hCG support for the early pregnancy.

If we take all the above factors away, then it has to be a pregnancy and nothing else (I stand corrected).

Most (up to 60%?) of pregnancies 'fade away' before most women realize them. These destined-to-fail pregnancies are being increasingly picked up due to heightened surveilance following fertility therapy.

For the benefit of students, a biochemical pregnancy is a pregnancy that fails before the beta-hCG levels enter the 'discriminatory zone'.

And you are what? No. 2 at home? Or is it No.3. Sure? Not 63?

I dedicate this article to all my biochemical brothers and sisters 'born' before me. :-)