Chemical Pregnancy: Causes, Symptoms, and What You Need to Know

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

For many hopeful parents, seeing a positive pregnancy test brings joy and excitement. However, in some cases, the pregnancy ends very early, before it can be detected on an ultrasound. This is known as a chemical pregnancy. Though it may be brief, the experience can have both emotional and physical impacts. Understanding the causes, symptoms, and recovery process can help bring clarity during this difficult time.

What Is a Chemical Pregnancy?

A chemical pregnancy is a very early miscarriage in a pregnancy in which a positive pregnancy test is obtained because a growing embryo is producing human chorionic gonadotropin (hCG), but the pregnancy is lost before the fifth week of gestation. This premature loss is usually confused with a late or missed one, or can result in mild effects such as spotting or cramping. The cause is often a chromosomal abnormality in the embryo, so that it cannot grow normally. 

What causes a chemical pregnancy?

The cause is usually not known, but the loss is normally caused by an issue with the developing embryo. Possible causes include: 

• Chromosomal abnormalities: This is most often due to a genetic problem with the embryo, making it fail to develop normally.
• Implantation issues: The embryo can fail to implant successfully on the uterine wall.
• Hormonal imbalances: Diseases of some hormones, including progesterone, can be a contributor.
• Other conditions: Thyroid disorders, abnormalities of the uterus, or some types of infections can also have a role to play.

Symptoms

Due to the early occurrence of a chemical pregnancy, some individuals can confuse it with a normal or late menstrual cycle. These may be observed in case you are actively attempting to conceive and are also on early pregnancy tests: 

• A positive test with a negative result a few days/weeks after.
• A time that comes a week or so later than planned.
• More menstrual bleeding or more severe menstrual cramps.
• A positive pregnancy test was received, and there were no signs of early pregnancy, including nausea or swelling of the breasts.

What to know about chemical pregnancies

• It is a real pregnancy: Although it is early, a chemical pregnancy is a real pregnancy, and it may bring loss and grief.
• Treatment is not necessary: The miscarriage normally corrects itself, and it does not need any medical intervention.
• Future pregnancies: A lot of individuals who undergo a chemical pregnancy proceed to develop healthy pregnancies in the future. And possessing one does not imply that you are having a fertility problem.
• It is normal: The occurrence of chemical pregnancies is quite normal, particularly when the highly sensitive early-detection tests are used. 

How Is a Chemical Pregnancy Diagnosed?

A chemical pregnancy is identified by a temporary increase and decrease of the pregnancy hormone, human chorionic gonadotropin (hCG), via blood or urine. An important component of the diagnosis is that the pregnancy terminates before a gestational sac is visible on an ultrasound, which is normally visible by the fifth week of pregnancy. 

Steps for diagnosis

1. First positive pregnancy test: When you are attempting conception and do a sensitive early home pregnancy test, you may end up with a positive result immediately after the fertilized egg has implanted and is now generating hCG.
2. Negative test and bleeding: Once you have had a positive test, a negative test will soon follow, and your period will come within a month or a little late. The hemorrhage of a chemical pregnancy can be excessive.
3. Hormone level testing: To clinically confirm, a medical practitioner will take a blood sample to test your hCG level.
   1. Decreasing hCG: If your first blood test shows elevated hCG, the doctor will take another test a few days later. A chemical pregnancy is indicated if your hCG levels are decreasing instead of rising, as they would in a healthy, progressing pregnancy.
   2. Ultrasound: To differentiate a chemical pregnancy from a later miscarriage or an ectopic pregnancy, an ultrasound may be performed. If no gestational sac or fetus is visible on the scan, it confirms the pregnancy did not progress beyond the chemical stage. 

Why medical confirmation is important

While a positive-then-negative home test result is a common indicator, medical confirmation is important for the following reasons:

• Excluding other conditions: Your physician can exclude a potentially severe ectopic pregnancy, where the fertilized egg implants extrauterine.
• Giving peace of mind: To the people actively attempting conception, a chemical pregnancy confirmation makes it feel more real and provides an answer to what occurred.
• Informing future care: HCG monitoring is a routine aspect of early pregnancy care in fertility patients who undergo IVF procedures, and can aid in future treatment decisions. 

Emotional Impact of Chemical Pregnancy

Chemical pregnancy can be extremely distressing, particularly in those couples who are actively pursuing pregnancy. The good news of being pregnant may immediately give hopes and dreams and a sudden loss may lead to sadness, confusion, and grief. The physical recovery may occur faster than the emotional recovery. 

Why the emotional toll is so high

• The birth of the dream: A positive test, even a weak one, can give the strongest emotions and visions of the future. The sudden termination of the pregnancy may be the loss of that dream.
• An actual loss: The term chemical pregnancy might be dismissiveness of the grief, and may not be regarded as a real miscarriage. However, in real life, a miscarriage is a miscarriage, and the feeling of grief is legitimate.
• Disenfranchised grief: Since other people are not aware of chemical pregnancies, grief may be isolated and lonely. This disenfranchised grief happens when the loss is not openly accepted or socially recognized, and the person might not easily grieve openly and get the support they need.
• Hormonal changes: A chemical pregnancy may abruptly cause a decrease in pregnancy levels of hormones such as hCG and progesterone, which in turn can lead to mood swings and irritability, exacerbating emotional pain.
• Guilt and self-blame: Most individuals attribute the loss to themselves; they feel they must have done something bad to make them lose, even when they are aware that they did not do anything.
• Fear of future pregnancies: This experience can cause anxiety and fear of subsequent pregnancies. It is hard to fully bond with a new pregnancy for many before they reach the mark of their loss. 

Treatment and Recovery After a Chemical Pregnancy

Mostly, a chemical pregnancy does not necessitate any medical treatment and can be left to pass. The physical recovery process is usually fast and only takes days or a week. But emotional recovery may be more prolonged and needs to be supported deliberately. 

Physical recovery

Most people who experience a chemical pregnancy do not have severe pain or heavy bleeding. The physical process is similar to a slightly heavier or late menstrual period. 

• Prognosis: The majority of symptoms improve after one week. After 4 to 7 days, an average hormone (hCG) level is normal.
• Symptoms: You can experience a period of two weeks of vaginal bleeding that is likely to be the same or a bit heavier than a regular period. Some cramping is also normal.
• Medical follow-up: A physician can prescribe a follow-up blood test to make sure the hCG is set at zero, which this to confirm the pregnancy is over, and to exclude other causes such as an ectopic pregnancy.
• See a doctor When: See a doctor immediately in case of severe pain, dizziness, or excessive bleeding (wet more than one pad in an hour). 

Emotional recovery

The emotional impact of a chemical pregnancy can be significant, and it is important to allow yourself time to grieve. 

• Accept the loss: Accept that you are truly grieving, that you are angry, confused, and disappointed by the loss.
• Find support: Find a friend, family member, or a counselor to talk to. You can also feel less isolated by joining a support group of people who have gone through miscarriage.
• Talk to your partner: There are two ways to go through grief. It is important to openly share your feelings and to respect each other’s coping styles so as to work through the loss together.
• Think of a ritual: Since chemical pregnancies are frequently not even visible to others, you can use creating a personal ritual to recognize the loss. This may involve planting a tree, jewellery, or a journal.
• Get easy on yourself: Learn to realize that it is not your fault. Allow yourself to experience your feelings without condemnation and have a work break. 

Trying to conceive again

A chemical pregnancy does not affect your future chances of having a healthy pregnancy. 

• Timing: Two weeks after a chemical pregnancy, you can ovulate and get pregnant again. Nevertheless, most doctors advise you to wait until after your next standard menstrual period, which makes it easier to date a new pregnancy. Finally, you should give a second attempt when you are physically and emotionally prepared.
• Lifestyle: Maintain a healthy lifestyle, including prenatal vitamins or folic acid, a healthy diet, physical activity, and avoidance of alcohol and tobacco.

Recurrent chemical pregnancies

If you experience two or more consecutive chemical pregnancies, your doctor may suggest further testing. 

• Diagnostic plans: A fertility specialist can order tests to check problems with hormonal imbalances, thyroid diseases, uterine defects, or chromosomes.
• Possible treatments: According to the diagnostic results, treatment might be hormone therapy, underlying medical causes, or surgical repair of uterine anomalies. Where nothing has been found, alternatives like In Vitro Fertilization (IVF) with genetic testing can be considered.

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Preventing Chemical Pregnancy – Is It Possible?

Nothing can be done to stop a chemical pregnancy because most of them are beyond your influence, which could be a chromosomal abnormality. A large percentage of these extremely early miscarriages occur because of some accidental genetic mistake in the embryo that it from developing. This does not belong to the fault of either partner and is not a manifestation of the overall capacity of a person to have a healthy pregnancy. 

Although you cannot avert a random chromosomal occurrence, you can act to increase overall well-being and reduce risk factors that might lead to pregnancy complications. Such measures may tend to raise the likelihood of a healthy pregnancy, although they do not imply the absence of early loss.

Final Thoughts

A chemical pregnancy is a very early miscarriage that occurs within the first few weeks, often before an ultrasound can confirm a pregnancy. It normally occurs when a fertilized egg implants but aborts shortly afterwards. Although most individuals might confuse it with a late or heavy period, it is crucial to comprehend chemical pregnancy as a way of emotional healing as well as future family planning.

FAQs

Is a chemical pregnancy still a baby?

A chemical pregnancy (or biochemical pregnancy) is a very early miscarriage that occurs within the first five weeks of pregnancy before the pregnancy is visible in an ultrasound. A fetus develops and implants in the uterine wall, and then ceases growing.

Are you more fertile after chemical pregnancy?

Indeed, you might be more prolific after a chemical pregnancy: A study discovered that those who had attempted to conceive 3 months after a miscarriage were 17 percent more likely to be pregnant and have a living baby than those who waited longer.

How long will a chemical pregnancy last?

A chemical pregnancy is a very premature miscarriage that happens in the first five weeks. The majority of people are not even aware they are pregnant, and they might not even experience any effects of a miscarriage.

What hormone imbalance causes chemical pregnancy?

A woman can have a recurrent chemical pregnancy due to several reasons. A progesterone deficiency is one of the most frequent causes. Ovaries produce this hormone when an egg is released by an ovary. The hormone is to prepare the uterine lining.