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Chemical pregnancy is a very early stage miscarriage. Also known as a biochemical pregnancy, trophoblast in regression and pre-clinical embryo loss, it usually happens shortly after implantation. This means that in the days before the miscarriage:

  • The woman’s egg would have been fertilised.
  • The egg would have travelled down the fallopian tubes and attached itself to the wall of the uterus.
  • This also means that the woman’s body would have started producing the human chorionic gonadotropin (hCG) hormone, and a pregnancy test would have been positive before the miscarriage.

However, in a chemical pregnancy, the implanted embryo is lost within two or three weeks. According to India's National Health Portal, 80% of all miscarriages happen in the first trimester. Further, the American College of Obstetrics and Gynecologists (ACOG) data show that chemical pregnancy accounts for 50-75% of all miscarriages.

Most women who are not planning a pregnancy or taking note of their ovulation and pregnancy status, would not even come to know that they have experienced a chemical pregnancy. On the other hand, those couples who are trying various means to get pregnant - including assisted reproductive therapy and methods like in vitro fertilisation (IVF) - would come to know immediately if implantation and later chemical pregnancy has occurred.

The idea that you are pregnant and then not within a few weeks can be devastating. Unlike a false positive pregnancy test - which can be disheartening - a chemical pregnancy is a very early form of miscarriage. Dealing with the loss of a confirmed pregnancy can be traumatic for any couple, but especially for those couples who are getting infertility treatment. Reaching out to friends and family for support and seeking psychotherapy is a good idea to come to terms with the loss.

Here is everything you need to know about a chemical pregnancy.

  1. Chemical pregnancy symptoms
  2. Chemical pregnancy causes
  3. Treatment of chemical pregnancy
  4. Is it normal to be upset after chemical pregnancy?

Chemical pregnancy is especially difficult to diagnose because not all women experience the symptoms. Because this pregnancy terminates too early, it cannot be detected by an ultrasound, and only pregnancy tests like the beta hCG test and blood tests can reveal its occurrence. However, the women who do experience some symptoms, describe the following:

  • A positive pregnancy test that quickly turns negative.
  • Mild spotting a week before the next period is due.
  • Mild abdominal cramps.
  • Vaginal bleeding after a positive pregnancy test.
  • Low hCG levels in blood test after a positive pregnancy test or blood test.

The exact causes of a chemical pregnancy are unknown. However, in most cases, it is believed that a chemical pregnancy occurs because of problems in the embryo. The following are some of the presumed causes of a chemical pregnancy:

Read more: How to get pregnant when you have a thyroid problem

Unfortunately, there is nothing you can do to prevent a chemical pregnancy. Most women don’t even realise they are pregnant unless symptoms like morning sickness, delayed periods, etc., show up. It usually takes about 5 weeks into the pregnancy for them to get a positive pregnancy result. Chemical pregnancy usually happens well before this and most women who are not planning a pregnancy assume they are just having a regular period even if it is a bit heavier, more painful and clotted.

However, in the case of women who have been planning a pregnancy, the realisation that they have suffered a chemical pregnancy can dawn pretty quickly. In such a case, getting grief counselling might be necessary to help the woman and her spouse deal with it.

If there is an underlying issue which led to the chemical pregnancy - like uterine abnormalities, sperm or egg quality, STIs, etc. - it should be treated. Talk to your doctor for the lab tests needed to diagnose any underlying condition.

It’s important to remember that going through a chemical pregnancy once does not mean that you won't be to conceive in future.

For those who are planning a pregnancy and looking to welcome a child into their family, the loss of a pregnancy, no matter how early, can be devastating. A chemical pregnancy can also be distressing to those who started making plans for the future after getting a positive pregnancy test result. In either case, feeling upset or distressed is quite natural.

However, not feeling upset by the loss of pregnancy due to chemical pregnancy is also natural. You might be relieved that the loss occurred early rather than late into the pregnancy, or you could even be looking forward to dealing with the underlying issues that made the pregnancy unsustainable. 

There are no right or wrong feelings when it comes to an issue like this, and couples as well as their family and friends should refrain from passing judgement on the situation. No matter how the woman who has gone through a chemical pregnancy feels, it’s necessary that people in her circle ensure that she and her spouse get the support they need.

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  1. Annan, John Jude Kweku. et al. Biochemical Pregnancy During Assisted Conception: A Little Bit Pregnant. J Clin Med Res. 2013 Aug; 5(4): 269–274. PMID: 23864915
  2. American Pregnancy Association [Internet]. Irving, Texas, USA; Miscarriage
  3. Schreiber, Courtney A. et al. A Little Bit Pregnant: Modeling How the Accurate Detection of Pregnancy Can Improve HIV Prevention Trials. Am J Epidemiol. 2009 Feb 15; 169(4): 515–521. PMID: 19095756
  4. Coulam, Carolyn B. and Roussev, Roumen. Chemical Pregnancies: Immunologic and Ultrasonographic Studies. Am J Reprod Immunol , 48 (5), 323-8. PMID: 12516655
  5. Lee, Hyun-Mi. et al. Etiological evaluation of repeated biochemical pregnancy in infertile couples who have undergone in vitro fertilization. Obstet Gynecol Sci. 2017 Nov; 60(6): 565–570. PMID: 29184865
  6. The Miscarriage Association [Internet]. UK; Chemical pregnancy
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