A chemical pregnancy is a miscarriage that happens before 5 weeks. It’s usually called chemical pregnancy because it happens before it can be detected via ultrasound. Pregnancies of less than 5 weeks can only be detected by chemical methods, like urine and blood tests. Some women don’t even know that they are pregnant yet at the time that they experience a chemical pregnancy. They may believe that the chemical pregnancy is just a heavier-than-normal period.
Many people misunderstand the term chemical pregnancy. A chemical pregnancy is not a false pregnancy. It is a completely real pregnancy that ends in early miscarriage. If you have experienced a chemical pregnancy, you are just as entitled to your grief as anyone who has had a pregnancy loss. And if you are concerned about fertility or recurrent miscarriage, your chemical pregnancy should be considered as a miscarriage by your doctor. If your doctor doesn’t take your chemical pregnancy seriously, it may be time to look for another provider who has a better understanding of pregnancy loss and fertility.
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What causes a chemical pregnancy?
With a chemical pregnancy, you won’t get the chance to have genetic testing like in a miscarriage that occurs later. Half of all early miscarriages are caused by fetal chromosome abnormalities. Most of these abnormalities are random errors that occur as cells divide and the embryo develops, and most of the time when miscarriages occur, both parents are chromosomally normal. Either way, you need to know that a chemical pregnancy is not your fault. There is nothing that you did that caused this chemical pregnancy to occur.
Am I experiencing a chemical pregnancy?
With a chemical pregnancy, you may notice that pregnancy symptoms are diminishing. If you were feeling sore breasts or nausea, that may start to go away. If you retest at home, you may see a negative pregnancy test. You may also start bleeding or spotting. A chemical pregnancy is often similar to a period. However it is heavier than a normal period, with more cramping and discomfort.
In early pregnancy, symptoms can vary, and 25% of women experience spotting in the first trimester of pregnancy. The only way to truly know if you are experiencing a chemical pregnancy is if your hCG levels begin to decrease. If you have had a blood test, your doctor may be able to repeat the test and see if your levels of hCG in the blood are decreased. If you haven’t had a blood test, you may find that you were testing positive for pregnancy with at-home urine tests and then begin to test negative.
Do I need any treatment after a chemical pregnancy?
Because a chemical pregnancy occurs so early in pregnancy, usually recovery is quick and the risk of complications is very, very small. If you are concerned about the amount of bleeding, you should speak to your doctor. And of course, if you are bleeding heavily, call your provider right away and they can direct you as to whether you need any medical treatment.
After a chemical pregnancy, do I have an increased chance of miscarriage?
Chemical pregnancy is, unfortunately, very common, and having one does not increase your chances of another loss. In a study by Wilcox et al, 22% of pregnancies end in miscarriage before the pregnancy could be detected clinically. Most of the women with early pregnancy loss in the study had normal fertility, with 95% of them becoming pregnant in 2 years.
Having recurrent pregnancy loss, defined as 2 or more miscarriages, can increase your risk of future miscarriage. After 2 miscarriages, the risk of miscarriage goes up from 20% to 25%. After 3 or more miscarriages, the chance of loss increases to 30-40%. If you are looking for more information specific to your history and age, datayze has a fabulous chart. Even with 3 or more miscarriages, your chance of a successful pregnancy is still higher than your chance of another loss, so you can remain hopeful. I have had 5 pregnancy losses in a row, no explanation for my losses, and I’m currently 27 weeks with a healthy pregnancy.
TTC after chemical pregnancy
You can start trying to conceive (TTC) as soon as you would like after a chemical pregnancy. There is no need to wait. Even in miscarriages that occur later, research has indicated that those who become pregnant within 3 months after miscarriage actually have the best likelihood of successful pregnancy.
Generally, there is no special testing that occurs after 1 miscarriage. So if this is your first pregnancy loss, you don’t need to seek any special treatment or testing. You can continue TTC knowing that it is still very likely that your next pregnancy will be successful.
After 2 or 3 miscarriages, your doctor may order testing to determine if there is an underlying cause of your pregnancy losses. This could include a pelvic exam, MRI or ultrasound of the uterus, karyotype test, or blood work to check for thyroid and blood clotting issues or for autoimmune conditions. If this chemical pregnancy is your 2nd or 3rd pregnancy loss, you may want to consider delaying TTC until testing is completed. That way you can start treatment right away if any issues are found, before becoming pregnant again.
Citations
- https://americanpregnancy.org/getting-pregnant/pregnancy-loss/chemical-pregnancy/
- https://www.sciencedirect.com/science/article/pii/S0925443912001494?via%3Dihub
- Sundermann AC, Hartmann KE, Jones SH, Torstenson ES, Velez Edwards DR. Interpregnancy Interval After Pregnancy Loss and Risk of Repeat Miscarriage. Obstet Gynecol. 2017 Dec;130(6):1312-1318. doi: 10.1097/AOG.0000000000002318. PMID: 29112656; PMCID: PMC5709156.
- Wilcox AJ, Weinberg CR, O’Connor JF, Baird DD, Schlatterer JP, Canfield RE, Armstrong EG, Nisula BC. Incidence of early loss of pregnancy. N Engl J Med. 1988 Jul 28;319(4):189-94. doi: 10.1056/NEJM198807283190401. PMID: 3393170.
- https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/pregnancy-after-miscarriage/art-20044134