What Is a Chemical Pregnancy and Is It a Miscarriage?
|Expert Reviewed||Dr. Mark Trolice, Director of Fertility Care|
What Is a Chemical Pregnancy?
Imagine this: You get a positive pregnancy test only to start your period a few days later. Chemical pregnancies are both common and extremely heartbreaking, yet very little is understood about them. The sperm and the egg have met, but while conception has taken place, development beyond chemical changes in the woman's body doesn't happen. That's because in very early pregnancy, the cells of the fertilized egg are still developing, but the fetal sac and fetus have not begun to develop yet.
Is a Chemical Pregnancy a Real Miscarriage?
A chemical pregnancy is a very early miscarriage that happens before anything can be seen on an ultrasound scan. According to the American Pregnancy Association, chemical pregnancies may account for 50-75% of all miscarriages.
The pregnancy chemicals, hormones, and cells have started to multiply, but the other physical attributes of a pregnancy have not. This early form of miscarriage is called a chemical pregnancy because the pregnancy is only evident in a blood or urine test and not through an ultrasound or physical examination by a doctor.
The only difference between a chemical pregnancy and a miscarriage is the duration of the pregnancy. Both are the loss of a pregnancy, but they take place at different stages in the development process of the baby. While the physical recovery process is different in a later-term miscarriage than in an early-term one, both bring grief and disappointment.
"A biochemical pregnancy is as devastating as a clinical pregnancy so the woman needs appropriate support from her partner and loved ones. Fortunately, the prognosis is good for an ultimate successful pregnancy and baby," says Mark Trolice, M.D., reproductive endocrinology and infertility specialist at Fertility CARE - The IVF Center and Associate Professor of Ob/Gyn at the UCF College of Medicine."
When Is an Early Miscarriage Considered a Chemical Pregnancy?
The term is used when a woman miscarries after conception but before the fetus has developed. Typically, it happens around weeks four or five. Basically, it occurs around the time when a woman’s body is producing just enough hCG (human chorionic gonadotrophin, the pregnancy hormone) to receive a positive result on a home pregnancy test.
Is It a Period or a Miscarriage?
This kind of pregnancy often goes unnoticed because it can look and act like a late period. When women are trying to get pregnant they'll chart symptoms, keep track of their ovulation, and take an early pregnancy test about a week before their period is due—these women will know almost immediately if they have an early miscarriage because they're acutely aware of the changes in their body. Because of the increase of early-detection pregnancy tests, more chemical pregnancies are being detected, leading to more recognition of the early loss. However, a woman who is not trying to conceive may chalk her late period up to stress and not even realize that she's having a miscarriage.
If you have anxiety, it might be best to wait to take a pregnancy test. Remember, that a chemical pregnancy cannot be avoided, so it might be best to wait until your period is actually late to take a test.
If you’re aware that you’ve had an early miscarriage, you should absolutely inform your doctor so that the two of you can keep track of any future changes or complications.
What Are the Signs of a Chemical Pregnancy?
Some women won't experience any symptoms while others will experience bleeding that resembles a period or cramps and light bleeding that is proceeded by a period. Chemical pregnancies can be painful, just like some periods are painful, but the severity of pain really varies from woman to woman. Most commonly though, they are much like a regular period, but with stronger cramps and a heavier flow.
How Can I Tell the Difference Between Implantation Bleeding and a Chemical Pregnancy?
While it can be difficult to tell the difference between the two, it ultimately comes down to timing. Implantation bleeding usually occurs the third week of your menstrual cycle or one week following ovulation while a chemical pregnancy bleed happens two to three weeks after ovulation
Another way to tell is to look at the amount of bleeding. Implantation bleeding usually results in extremely light bleeding or discharge that only lasts 24-48 hours while a chemical pregnancy will cause a heavier bleed.
What Is the Difference Between a False Positive and a Chemical Pregnancy?
If you take a home pregnancy test and notice two lines, this can indicate that you're pregnant, but it also may be a faint positive line. If you had a chemical pregnancy, it doesn't mean that the test was a false positive. It just means that your body may still have residual hCG in its system, even though you're no longer carrying an embryo. Also, if you take a home pregnancy test while bleeding and see a faint positive line, this can also indicate a very early miscarriage.
Can I Get Pregnant After Having a Chemical Pregnancy?
Since some go undetected, they are not typically considered dangerous. The good news is that is absolutely possible to get pregnant again. Trolice says, "Actually, a biochemical pregnancy is somewhat encouraging since it shows the woman’s partner’s sperm can fertilize her egg and her uterus can allow for embryo implantation."
In fact, a National Institutes of Health study found that couples who try to conceive within three months after an early pregnancy loss have the same, if not greater, chance of having a successful pregnancy than those who wait for three months or more. However, it's important to mention that attempts at another conception should only occur once you have fully grieved and resolved your pregnancy loss. Everyone is on their own timeline, and there is nothing wrong with that.
Also, if you’re aware that you’ve had an early miscarriage, you should absolutely inform your doctor so that the two of you can keep track of any future changes or complications.
Why Do Chemical Pregnancies Happen?
No one really understands why chemical pregnancies happen, what causes them, or how to definitively prevent them. However, contrary to popular belief, they are not the result of a failure to implant. Implantation must take place for hCG to begin developing and for a pregnancy test to come up positive.
In the case of a chemical pregnancy, it’s possible that while implantation started, it happened incorrectly or there were chromosomal abnormalities in the fertilized egg that caused the woman’s body to reject it.
Remember that these early miscarriages happen much more frequently than anyone realizes. Women at an increased risk include those over the age of 35 and those who have certain medical problems, including blood clotting and thyroid disorders. If you experience multiple chemical pregnancies or miscarriages (defined by medical professionals as two or more), your doctor can run some tests to rule out any underlying causes. including uterine fibroids, endometrial polyps, or hormonal abnormalities. According to USC Fertility, only 2% of pregnant women experience two pregnancy losses in a row and only about 1% have three consecutive pregnancy losses.
What Are Other Types of Pregnancy Loss?
A chemical pregnancy is just one type of pregnancy loss (though it is one of the most common). Here are other types of pregnancy loss to watch out for:
The term “blighted ovum” has been used when the gestational sac visualized on ultrasound has no signs of an embryo and is “empty” plus the mean sac diameter measures >= 25mm.
- Ectopic pregnancies are defined as a pregnancy in any location other than the upper uterine cavity. The most common location is the fallopian tube (>90%), usually the part closest to the ovary and where fertilization occurs
- Symptoms include vaginal bleeding, sharp or stabbing pain, and is commonly diagnosed by a transvaginal ultrasound and based on the blood hCG level.
- A missed miscarriage is also known as a silent miscarriage because you may not experience typical miscarriage symptoms and will only know you had a miscarriage until the next ultrasound when there is no heartbeat.
First-Trimester Clinical Miscarriage
- This is intrauterine pregnancy confirmed via ultrasound.
- Symptoms include mild to severe cramps; nausea or vomiting; pain in your back or abdomen, and passing tissue or clot-like material.
- May go undetected until your ultrasound scan at weeks 11-13
- Symptoms include vaginal bleeding, increased hCG levels, nausea/vomiting, and early preeclampsia.
- Symptoms include bleeding, cramping, and loss of fetal movement (most women will feel the baby moving by week 20).
How to Find Support After a Pregnancy Loss
Whether the pregnancy was planned or not, going through a miscarriage at any stage can be totally devastating. A pregnancy loss is a loss no matter what. It's common to feel everything from sadness to anxiety to guilt. Here are a few things to keep in mind if you have experienced an early miscarriage:
- It's necessary to grieve. This may seem like an obvious point but in the case of a chemical pregnancy, some women feel an obligation to move past the experience quickly. It's important to accept that what you've experienced isn't some weird phenomenon that's not serious. It is serious. It's the loss of a pregnancy and that has emotional ramifications.
- You don't have to talk about it with everyone. Chances are that this early on, you've only told a handful of people anyway. How and when you decide to approach the subject of your loss is up to you. However, it's also more than okay if you decide you want to speak with a therapist or close friends about your loss. Don't ever feel like you aren't worthy of help and support.
- Don't let the fear of a future miscarriage paralyze you. Again, half (half!) of all known pregnancies end in miscarriage. That's a sad, hard fact of life that you can't let hold you down in fear. It might be comforting to know that having a chemical pregnancy doesn't necessarily mean you'll have another one. And you're certainly not alone. Reach out and find other women who've had your experience. Online forums are a great way to interact with other women going through the same thing you are.
For those trying to conceive again, there are endless resources available online. Because early miscarriages wreak less havoc on a woman's body than a later miscarriage, not all doctors will discourage a woman from trying to conceive right away as they would with a later miscarriage. Regardless, you should talk to your doctor about what's best for you and your body because everyone is different. If you feel comfortable, be candid with your doctor about the emotions you are feeling. They can help you work through any fears and discuss with you what you can expect in your next pregnancy to help quell your anxieties.
It might also be helpful to find an online support group for women trying to conceive. In the group, you can share stories and tips and feel comfortable with other women who know what you're going through.
Dr. Mark Trolice
- The article has been modified since this review was written.