Chemical Pregnancy

Overview

What is a chemical pregnancy?

A chemical pregnancy is a very early miscarriage that happens within the first five weeks of pregnancy. An embryo forms and may even embed in your uterus lining (implantation), but then it stops developing. Chemical pregnancies occur so early that many people who miscarry don’t realize it.

Sometimes, the loss from a chemical pregnancy feels devastating, especially if you’ve been trying hard to have a baby. Having one chemical pregnancy doesn’t mean you can’t carry a baby to term, though. Many people who’ve experienced early miscarriages go on to have successful pregnancies.

What is the difference between a chemical pregnancy and a clinical pregnancy?

Calling a pregnancy “chemical” can sound cold and removed. But the name isn’t about the experience of pregnancy. Instead, chemical pregnancies get their name from the chemicals in your body, or hormones, that produce a positive result on a pregnancy test. Within the first five weeks, the embryo will produce human chorionic gonadotrophic (hCG) hormone. Your hCG hormone levels provide the only real clue that you’re pregnant at this point because it’s too early to see signs of your developing fetus on an ultrasound. Once the embryo stops developing, your hCG levels fall.

With a clinical pregnancy, your hCG levels rise. Your healthcare provider will be able to see signs of your fetus on an ultrasound and hear a heartbeat by weeks six or seven.

Is a chemical pregnancy a real pregnancy?

A chemical pregnancy ends early because an embryo stops growing. It’s different from a clinical pregnancy, where there’s evidence of a fetus. But that doesn’t mean a chemical pregnancy isn’t real. Sometimes, learning that you’re pregnant is what makes the experience feel real. Sometimes, though, it’s hearing a heartbeat. How real the experience seems depends on each person. Each experience is valid.

Is a chemical pregnancy bad?

There’s no right way to respond to a chemical pregnancy. Learning that you’re no longer pregnant might be a relief if you hadn’t planned on becoming pregnant. Experiencing a chemical pregnancy can be heartbreaking if you’ve been trying to have a baby, without success. But just because your pregnancy ended early doesn’t mean you can’t become pregnant again. It also doesn’t mean your next pregnancy won’t end with a new baby.

Who do chemical pregnancies affect?

Anyone who can become pregnant can experience a chemical pregnancy. You may be more likely to notice a chemical pregnancy if you’re trying to conceive through in vitro fertilization (IVF), since these pregnancies are monitored so closely. IVF alone isn’t a risk factor for chemical pregnancy, though.

Your odds of experiencing an early miscarriage increase if:

Talk about potential risk factors with your healthcare provider. Together, you can come up with a care plan to address any underlying issues that may be negatively impacting your fertility.

How common are chemical pregnancies?

They’re very common. About a quarter of all pregnancies end before the first 20 weeks. And about 80% of those miscarriages happen early. It can be hard to know just how common chemical pregnancies are, though. Many people likely miscarry early without ever receiving a diagnosis.

Symptoms and Causes

What are the signs and symptoms of a chemical pregnancy?

It can be helpful to know the common signs of a chemical pregnancy.

  • Your period comes about a week later than usual.
  • You have a positive pregnancy test, but then you get your period.
  • You have a positive pregnancy test and then a negative pregnancy test a few weeks later.
  • Your period is heavier than usual, and you’ve got more intense menstrual cramps.
  • You have a positive pregnancy test, but you don’t notice the usual signs of early pregnancy.

It’s not possible to know whether you’ve had a chemical pregnancy without taking a pregnancy test (using a urine or blood test).

What does chemical pregnancy bleeding look like?

The bleeding from a chemical pregnancy may look and feel differently for different people. Your period may feel normal, or you may notice that it’s heavier than usual and causing you to cramp more. Sometimes, the bleeding begins as spotting and then gets really heavy, with blood clots.

What causes a chemical pregnancy?

With a chemical pregnancy, the embryo produces hCG, a hormone that it needs to grow. It’s also the hormone that pregnancy tests check for to see if you’re pregnant. If an embryo stops developing, it no longer produces hCG.

No one knows exactly why an embryo stops developing during a chemical pregnancy. Likely, the embryo stops developing because of a problem in its genetic makeup, or DNA. Sometimes, an embryo doesn’t take hold, or implant, in the uterus lining the way it needs to in order to grow. As a result, your hCG levels drop, and pregnancy tests come back negative.

Diagnosis and Tests

How is a chemical pregnancy diagnosed?

Your healthcare provider will check your medical history to see when you had your last period. A pregnancy test will let your healthcare provider know whether you’ve had a chemical pregnancy.

Management and Treatment

How are chemical pregnancies treated?

There isn’t a treatment for chemical pregnancies. But many people who have one pregnancy end early go on to have healthy pregnancies in the future. If you have recurring chemical pregnancies, your doctor may refer you to a fertility specialist.

Knowing that your chances are good for a successful pregnancy in the future doesn’t mean that you don’t need help processing your pregnancy coming to an end. Everyone experiences pregnancy loss differently. You may feel relieved if you weren’t ready for the pregnancy. You may feel disappointed that you got to experience the joy of learning you were pregnant only to have that feeling taken away a short while after. You may not feel any particular way at all, and that’s OK.

If you need to process your loss or if you need to speak to someone who can guide you when it comes to next steps, though, reach out to your healthcare provider or a counselor. They can connect you with the resources you need to put your self care first.

Prevention

How can I prevent a chemical pregnancy?

You can’t prevent a chemical pregnancy. Most chemical pregnancies likely happen when there’s a problem in the embryo’s DNA that prevents it from developing. There’s a good chance that the next embryo and the ones that follow will develop without a problem.

Outlook / Prognosis

What can I expect if I have a chemical pregnancy?

Having one chemical pregnancy or even multiple chemical pregnancies doesn’t mean you can’t have a healthy pregnancy someday. What you decide to do moving forward depends on you. Take the time to process whatever emotions you’re feeling. Speak with your partner and/or healthcare provider about what you need to happen next.

When do you ovulate after a chemical pregnancy?

Many people choose to try for another pregnancy immediately after an early pregnancy loss. You can ovulate two weeks after a chemical pregnancy and potentially get pregnant.

Living With

What questions should I ask my healthcare provider after a chemical pregnancy?

Reach out to your healthcare provider if you need help processing your pregnancy loss or if you’d like advice about improving your pregnancy chances in the future. Questions you could ask include:

  • When should I see a fertility specialist?
  • How long should I wait before trying to become pregnant again?
  • What changes can I make to improve my chances of having a healthy pregnancy?
  • Are there any tests you recommend to see if there’s an underlying issue that affected my pregnancy?

A note from Cleveland Clinic

Pregnancies often end within the first few weeks. There’s no way to prevent a chemical pregnancy from happening, and there’s no way to treat one that has happened. Keep in mind, though, successful pregnancies often follow chemical pregnancies. Regardless of how you feel about your pregnancy loss, take the time you need to process or plan your next steps. Speak with a counselor if you need help dealing with your grief or disappointment. And speak with your healthcare provider about any fertility concerns you may have as you plan your next steps. Reach out to your support network, too. But ultimately, you’re the best judge of what you need and what comes next.

Last reviewed by a Cleveland Clinic medical professional on 12/11/2021.

References

  • Annan JJ, Gudi A, Bhide P, Shah A, Homburg R. Biochemical pregnancy during assisted conception: a little bit pregnant. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712881/) J Clin Med Res. 2013;5(4):269-274. Accessed 12/11/2021.
  • Larsen EC, Christiansen OB, Kolte AM, Macklon N. New insights into mechanisms behind miscarriage. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3699442/) BMC Med. 2013;11:154. 2013 Jun 26. Accessed 12/11/2021.
  • Lee HM, Lee HJ, Yang KM, et al. Etiological evaluation of repeated biochemical pregnancy in infertile couples who have undergone in vitro fertilization. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694731/) Obstet Gynecol Sci. 2017;60(6):565-570. Accessed 12/11/2021.

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