Chemical Pregnancy

What is a chemical pregnancy?

A chemical pregnancy (or biochemical pregnancy) is a very early miscarriage that happens within the first five weeks of pregnancy before the pregnancy can be seen on an ultrasound. An embryo forms and implants in your uterine lining, but then it stops developing. Chemical pregnancies occur so early that many people don’t realize they’ve miscarried.

If you were aware of being pregnant, the loss from a chemical pregnancy may feel 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.

Chemical pregnancy vs. clinical pregnancy

Calling a pregnancy “chemical” can sound a little cold. But the name isn’t about your experience of pregnancy. Instead, chemical pregnancies get their name from the hormones that produce a positive result on a pregnancy test. Within the first five weeks, the embryo will produce human chorionic gonadotrophic (HCG). 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 the fetus on an ultrasound. But once the embryo stops developing, your HCG levels fall.

With a clinical pregnancy, your HCG levels rise steadily. Your healthcare provider uses the term clinical pregnancy when they confirm a pregnancy with chemical evidence (positive urine or blood test) or by being able to see signs of the fetus on an ultrasound.

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 an embryo. But that doesn’t mean a chemical pregnancy isn’t a real pregnancy. Sometimes, learning that you’re pregnant is what makes the experience feel real. Sometimes, though, it’s seeing a heartbeat on an ultrasound screen. How real the experience seems depends on each person. Each experience is valid.

How common are chemical pregnancies?

They’re very common. About 25% of all pregnancies end in 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 or knowing they’re pregnant.

What are the signs 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 have more intense menstrual cramps.
• You have a positive pregnancy test, but you don’t notice the usual signs of early pregnancy.

What does chemical pregnancy bleeding look like?

The bleeding from a chemical pregnancy can look and feel different for everyone. 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.

How long does it take to miscarry a chemical pregnancy?

The passing of the tissue from a chemical pregnancy can take several days or a few weeks. It varies from person to person.

Some people experience a chemical pregnancy right around the time they’re supposed to get their period. For this reason, many people aren’t aware they were pregnant and mistake a chemical pregnancy for a menstrual period.

But in other cases, it can take longer for your body to realize there’s no pregnancy. It can take a week or longer to pass the pregnancy tissue.

What causes a chemical pregnancy?

A chemical pregnancy is a miscarriage that happens within the first week of implantation. Implantation is when the fertilized egg implants in your uterine wall and turns into an embryo. This triggers your body to create HCG, a hormone that helps the embryo grow. It’s also the hormone that pregnancy tests check for to see if you’re pregnant. But then the embryo stops developing, usually within a few days. But since HCG is in your bloodstream, it can show up as a positive pregnancy test. It can take several days or weeks for HCG levels to go back down.

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 uterine lining the way it needs to in order to grow. But once your HCG levels drop below a certain point, a pregnancy test will come back negative.

How quickly does HCG drop after a chemical pregnancy?

HCG levels tend to drop quickly after a chemical pregnancy. On average, HCG levels decrease by about 50% every two days. But it also depends on how high your levels were to begin with. You can still get a positive at-home pregnancy test after HCG levels begin to drop. This is because your levels may still be high enough to trigger a positive pregnancy test. Eventually, HCG levels will return to normal and a pregnancy test will be negative.

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:

• You’re 35 or older.
• You have an irregularly shaped uterus.
• Your hormone levels are too high or too low.
• You have a sexually transmitted infection (STI).
• You have thyroid disorders, diabetes or polycystic ovary syndrome (PCOS).

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 impacting your fertility.

How is a chemical pregnancy diagnosed?

Your healthcare provider will check your medical history to see when you had your last period. Then, they may perform the following:

• A pregnancy test. A pregnancy blood test may show you’re not pregnant.
• Blood tests to measure HCG. Your provider may order another blood test to check your HCG levels. The level can tell them if there’s a chance you’re pregnant. A second HCG test can show if HCG levels are increasing or decreasing. With a chemical pregnancy, HCG levels will be much lower on the second blood test.
• Ultrasound. An ultrasound will show that there’s no fetus developing.

Can you save a chemical pregnancy?

No. Usually, the embryo stops growing very soon after it implants into your uterus. There’s nothing you or your pregnancy care provider can do to save the embryo when this happens.

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 pregnancy care provider 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. You may not feel any 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, reach out to your healthcare provider or a counselor. They can connect you with the resources you need to put your self-care first.

How can I prevent a chemical pregnancy?

You can’t prevent a chemical pregnancy. Most chemical pregnancies 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.

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 to do next.

How should I feel after a chemical pregnancy?

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.

What are tips for getting pregnant 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. The tips on having a healthy pregnancy are the same, regardless of your situation. Some tips are:

• Get early and regular prenatal care. Contact a pregnancy care provider as soon as you know you’re pregnant. This is essential in preventing potentially dangerous pregnancy complications.
• Maintain a pregnancy weight that’s healthy for you. Eat nutritious foods like fruits, vegetables, whole grains and protein. Take a prenatal vitamin if you’re trying to get pregnant.
• Exercise regularly. Aim for at least 30 minutes of movement most days of the week.
• Avoid alcoholic beverages and tobacco products.
• Drink plenty of water.

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:

• 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

There’s no way to prevent a chemical pregnancy from happening, and there’s no way to treat one that has happened. No matter what feelings you have — those feelings are valid. 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.