What Is A Chemical Pregnancy: Causes, Symptoms and Treatment

Have you heard of the term chemical pregnancy? Learn more about this occurrence that causes pregnancy loss even before the mum finds out she’s pregnant.

What is a Chemical Pregnancy

A chemical pregnancy refers to a very early miscarriage which occurs before the fifth week of gestation, and well before the foetus can be visibly detected on an ultrasound. Chemical pregnancies account for up to 50 to 75 per cent of all miscarriages.

For instance, your pregnancy test might show positive, but you still get your period after a few days. This could mean a chemical pregnancy.

It is a pregnancy that happens before the foetus can be seen on an ultrasound, neither a false pregnancy or a false positive on a pregnancy test.

Chromosome abnormalities in the embryo can result in chemical pregnancies.

Many women who have a chemical pregnancy actually don’t even realise they’ve conceived, very often they mistake it to be a late period.

Chemical pregnancy is quite common. Most women who experience an early loss go on to experience a subsequent, healthy pregnancy.

How does it happen?

Many women learn they are pregnant quite early—even before their expected period—thanks to the sensitivity of modern home pregnancy tests.

So what happens is that a fertilised egg implants in the uterus, and the pregnancy hormone hCG (human chorionic gonadotropin) is now produced.

This time, hCg is high enough to be detected on a blood or urine test and this will elicit a positive pregnancy test result, but then the embryo stops developing.

However, for some reason implantation never fully happens, which is why the ultrasound won’t detect a gestational sac or placenta developing. This results in bleeding around a week after your regular period was due.

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The Difference Between Chemical Pregnancy and Clinical Pregnancy

Only a pregnancy test that reveals high hormone levels can identify a chemical pregnancy. When a doctor can confirm a pregnancy with an ultrasound or foetal heartbeat, the pregnancy is considered clinical. No physical or audible symptoms exist for a chemical pregnancy.

Typically, an ultrasound at five to six weeks or the confirmation of a foetal heartbeat at seven to eight weeks might show clinical pregnancy symptoms. But as early as two weeks after conception, hormonal pregnancy tests can identify a chemical pregnancy.

Because it occurs so early on in pregnancy, chemical pregnancy thus refers to the loss of a pregnancy before the gestational sac could be seen through ultrasound, whereas a clinical miscarriage refers to the loss of a pregnancy that was visibly confirmed with ultrasound.

What Does Chemical Pregnancy Bleeding Look Like

Different people may experience and perceive a chemical pregnancy’s bleeding in different ways. You can feel that your period is regular or you might notice that it’s heavier than usual and giving you more cramps.

Chemical pregnancy haemorrhage may begin as light spotting and progress to severe bleeding with apparent clotting (dark red clots), much like a heavy period.

Implantation bleeding vs. a chemical pregnancy

After a positive pregnancy test, little bleeding or spotting doesn’t always indicate a chemical pregnancy. Light implantation bleeding, which is an indication of pregnancy in some women (but not all), can happen.

Contrarily, severe bleeding and cramping similar to menstruation during pregnancy may portend an impending early loss.

The American College of Obstetricians and Gynecologists (ACOG) advises calling your doctor in any case if you suffer any bleeding following a positive pregnancy test.

How long does chemical pregnancy bleeding last?

Chemical pregnancy is different from other miscarriages. One person early in the pregnancy may have a miscarriage and only experience bleeding and cramping for a few hours. Another person may have miscarriage bleeding for up to a few days, and it may look like menstrual bleeding. This is why chemical pregnancies often go unrecognised.

Chemical Pregnancy Symptoms

Symptoms of chemical pregnancy can vary between women. Some will not experience any symptoms at all. Some women may not have realised that they were pregnant, they mistake it to be a late period.

However, some women do notice the following:

• A positive pregnancy test that can quickly turn negative
• Mild spotting a week before their period is due
• About a week later than usual, your menstruation arrives.
• Your pregnancy test is positive, but you then start getting your period.
• Your menstrual cramps are more painful and your period is heavier than normal.
• Despite a positive pregnancy test, you don’t experience the typical early pregnancy symptoms.
• Very mild menstrual-like abdominal cramping
• Vaginal bleeding days after getting a positive pregnancy result, bleeding may be a little heavier than normal, and you may pass some small blood clots.
• Low hCG levels if your doctor takes a blood test

Without taking a pregnancy test (using a urine or blood test), you cannot determine if you had a chemical pregnancy.

What Causes Chemical Pregnancy

Experts believe that half of all chemical pregnancies are due to some form of chromosomal abnormality. 

Human cells normally contain 23 pairs of chromosomes. At the time of conception, an egg and a sperm combine chromosomes (23 from father, 23 from mother) to form a zygote, which begins to grow through rapid cell division. 

Sometimes a mistake happens during the process, producing too many chromosomes or not enough chromosomes. These chromosomal abnormalities are believed to be behind most early pregnancy losses.

Abnormal chromosomes can be the result of many factors, such as poor quality of the sperm or egg, genetic abnormalities passed down by the mother or father, or an abnormal cell division of the foetus. 

Additional causes and risk factors may include:

• Being over the age of 35
• Diabetes
• Blood clotting disorder
• Thyroid disorder
• Polycystic Ovary Syndrome (PCOS)
• Pregnancy with an IUD in place
• Problem with DNA in the sperm
• Infections such as toxoplasmosis, chlamydia, or syphilis
• Systemic illnesses such as untreated thyroid disease
• Uterine abnormalities (congenital and acquired)
• Abnormal hormone levels
• Luteal phase defect
• Inadequate uterine lining
• Implantation outside the uterus

A chemical pregnancy can result in mental suffering even though it normally has no negative medical effects. Deep sadness and grief can result from even early pregnancy loss.

How is a chemical pregnancy diagnosed?

Oftentimes, after a positive pregnancy or blood test, a woman will begin bleeding. In this situation, more blood tests might be performed to determine the cause. Because a pregnancy test could come back negative after only a few days, blood tests are occasionally skipped.

A woman will be labelled as miscarrying a chemical pregnancy if blood tests reveal that pregnancy hormones are falling rather than growing.

It’s crucial to get checked if you experience any bleeding when pregnant, whether or not it hurts.

Treatment for Chemical Pregnancy

Only if any of the tissue remains in your uterus and needs to be removed will you require physical therapy following a miscarriage. It’s extremely improbable that you will require any of those therapies because a chemical pregnancy occurs at such an early stage.

There is no specific treatment usually involved in a chemical pregnancy. A pregnancy loss can take an emotional toll on couples, especially if they were really hoping to conceive. Counselling can help in coping with pregnancy loss.

Women who experience a chemical pregnancy are also encouraged to follow up with tests to ensure that their hCG levels return to normal. This is because higher levels of hCG can also occur with an ectopic pregnancy, when an egg implants outside the uterus. Since an ectopic pregnancy can mimic a chemical pregnancy, your doctor may run tests to rule out this condition.

For recurrent miscarriage, doctors may advise to run some tests to identify the possible causes.

Treatment for recurrent chemical pregnancies may include:

• Progesterone
• Baby aspirin
• Antibiotics 
• Surgery to fix a uterine abnormality

If you are eager to try to become pregnant again, it is recommended that you wait for at least one regular menstrual cycle. Discuss with your doctor about any risks.

Coping With Chemical Pregnancy 

It is natural to feel sad and upset after a chemical pregnancy, especially if you were really hoping to conceive and the pregnancy test showed positive early on. It will be particularly distressing for couples who took a long time, and possibly fertility treatment, to conceive.

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Do understand that a chemical pregnancy is not your fault. In the majority of the cases, it is caused by chromosomal abnormalities and there’s little you can do to prevent them.

Even though it happens very early on in pregnancy, for some, a chemical pregnancy can be as devastating as a clinical miscarriage. Counselling can help you cope with pregnancy loss. Do talk to your partner, family or friends about how you feel.

The following are some coping strategies for a miscarriage:

• Recognise that, following a chemical pregnancy, your emotions are normal.
• Give yourself permission to mourn at your own pace.
• Recognise that everyone’s mourning process differs, and give yourself permission to grieve in your own manner.
• Be aware that not everyone will comprehend your circumstance. Because it wasn’t a “real kid,” some people might be reluctant to accept the loss or even say that it’s ridiculous to feel this way.
• Think about joining a group for support.
• Take into account consulting a therapist
• Be upfront and honest with your partner about your feelings.
• Acknowledge that dread of becoming pregnant again is common.
• It’s common for emotional recovery to lag behind physical recovery.

Discussing with your doctor about conceiving again, the treatment required and the possible risks involved can help you deal with your anxiety and prepare better for your next pregnancy. 

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Can I Get Pregnant After a Chemical Pregnancy

There is no issue with getting pregnant after a chemical pregnancy, since it happens so early on that there is little effect on a woman’s body. It is better to wait for at least one regular menstrual cycle before trying again.

Following an early pregnancy loss, many people decide to attempt another pregnancy right away. Two weeks after a chemical pregnancy, you may ovulate and become pregnant.

On the bright side, if you have had a chemical pregnancy, chances are high that your next pregnancy will be normal, since it shows that your partner’s sperm was able to fertilise your egg.

In case of multiple miscarriages, it is recommended that you consult your doctor to do tests that identify the possible causes.

Keep in mind that a chemical pregnancy does not preclude a healthy pregnancy in your body. You might be able to get the right care if you discover the causes of an early pregnancy miscarriage. This can address the root issue.

How To Prevent Chemical Pregnancy

Unfortunately, there are no known ways to prevent a chemical pregnancy. There is nothing specifically that can be done to avoid miscarriages because the majority occur as a result of chromosomal defects that arise at random.

However, one of the best ways to ensure a successful pregnancy is to keep a healthy lifestyle. Before getting pregnant, keeping an eye on your health and getting ready can assist in a successful pregnancy. The following actions will help you maintain strong pre-pregnancy health:

• Consistent exercise
• A balanced diet
• Stress reduction
• Maintainance of a healthy weight
• Consuming foods high in iron and taking folic acid each day.
• Refrain from drinking and smoking
• Managing and controlling current medical conditions (e.g., diabetes, thyroid issues, and blood diseases)

If you intend to become pregnant, start taking prenatal vitamins as soon as you learn you are. Some medical professionals advise taking prenatal vitamins just in case for anyone who might become pregnant, even unintentionally.

However, in the case of multiple miscarriages, your doctor may advise some tests to identify the possible causes.

If an early miscarriage was caused by an undiagnosed infection, taking antibiotics to clear the infection can improve your chances of conceiving and having a healthy delivery in the future.

If the miscarriage was due to problems with your uterus, you may need a surgical procedure to correct the issue and have a healthy pregnancy.

Will I Have Another Chemical Pregnancy

There is no evidence suggesting that a chemical pregnancy will affect future pregnancies, and many women who experience chemical pregnancies go on to have healthy pregnancies and deliveries.

You can still have a healthy pregnancy eventually even if you’ve had one or even several chemical pregnancies. It is up to you to decide what you want to do going forward. Spend some time processing the emotions you’re experiencing. Discuss your next steps with your partner and/or your healthcare practitioner.

Updates from Matt Doctor

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