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 50-75 percent 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.
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.
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.
So what happens is that a fertilized egg implants in the uterus, and the pregnancy hormone hCG is produced, which is high enough to be detected on a blood or urine test. 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.
Symptoms of chemical pregnancy
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
- 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
Causes of 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
- 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
Treatment of chemical pregnancy
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 the 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:
- Baby aspirin
- Surgery to fix a uterine abnormality
If you are eager to try to become pregnant again, it is recommended that you wait at least one regular menstrual cycle. Discuss with your doctor about about any risks.
How to cope with a 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.
Do understand that a chemical pregnancy is not your fault. In majority of the cases, it is causes 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 the pregnancy loss. Do talk to your partner, family or friends about how you feel.
Discussing with your doctor about conceiving again, treatment required and possible risks involved can help you deal with your anxiety and prepare better for your next pregnancy.
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.
On the brightside, 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 miscarriage, it is recommended that you consult your doctor to do tests that identify the possible causes.
Unfortunately, there are no known ways to prevent a chemical pregnancy. In case of multiple miscarriage, 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.