A chemical pregnancy is a very early miscarriage – usually occurring around the 5th week of pregnancy (so, for some of us, before we even miss a period). It happens when a sperm fertilises your egg but, later on, the egg fails to survive.

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It is called a chemical pregnancy (or biochemical pregnancy) to distinguish it from a clinical pregnancy – which is the term given to a pregnancy that is confirmed by ultrasound. "With a chemical pregnancy," says expert NHS GP Dr Philippa Kaye, "it is only the positive pregnancy test that shows that you are pregnant. The embryo would be lost before it could be seen on an ultrasound scan."

But, says Dr Philippa, the term chemical pregnancy can feel cruel and insensitive – as if it wasn't 'real' somehow. "However early your pregnancy loss," she says, "I know it can be still be extremely difficult to cope with."

What are the signs of a chemical pregnancy?

At first, the symptoms are the same as for any pregnancy: you may not feel any different at all or you may experience signs that are very similar to how you feel just before a period, such as tender breasts and mood swings.

If you take an 'early' pregnancy test (that's designed for testing before a missed period), you're likely to get a positive result.

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Then, somewhere in the couple of weeks or so after your period would have been due, you will experience:

  • a bleed that resembles a period
  • cramping or light spotting before the bleed

"It feels the same as your normal period," says Dr Philippa, "or even a little bit heavier."

This is how it was to Amy in our MadeForMums Community. "Last week I had a positive with an early pregnancy test," she says. "My period was due on the Thursday and it didn't arrive. I took another test and it was a definite positive. Then on Friday morning my period arrived but was majorly, majorly heavy. I had severe cramping too."

But of course if you haven't done an early pregnancy test, like Amy did, you may never know you've had an early miscarriage. You could assume any bleeding is your usual period.

How do I know if it’s a chemical pregnancy or something else like implantation bleeding?

Generally, the difference is all about timing and heaviness of the bleeding.

Implantation bleeding (or spotting) is the early bleeding that can occur when your fertilised egg embeds into the uterus lining. "This usually happens around week 3 of your cycle, a week or so before you expect your period," says Dr Philippa.

"Usually this is extremely light spotting, or light pinkish discharge and is short-lived. Many women do not have implantation bleeding."

By contrast, a chemical pregnancy bleed occurs at a later point in your cycle, around or after the time you would expect your next period to occur. And it is heavier than implantation bleeding: it will look like your normal period.

If you can unsure about the cause of your bleeding in early pregnancy, though, do contact a health professional.

Why do you get a positive pregnancy test with a chemical pregnancy?

This happens because, even with a chemical pregnancy, the hormone hCG (human chorionic gonadotrophin) is present – and it's hCG that a pregnancy test is designed to detect.

Your levels of hCG will drop gradually after the bleeding starts, and any further pregnancy tests will be negative.

Do I need to see a doctor after a chemical pregnancy?

This is your choice.

"If you are well and the bleeding has stopped you don't have to see your GP," says Dr Philippa.

"However, you may wish to contact them to inform them that you have had an early miscarriage, so that it can be recorded in your medical notes. It can be important to do this, as, if you get pregnant in the future and have bleeding again, you may be offered progesterone treatment if the pregnancy can be seen on ultrasound scan."

Under changes soon to be implemented from the government's recent Women’s Health Strategy, it should also possible to obtain a pregnancy loss certificate.

How soon after a chemical pregnancy can I get pregnant again?

"There is no medical reason to wait for any length of time after a chemical pregnancy," says Dr Philippa. "If you and your partner want to, you could try to conceive again straightaway.

"Some people will want to do this, while others will prefer to take some time and use contraception in the meantime. There is no medical right or wrong in this situation – only what is right for you."

Your fertility is not affected by a chemical pregnancy. "You may ovulate as normal (approximately 14 days before the next expected period) or may find that your next cycle is slightly longer than previously," say Dr Philippa. "Consider the 1st day of bleeding as the 1st day of your cycle. "

It may, of course, take you a while to get pregnant again but it's not unknown for things to move pretty fast – as Demi in our MadeForMums Community. found out. "I’ve just got a positive on my ovulation predictor kit only 15 days after a chemical pregnancy," she says. " I was convinced it would take my body months to get back to normal."

What causes a chemical pregnancy?

It's thought there are a number of things that could cause chemical pregnancy, including:

  • chromosomal abnormalities
  • the egg implanting outside the uterus
  • clotting problems
  • issues with hormone levels
  • a uterus lining which is too thin

If you’ve had a chemical pregnancy, what can you do to try and ensure a successful pregnancy next time?

"The majority of chemical pregnancies are caused by problems with the genetic make-up of the embryo itself and so cannot be prevented," says Dr Philippa.

"However, stopping smoking, giving up alcohol and any recreational drugs, eating healthily and being at a healthy weight may help with some causes – and certainly will help your own health."

Is a chemical pregnancy common?

Yes, but it is difficult to know how common, as many occur before you find out you are pregnant. You'd only know if you did an early test (before your period comes).

"And having one chemical pregnancy doesn’t necessarily mean you’re likely to have another," says Dr Philippa.

Does IVF raise your chance of having a chemical pregnancy?

No, there’s no scientific evidence that women who conceive via IVF have an increased chance of miscarriage, so long as they are using fresh embryos.

"Miscarriage rates are slightly higher in patients using frozen embryos," says Dr Philippa, who also points out that if you're having IVF, you may well do a pregnancy test at the first possible opportunity and so are more likely to pick up a chemical pregnancy.

Older mothers, who more commonly use IVF, are more susceptible to early miscarriage. "Age affects the quality of the eggs produced,"says Dr Philippa. "Older women are therefore more likely to have a chemical pregnancy or very early miscarriage."

Is it normal to grieve after a chemical pregnancy?

Yes! Lots of women find a chemical pregnancy a worrying, confusing experience, and feel a level of grief afterwards.

"For many, this represents the loss of a baby, however early in pregnancy," says Ruth Bender-Atik, National Director of the Miscarriage Association.

"Many, but not all, will have a real sense of loss and grief, perhaps for months or even longer. Some will just feel sad and/or disappointed and then move on."

So should I avoid taking an early pregnancy test next time?

This can be a tricky decision, especially as some pregnancy tests can now be used as early as 4 days before your period.

Waiting to test until after your period is due can be hard, especially if you are super-keen to find out. However, waiting to test until you have missed a period can mean that, if you're pregnant, your hCG levels will be higher and you are more likely to get an accurate result. Again, there's no right or wrong here; just what works for you.

Pic: Getty

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Authors

Helen Brown
Helen BrownHead of Content Delivery

Helen is author of the classic advice book Parenting for Dummies and a mum of 3. Before joining MadeForMums, she was Head of Community at Mumsnet and also the Consumer Editor of Mother & Baby.

Dr Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice.

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