Posted on January 20th, 2020by Dr. Matthew A. Lederman

What Does it Mean to Have a Chemical Pregnancy?

Miscarriage, also known as spontaneous abortion and pregnancy loss, is more common than most realize, and can occur in 25% of pregnancies. The majority of miscarriages occur at less than 10 weeks gestation and result from chromosomal abnormalities in the embryo. A chemical pregnancy, also known as a biochemical pregnancy, is a type of miscarriage which is believed to account for 50% to 75% of all miscarriages, and occurs when a pregnancy is lost shortly after implantation, resulting in bleeding about a week or so after a period was due.

When an embryo implants in the uterus, it begins to produce the pregnancy hormone hCG, which can be detected by a blood or urine pregnancy test. However, early in the pregnancy, when hCG levels are low, an ultrasound cannot detect a pregnancy sac. As a result, a chemical pregnancy occurs before an ultrasound exam can detect a pregnancy sac in the uterus. Since a chemical pregnancy occurs early on, women may have no pregnancy symptoms other than having a positive home pregnancy test and many women may not realize they are pregnant if they did not take a pregnancy test. Symptoms of a chemical pregnancy can vary, including no symptoms at all, a positive home pregnancy test that quickly became negative, spotting or vaginal bleeding, menstrual-like cramping, or having low levels of serum hCG from a blood pregnancy test. Bleeding shortly after a positive pregnancy test does not necessarily mean a chemical pregnancy is occurring as bleeding can also be due to normal implantation of the embryo in the uterus, which can occur in a normally developing pregnancy.

A chemical pregnancy generally does not require medical treatment, as the pregnancy recedes on its own. Women may experience vaginal bleeding with small clots and the hCG levels fall to zero. Following a chemical pregnancy, women do not need to delay trying to conceive again and can often start right away.

Although chemical pregnancies are common, multiple chemical pregnancies or recurrent pregnancy loss (RPL) may warrant a consultation with your OB/GYN or fertility specialist for further evaluation and possible treatment. No apparent causative factor is identified in 50-75% of cases with RPL. Once again, the majority of miscarriages are sporadic, resulting from chromosomal abnormalities in the embryo, and are influenced tremendously by maternal age. In women over the age of 35, the incidence of miscarriage increases as a result of the associated increased risk of a chromosomally abnormal pregnancy.

The grief and anxiety associated even with just a single pregnancy loss can be devastating to couples, who often bottle up these emotions as they may feel uncomfortable discussing it with friends and family. At RMA of New York, we offer a comprehensive team approach to care for patients, recognizing the associated emotional and psychological needs. In addition to receiving care from our reproductive endocrinologists and genetics counselor, many of our patients also benefit from speaking with our licensed psychologist or social worker. With the right support, the majority of patients who suffer from chemical pregnancies will ultimately go on to have healthy pregnancies and deliveries

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