Chemical Pregnancy and Very Early Miscarriage

Chemical Pregnancies and False Positives - The Difference

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A chemical pregnancy is like a cruel joke. You take an early pregnancy test around the time your period is due and it shows a faint positive. Naturally, you get excited and start spreading the joyful news that you're expecting. Then, a few days later you get your period and the doctor says, "It was just a chemical pregnancy."

Meanwhile, you're left confused and possibly devastated. The term chemical pregnancy sounds like a false positive pregnancy test as if you were not really pregnant at all.

But the truth is that a chemical pregnancy was indeed a conception and is actually a very early miscarriage; the pregnancy just ended before there was any other evidence of the pregnancy except biochemical changes (ie., increases in hcg levels).

What Chemical Pregnancy Means

Usually, the term "chemical pregnancy" refers only to an early pregnancy loss and not the early stages of a viable pregnancy. In a chemical pregnancy, the hCG levels never rise very high and the woman usually begins to have bleeding less than a week after having a positive pregnancy test. Doctors believe that chemical pregnancies never fully implant properly and they suspect that most involve chromosomal abnormalities.

When the pregnancy develops to the point that ultrasound could confirm the existing pregnancy, the term becomes clinical pregnancy. Thus, a chemical pregnancy would be a miscarriage before the fifth week of gestation -- or within about week after your missed menstrual period.

Symptoms of Chemical Pregnancy

The primary symptom of chemical pregnancy would be if you begin to have vaginal bleeding shortly after having a positive pregnancy test. Blood tests reveal low hCG levels that are decreasing rather than increasing.

Causes

Doctors believe that chemical pregnancies happen for the same reasons as most other miscarriages –- probably because of chromosomal abnormalities in the developing baby.

It is hard to know what causes these early miscarriages, however, because it is nearly impossible to retrieve any samples for chromosomal testing.

Frequency

No one really knows how common chemical pregnancies are, but some researchers have theorized that as many as 70 percent of conceptions end in miscarriage. Women who are not actively trying to conceive and not closely watching their menstrual cycles may have chemical pregnancies and never know it; in other cases, chemical pregnancy could be a reason (but not the only possible reason) why a menstrual period arrives a few days late.

Physical Recovery

Chemical pregnancies happen early enough that they have little effect on women’s bodies, and in many cases, they can be mistaken for a normal period that is a few days late (or even on time). One 2007 study found that the bleeding after a chemical pregnancy is sometimes even lighter than a woman’s usual menstrual period. The bleeding from a chemical pregnancy might be accompanied by more cramps than usual also, but recovery should be fairly swift.

Trying Again

With a very early miscarriage, many doctors will say that it’s OK to go ahead and try again right away. Other doctors recommend waiting to try to get pregnant again as a standard answer after all miscarriages, no matter how early. Talk to your doctor about what is right for your specific situation.

Grieving a Chemical Pregnancy

In many cases, chemical pregnancy might put you in a weird situation from a grieving perspective. Some women don’t feel very sad over chemical pregnancies, whereas others are completely devastated emotionally. People in your life might not recognize the validity of your loss, insisting that you are wrong to grieve because it happened too early for you to get attached to the pregnancy or that “it wasn’t a real baby.”

Regardless of what anyone says, a miscarriage is a miscarriage. You do not have to justify your grief or compare it to anyone else’s grief for it to be valid. A chemical pregnancy was still a pregnancy, and for many women, it’s still a loss of a baby and grief that will always they will carry for their entire lives.

It’s also OK to not be too sad about a very early miscarriage and to decide you just want to try again. Everyone reacts differently to the situation, and there is no single, right emotional response to chemical pregnancy.

If you do tend to grieve chemical pregnancies deeply, and you are actively trying to conceive, think about perhaps waiting to test each cycle until your period is actually late. This way, you do not necessarily have to know about very early miscarriages. Many doctors recommend against early pregnancy testing for this reason.

Sources:

Promislow, J.H.E., D.D. Baird, A.J. Wilcox, and C.R. Weinberg, "Bleeding following pregnancy loss before 6 weeks' gestation." Human Reproduction 2007. Accessed 23 Jan 2008.

Wilcox, A.J., C.R. Weinberg, J.F. O'Connor, D.D. Baird, J.P. Schlatterer, R.E. Canfield, E.G. Armstrong, and B.C. Nisula, "Incidence of early loss of pregnancy." New England Journal of Medicine 1988. Accessed 23 Jan 2008.

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