Chemical Pregnancy

You can’t prevent a chemical pregnancy. Most chemical pregnancies likely happen when there’s a problem in the embryo’s DNA that prevents it from developing. There’s a good chance that the next embryo and the ones that follow will develop without a problem.

What Is a Chemical Pregnancy?

Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage.

Updated on July 23, 2022

Brian Levine, MD, MS, FACOG, is board-certified in obstetrics-gynecology, as well as reproductive endocrinology and infertility (REI). He is the director and founding partner of CCRM New York and was named a rising star by Super Doctors from 2017 to 2019.

Verywell / Brianna Gilmartin

Table of Contents
Table of Contents

Part of the reason for these long wait times and short appointments is due to a nationwide shortage of physicians that is only getting worse. A report by the Association of American Medical Colleges predicts that, due to population growth and specifically growth of the elderly population, the physician shortfall in the U.S. could reach 121,300 by the year 2030.

A chemical pregnancy, also known as a biochemical pregnancy, is a very early miscarriage that occurs when an embryo stops developing before the fifth week of gestation, around the same time as an expected menstrual period. Chemical pregnancies account for between 8% and 33% of pregnancies that end in miscarriage and between 18% and 22% of in vitro fertilization (IVF) pregnancies.

It is not a false pregnancy or a false positive on a pregnancy test, but a pregnancy that occurs before the fetus can be visibly detected on an ultrasound. Chemical pregnancies are often caused by chromosomal abnormalities in the embryo.

Chemical Pregnancy Symptoms

The majority of people who have had a chemical pregnancy never actually realize they’ve conceived, since the only real symptom is a late period. A chemical pregnancy is sometimes revealed when an early pregnancy test shows a faint positive result but later returns a negative result in a week or two.

Since home pregnancy tests are now quite sensitive, many people find out that they are pregnant very early—even before their expected period. When a chemical pregnancy occurs, the cells of the fertilized egg produce enough of the pregnancy hormone hCG (human chorionic gonadotropin) to elicit a positive pregnancy test result, but then the embryo stops developing.

The loss of a chemical pregnancy will typically happen about a week after your regular period was due.

While you might expect that the menstrual bleeding would be heavier than usual with a chemical pregnancy, it is often the same as a normal period. Other signs of a chemical pregnancy may include:

• Low hCG levels on a blood test
• Mild abdominal cramping or more cramping than usual during a period
• Mild spotting about a week before a normal period is due (this is different than implantation bleeding, or spotting that occurs in early pregnancy)

Because pregnancy hormone levels are present but low in a chemical pregnancy, you wouldn’t normally experience any of the other common signs of early pregnancy, such as fatigue or nausea.

While a chemical pregnancy typically doesn’t cause any physical harm, it can cause emotional distress. Even the earliest pregnancy loss can lead to feelings of deep sadness and grief.

Chemical Pregnancy Diagnosis

In a chemical pregnancy, the gestational sac will not be large enough to be visible on an ultrasound, so the only way to confirm the pregnancy is through blood tests. (The term “chemical pregnancy” refers to the biochemical means of diagnosis.)

By contrast, a “clinical pregnancy” is one in which either a fetal heartbeat is detected or there is visual evidence on an ultrasound.

Blood pregnancy tests may not be necessary in the case of a chemical pregnancy, but if they are done, they may not be able to detect any hCG or find that levels are falling. In a clinical pregnancy, hCG would be present and rising.

• The gestational sac will not be large enough to be visible on an ultrasound.
• Blood pregnancy tests will show no pregnancy hormones or falling levels.

• A fetal heartbeat is detected and/or there is visual evidence on an ultrasound.
• Blood tests will detect pregnancy hormones, confirming pregnancy.

Chemical Pregnancy Causes

While the exact cause of a chemical pregnancy is usually never known, in many cases, they occur because the fertilized egg had some sort of chromosomal abnormality that made it nonviable from the start. Typically, in this case, the fertilized egg will stop developing soon after the egg implants. Or the egg may never implant at all.

Other causes may include:

• Abnormal hormone levels
• Implantation outside the uterus
• Infections (chlamydia or syphilis)
• Uterine abnormalities

Risk Factors

While you can’t prevent a chemical pregnancy, there are some known risk factors. Chemical pregnancies are often identified in women who are undergoing IVF.   The heightened anticipation of a pregnancy during IVF may lead some couples to test more frequently and earlier than those conceiving naturally.

Other risk factors and untreated conditions that may increase your chances of having a chemical pregnancy include:  

• A blood clotting disorder
• Diabetes
• Maternal age over 35
• Polycystic ovary syndrome (PCOS)
• Thyroid disorder

If you have had a chemical pregnancy miscarriage, the chances are high that your next pregnancy will be normal. Even if you have had more than one miscarriage, your chances of conceiving and carrying a healthy pregnancy are still very good.

Chemical Pregnancy Treatment

Chemical pregnancies happen early enough that they generally have little effect on a pregnant person’s body and do not require treatment. If one happens, there is also usually nothing barring the couple from trying again immediately.

If you’ve had more than one chemical pregnancy, however, consult with your doctor to rule out any possible underlying causes and reduce the risk of another early miscarriage.

Grief and Coping

A chemical pregnancy can lead to varying degrees of grieving and loss. Some people may feel little sadness, whereas others may be completely devastated. It is just as ​OK not to feel sad or depressed. Everyone reacts differently to a chemical pregnancy, and there is no single, right response.

As you cope with a chemical pregnancy, keep in mind the following:

• Grief can be isolating. While feelings of sadness and depression are not uncommon, people facing these emotions will often feel isolated in their grief.
• Others may not understand. People may be reluctant to acknowledge the loss and may even suggest that it is unreasonable to feel this way because it wasn’t a “real baby.”
• Your feelings are valid. Regardless of what anyone says, a miscarriage is still a miscarriage. You neither have to justify your grief nor compare it to anyone else’s loss. It is a loss from which you may need time to recover. Give yourself grace and time, and seek support. In addition to reaching out to trusted friends and loved ones, there are many pregnancy loss and support services available.

A Word From Verywell

If you are trying to conceive and are experiencing extreme anxiety (such as can happen in couples undergoing assisted reproduction), some doctors will advise against early pregnancy testing. In order to avoid unnecessary distress, it’s wise not to test presumptively or in anticipation of a possible pregnancy, but rather wait until your period is actually late.

It is important to remember that miscarriage from a chemical pregnancy is unavoidable. You can neither stop it nor intervene to prevent it—and it’s no one’s fault.

Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Lee HM, Lee HJ, Yang KM, Cha SH, Ahn HK, Kim YJ. Etiological evaluation of repeated biochemical pregnancy in infertile couples who have undergone fertilization. Obstet Gynecol Sci. 2017;60(6):565-570. doi:10.5468/ogs.2017.60.6.565
2. Annan JJ, Gudi A, Bhide P, Shah A, Homburg R. Biochemical pregnancy during assisted conception: A little bit pregnant. J Clin Med Res. 2013;5(4):269-74. doi:10.4021/jocmr1008w
3. Prager S, Micks E, Dalten V. Pregnancy loss (miscarriage): Risk factors, etiology, clinical manifestations, and diagnostic evaluation.

Additional Reading

• Doubilet P, Benson C, Bourne T, et al. Diagnostic criteria for nonviable pregnancy early in the first trimester. N Engl J Med. 2013;369:1443-51. doi:10.1056/NEJMra1302417
• Larsen C, Christiansen O, Kolte A, et al. New insights into mechanisms behind miscarriage. BMC. 2013;11:154. doi:10.1186/1741-7015-11-154

By Krissi Danielsson
Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage.

Chemical Pregnancy

A chemical pregnancy is a pregnancy loss that happens before the fifth week. Testing positive on a pregnancy test only to get a negative result a few weeks later can signal a chemical pregnancy. Most people who experience them go on to have healthy pregnancies.

Overview

How chemical pregnancies happen.

What is a chemical pregnancy?

A chemical pregnancy is a very early miscarriage that happens within the first five weeks of pregnancy. An embryo forms and may even embed in your uterus lining (implantation), but then it stops developing. Chemical pregnancies occur so early that many people who miscarry don’t realize it.

Sometimes, the loss from a chemical pregnancy feels devastating, especially if you’ve been trying hard to have a baby. Having one chemical pregnancy doesn’t mean you can’t carry a baby to term, though. Many people who’ve experienced early miscarriages go on to have successful pregnancies.

What is the difference between a chemical pregnancy and a clinical pregnancy?

Calling a pregnancy “chemical” can sound cold and removed. But the name isn’t about the experience of pregnancy. Instead, chemical pregnancies get their name from the chemicals in your body, or hormones, that produce a positive result on a pregnancy test. Within the first five weeks, the embryo will produce human chorionic gonadotrophic (hCG) hormone. Your hCG hormone levels provide the only real clue that you’re pregnant at this point because it’s too early to see signs of your developing fetus on an ultrasound. Once the embryo stops developing, your hCG levels fall.

With a clinical pregnancy, your hCG levels rise. Your healthcare provider will be able to see signs of your fetus on an ultrasound and hear a heartbeat by weeks six or seven.

Is a chemical pregnancy a real pregnancy?

A chemical pregnancy ends early because an embryo stops growing. It’s different from a clinical pregnancy, where there’s evidence of a fetus. But that doesn’t mean a chemical pregnancy isn’t real. Sometimes, learning that you’re pregnant is what makes the experience feel real. Sometimes, though, it’s hearing a heartbeat. How real the experience seems depends on each person. Each experience is valid.

Is a chemical pregnancy bad?

There’s no right way to respond to a chemical pregnancy. Learning that you’re no longer pregnant might be a relief if you hadn’t planned on becoming pregnant. Experiencing a chemical pregnancy can be heartbreaking if you’ve been trying to have a baby, without success. But just because your pregnancy ended early doesn’t mean you can’t become pregnant again. It also doesn’t mean your next pregnancy won’t end with a new baby.

Who do chemical pregnancies affect?

Anyone who can become pregnant can experience a chemical pregnancy. You may be more likely to notice a chemical pregnancy if you’re trying to conceive through in vitro fertilization (IVF), since these pregnancies are monitored so closely. IVF alone isn’t a risk factor for chemical pregnancy, though.

Your odds of experiencing an early miscarriage increase if:

• You’re 35 or older.
• You have an atypically shaped uterus.
• Your hormone levels are too high or too low.
• You have a sexually transmitted infection (STI).
• You have thyroid disorders, diabetes or polycystic ovarian syndrome (PCOS).

Talk about potential risk factors with your healthcare provider. Together, you can come up with a care plan to address any underlying issues that may be negatively impacting your fertility.

How common are chemical pregnancies?

They’re very common. About a quarter of all pregnancies end before the first 20 weeks. And about 80% of those miscarriages happen early. It can be hard to know just how common chemical pregnancies are, though. Many people likely miscarry early without ever receiving a diagnosis.

Symptoms and Causes

What are the signs and symptoms of a chemical pregnancy?

It can be helpful to know the common signs of a chemical pregnancy.

• Your period comes about a week later than usual.
• You have a positive pregnancy test, but then you get your period.
• You have a positive pregnancy test and then a negative pregnancy test a few weeks later.
• Your period is heavier than usual, and you’ve got more intense menstrual cramps.
• You have a positive pregnancy test, but you don’t notice the usual signs of early pregnancy.

It’s not possible to know whether you’ve had a chemical pregnancy without taking a pregnancy test (using a urine or blood test).

What does chemical pregnancy bleeding look like?

The bleeding from a chemical pregnancy may look and feel differently for different people. Your period may feel normal, or you may notice that it’s heavier than usual and causing you to cramp more. Sometimes, the bleeding begins as spotting and then gets really heavy, with blood clots.

What causes a chemical pregnancy?

With a chemical pregnancy, the embryo produces hCG, a hormone that it needs to grow. It’s also the hormone that pregnancy tests check for to see if you’re pregnant. If an embryo stops developing, it no longer produces hCG.

No one knows exactly why an embryo stops developing during a chemical pregnancy. Likely, the embryo stops developing because of a problem in its genetic makeup, or DNA. Sometimes, an embryo doesn’t take hold, or implant, in the uterus lining the way it needs to in order to grow. As a result, your hCG levels drop, and pregnancy tests come back negative.

Diagnosis and Tests

How is a chemical pregnancy diagnosed?

Your healthcare provider will check your medical history to see when you had your last period. A pregnancy test will let your healthcare provider know whether you’ve had a chemical pregnancy.

Management and Treatment

How are chemical pregnancies treated?

There isn’t a treatment for chemical pregnancies. But many people who have one pregnancy end early go on to have healthy pregnancies in the future. If you have recurring chemical pregnancies, your doctor may refer you to a fertility specialist.

Knowing that your chances are good for a successful pregnancy in the future doesn’t mean that you don’t need help processing your pregnancy coming to an end. Everyone experiences pregnancy loss differently. You may feel relieved if you weren’t ready for the pregnancy. You may feel disappointed that you got to experience the joy of learning you were pregnant only to have that feeling taken away a short while after. You may not feel any particular way at all, and that’s OK.

If you need to process your loss or if you need to speak to someone who can guide you when it comes to next steps, though, reach out to your healthcare provider or a counselor. They can connect you with the resources you need to put your self care first.

Care at Cleveland Clinic

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Prevention

How can I prevent a chemical pregnancy?

You can’t prevent a chemical pregnancy. Most chemical pregnancies likely happen when there’s a problem in the embryo’s DNA that prevents it from developing. There’s a good chance that the next embryo and the ones that follow will develop without a problem.

Outlook / Prognosis

What can I expect if I have a chemical pregnancy?

Having one chemical pregnancy or even multiple chemical pregnancies doesn’t mean you can’t have a healthy pregnancy someday. What you decide to do moving forward depends on you. Take the time to process whatever emotions you’re feeling. Speak with your partner and/or healthcare provider about what you need to happen next.

When do you ovulate after a chemical pregnancy?

Many people choose to try for another pregnancy immediately after an early pregnancy loss. You can ovulate two weeks after a chemical pregnancy and potentially get pregnant.

Living With

What questions should I ask my healthcare provider after a chemical pregnancy?

Reach out to your healthcare provider if you need help processing your pregnancy loss or if you’d like advice about improving your pregnancy chances in the future. Questions you could ask include:

• When should I see a fertility specialist?
• How long should I wait before trying to become pregnant again?
• What changes can I make to improve my chances of having a healthy pregnancy?
• Are there any tests you recommend to see if there’s an underlying issue that affected my pregnancy?

A note from Cleveland Clinic

Pregnancies often end within the first few weeks. There’s no way to prevent a chemical pregnancy from happening, and there’s no way to treat one that has happened. Keep in mind, though, successful pregnancies often follow chemical pregnancies. Regardless of how you feel about your pregnancy loss, take the time you need to process or plan your next steps. Speak with a counselor if you need help dealing with your grief or disappointment. And speak with your healthcare provider about any fertility concerns you may have as you plan your next steps. Reach out to your support network, too. But ultimately, you’re the best judge of what you need and what comes next.