What is a chemical pregnancy?

A chemical pregnancy is a very early pregnancy loss. It usually happens by around 5 weeks of pregnancy, soon after the fertilised egg implants and before a pregnancy can be seen on a scan.

Why is it called “chemical”?

Because the pregnancy is only picked up through the pregnancy hormone hCG, in a pee or blood test, rather than seen on an ultrasound scan. You may also hear it called a biochemical pregnancy.

Is it a miscarriage?

Yes. It’s a very early miscarriage, and you were pregnant. Miscarriage UK says a chemical pregnancy should count as a miscarriage if you’re ever assessed for recurrent pregnancy loss.

How common is it?

Early pregnancy loss is common. Many very early losses happen without anyone knowing, because a period comes at around the usual time. More people now find out they’ve had one because pregnancy tests have become more sensitive and people test earlier.

What are the signs?

a positive pregnancy test, sometimes with a faint line, then a negative test soon after
bleeding like a period after a positive test, around when your period was due or a little later
spotting about a week before your period
mild cramping

The bleeding is usually similar to a normal period, though for some people it feels heavier or more painful. Some people have no signs at all.

If you’ve had a positive test and you’re bleeding

If you’ve had a positive test and then start bleeding, contact your maternity unit, an early pregnancy unit or NHS 111 so you can be checked, even if you think it’s a chemical pregnancy. Nobody can tell the cause of bleeding at home. Bleeding after a positive test can have several causes, including an ectopic pregnancy or bleeding in a pregnancy that’s carrying on. If it isn’t clear what’s happening, you may be offered 2 blood tests about 48 hours apart to see what your hCG is doing.

Why does it happen?

Most very early losses happen because of a problem with the pregnancy’s chromosomes. This happens by chance and means the embryo can’t develop. Sometimes the lining of the womb may not be ready at the right time. It’s very unlikely to have been caused by anything you did.

Do I need treatment?

Once it’s clear you’ve had a chemical pregnancy, you don’t usually need any treatment. Your body passes the pregnancy like a period. If you weren’t seen by an early pregnancy unit, you might like to ask your GP to note it on your record, so it’s counted if you ever need tests in future.

hCG takes a little while to fall. If your tests are still positive about 3 weeks later, contact your GP or early pregnancy unit.

Can I try again?

Doctors usually suggest waiting until after your next period, as it makes a new pregnancy easier to date, but you can try straight away if you want to. Tommy’s says a chemical pregnancy can be a reason to be hopeful about a successful pregnancy another time, as it shows you can conceive.

If it happens more than once

Most early losses are a one-off. The NHS says to talk to your GP if you’ve had 3 or more miscarriages, and Miscarriage UK says chemical pregnancies should be counted. You’ll usually be referred for tests to look for a cause that can be treated.

Local policies vary on counting chemical pregnancies. In Scotland, you should be offered some blood tests after 2 miscarriages. Elsewhere in the UK, some hospitals will investigate after 2, so it’s worth asking your GP.

After fertility treatment

A chemical pregnancy during fertility treatment can feel very upsetting, after so much waiting. Your clinic can talk you through what happened. The NHS says fertility clinics should offer you the chance to talk to a counsellor before, during and after treatment. Some clinics charge for this, so ask yours.

How you might feel

Even the earliest loss can be very distressing, and there’s no right or wrong way to feel. You might grieve, or feel relief, confusion, or a bit of everything. Partners can be affected too. Some people don’t feel they’re allowed to be sad about a very early loss, but you are.

Support is there if you need it:

Miscarriage UK (formerly the Miscarriage Association): helpline 0303 003 6464, 9am to 8pm on Monday, Wednesday and Friday, and 9am to 4pm on Tuesday and Thursday. It also has live chat.
Tommy’s midwives: free helpline 0800 0147 800, Monday to Friday, 9am to 5pm. Tommy’s also has a free online Wellbeing after Miscarriage programme for losses before 24 weeks.

Questions people ask

Is a chemical pregnancy a real pregnancy?

Yes. You were pregnant. However early it happened, it’s OK to feel it as a loss, and it’s OK if you don’t.

How long does the bleeding last?

It’s usually similar to a period. If the bleeding is heavy, soaking a pad soon after putting it on, call 999.

Will it happen again?

Most miscarriages are a one-off, and there’s a good chance of a successful pregnancy in future. If you’ve had more than one, talk to your GP.

When will a pregnancy test go back to negative?

It can take a little while for hCG to clear. If tests are still positive about 3 weeks later, contact your GP or early pregnancy unit.

When to get help

Mild cramps that ease with rest are usually nothing to worry about. But if you’re pregnant, or think you could be, get urgent advice from your maternity unit, an early pregnancy unit or NHS 111 if you have:

any bleeding or spotting, even if it’s light
tummy pain that’s severe, on one side, or hasn’t eased after resting for 30 to 60 minutes
pain in the tip of your shoulder

Call 999 if you have bleeding along with severe tummy pain, pain in your shoulder, or feeling sick, faint or dizzy, or if the bleeding is heavy (soaking a pad soon after putting it on). Also call 999 if you have sudden, sharp and intense tummy pain and you feel very dizzy or faint, feel sick or look very pale. These can be signs of an ectopic pregnancy or a miscarriage that need treating straight away.