Have you been both tracking with ovulation tests and targeting your sexual activity to peak fertility days? Have you also had a cycle that was longer than usual with heavier and more days of menstruation?
If you have answered yes to both questions, you may have experienced a chemical pregnancy.
What is a chemical pregnancy?
A chemical pregnancy, or early pregnancy loss, happens to 30% of pregnancies following assisted reproduction and to 20-25% of spontaneously conceived pregnancies.
This term can be defined as a miscarriage that occurs between 6 days of gestation and 5 weeks of pregnancy. It is considered a miscarriage because it ends before it is even assessed by an ultrasound or a baby’s heartbeat. In other words, the gestational sac was not formed yet. It is also called hormonal pregnancy by medical doctors. The pregnancy did not continue because something was not quite optimal in the lining of the uterus after implantation had occurred.
Chemical Pregnancy Symptoms
A Chemical pregnancy could go unnoticed and ignored. We recommend that you take a pregnancy test on the first or second day of your missed period. If hCG drops and bleeding occurs in one to two weeks, a miscarriage has occurred.
Charting menstrual cycles, particularly with a fertility app that tests for hormones like LH, can help women detect a chemical pregnancy. A woman who charts her fertility biomarkers and tracks ovulation can count the number of days after the most probable day of ovulation. If more than 19-20 days have passed since she identified her LH peak, then she could be pregnant if she timed intercourse on her most fertile days (2 days before ovulation day, 1 day before ovulation and ovulation day).
A home pregnancy test or an hCG-quantitative test will assess the early pregnancy state. Women should continue to monitor their hCG levels until they are scheduled for hCG blood testing in a laboratory and have their first transvaginal ultrasound around weeks 7-8. The ultrasound will assess the viability of the embryo.
Why should you track a chemical pregnancy?
A chemical pregnancy can be normal, even unnoticed. However, it’s important to take note when it is recurrent: two or more miscarriages within 12 months while trying to conceive, or two or more miscarriages in 6 months with well-timed intercourse during the fertile window while tracking cervical mucus and using ovulation tests.
It is important to address the potential problem behind them. One cause could be not enough progesterone produced by the corpus luteum from the ovary after ovulation. The most common causes are genetic abnormalities which occur more frequently as women age.
A woman with recurrent miscarriages due to low progesterone should be a candidate for progesterone supplementation during early pregnancy under medical supervision. These women need close monitoring with laboratory and transvaginal ultrasound to continue the pregnancy. A fertility consultant could help you to address the causes and refer you to medical management for treatment.
References
- Gimovsky AC, Pham A, Moreno SC, Nicholas S, Roman A, Weiner S. Genetic abnormalities seen on CVS in early pregnancy failure. Journal of Maternal-Fetal and Neonatal Medicine. 2020;33(13):2142-7.
- Okeke Ogwulu CB, Goranitis I, Devall AJ, Cheed V, Gallos ID, Middleton LJ, et al. The cost-effectiveness of progesterone in preventing miscarriages in women with early pregnancy bleeding: an economic evaluation based on the PRISM trial. BJOG: An International Journal of Obstetrics and Gynaecology. 2020;127(6):757-67.
- Han S. The chemical Pregnancy: technology, Mothering, and the making of a Reproductive experience. Journal of Motherhood Initiative for research and Community Involvement. 2014;5(2):41-53.
- Detti L, Francillon L, Christiansen ME, Peregrin-Alvarez I, Goeske PJ, Bursac Z, et al. Early pregnancy ultrasound measurements and prediction of first trimester pregnancy loss: A logistic model. Scientific Reports. 2020;10(1).
