Written by Jenny Wordsworth. Reviewed by Dr. Katherine Joseph

These are all extremely common questions, and you’re not alone if you’re wondering what a chemical pregnancy loss, or early miscarriage, is and what it means for you. There might be feelings you’re unsure about and perhaps you hadn’t shared your news with others, so many can feel alone with the loss and unsure of the next steps. Physically you might also want to know when you can safely start trying again, and what are the chances of this happening again? 

First let’s clarify a few important terms: A miscarriage is the loss of a pregnancy during the first 23 weeks. If the loss is suffered before the 12th week it is known as an ‘early miscarriage’. A ‘late miscarriage’ is when a pregnancy is lost after 12 weeks but before 24 weeks, and a loss after 24 weeks is a stillbirth. 

What is a ‘Chemical Pregnancy’?

You’ll sometimes see an early miscarriage referred to as a chemical pregnancy. We don’t love the term ‘chemical pregnancy’ and it can be upsetting for some. It has a clinical feel to it that almost sounds like it barely happened. Let’s be clear, there was an embryo, and it did exist. 

The term ‘chemical pregnancy’ is thought to have arisen from the fact that a pregnancy at this early stage can only be detected by the hormone hCG in your blood or urine. The embryo would still be too small to be viewed on ultrasound. This early stage of pregnancy would not be visible on an ultrasound scan.

If you have a positive pregnancy test result but later find out before the 5th week that you are not pregnant, then you have likely experienced what some people would refer to as a chemical pregnancy. However, it is still an early miscarriage.

Why did this happen?

An estimated 75% of pregnancies are chemical pregnancies and Doctors think these kinds of miscarriages mostly happen because of chromosomal problems with the developing embryo. Think of chromosomes as blocks of DNA which, if they function correctly, form the how-to guide for the embryo to continue developing as it should. Errors in the formation or separation of chromosomes can often prevent the embryo from developing and lead to miscarriage. The embryo might also not have implanted in the uterus lining in the way it needed to in order to keep developing. There are many causes for these early miscarriages. Doctors believe that the most common issue is a chromosomal abnormality. This means an error in the blocks of DNA (e.g. missing or having too many of a particular chromosome). Some of these errors are incompatible with life and a miscarriage results.

They are common and do not usually indicate there is a wider fertility concern at hand. Most who experience them go on to have healthy pregnancies. 

I think I’ve suffered a chemical pregnancy loss. Now what?

No matter when you miscarry during a pregnancy, it can be a painful and horrid experience. Or maybe you’re feeling ok, concerned but ok? There’s no right or wrong here. Whilst there might not be immediate or obvious support available through your GP, help is available. Reach out to Tommy’s - you can talk to a midwife for free, Monday-Friday, 9am-5pm. You can call them on 0800 0147 800 or email midwife@tommys.org. This service is invaluable and we really recommend it. 

Given many do not find out they are pregnant until after 5 weeks, a chemical pregnancy or early miscarriage may actually be mistaken for a late or normal period. If you have a positive pregnancy test result then the bleed as a result of the loss could be like a normal period. 

Questions for your GP

In the U.K, a referral to a recurrent miscarriage clinic will only be offered by your GP under current NICE guidelines if you have suffered from 3 or more confirmed miscarriages. This is currently the case under normal NHS funded practice, however some will refer after 2.

If you had an at-home positive pregnancy test and subsequently find that you are no longer pregnant, this is an early miscarriage and you should let your GP know so it is noted as a confirmed miscarriage. After a first loss, we also suggest asking your GP the following questions:

• If you are having any symptoms of a potential underlying medical condition (e.g. tiredness with vitamin D deficiency or weight gain and constipation with an underactive thyroid), are there any blood tests they would recommend? Many medical conditions can affect fertility and it is worth investigating these early.
• When is it safe for me to start trying to conceive again?
• Are there lifestyle factors I should take into account whilst ttc?
• At what point would you refer me to see a fertility specialist, or recurrent miscarriage clinic? 

If your GP is unable to help, then the only other option would be to have some private tests carried out and we’d also suggest contacting Tommy’s to ask for their advice on your personal circumstances.

Chemical Pregnancy and the Early Detection Pregnancy Test

As pregnancy tests become more sensitive and many women are choosing to test as early as possible, chemical pregnancies or early miscarriages that previously could have gone unnoticed are now confirmed with an early positive test result. Is this the double-edged sword of pregnancy tests? Would you rather test early and then find out you’ve suffered a loss that you otherwise would not have known about? We stress the importance of campaigns such as the #waittowee, you can read more about that on the wait to wee page . We also believe that with knowledge comes power and being aware of any chemical pregnancies that might have occurred, whilst painful and emotionally draining, can also be useful in terms of any future care that might be needed. 

The Takeaways

• A miscarriage is the loss of a pregnancy during the first 23 weeks. An early miscarriage is the loss of pregnancy during the first 12 weeks. 
• Early miscarriages are common (not necessarily an indicator of infertility) and mostly happen because of chromosomal problems with the developing embryo.
• You can reach out to Tommy’s or other support resources if you think you have suffered from an early miscarriage.
• In the U.K, a referral to a recurrent miscarriage clinic will only be offered by your GP under current guidelines if you have suffered from 3 or more confirmed miscarriages.
• It can be tempting to test as early as possible, this has its advantages and disadvantages.