Chemical pregnancy: very early pregnancy loss explained

Miscarriage UK describes a chemical pregnancy as a very early loss, usually just after the embryo implants. Tommy's explains that a pregnancy test detects an increase in the pregnancy hormone, but the embryo is lost before it can be seen on an ultrasound scan, which separates it from a clinical pregnancy, one that has been seen on a scan. It can still be hard to cope with, and Tommy's says there are no right or wrong feelings.

Some people never know. Miscarriage UK says you may not realise you have had one if you did not test or did not miss a period, but because tests are now much more sensitive, hormones can be detected up to 5 days before a period is due, so more very early losses are being noticed than in the past.

Symptoms vary, and Miscarriage UK says some people have none. The two charities list similar features, summarised below. Tommy's adds that if you are having fertility treatment and your hormone levels are monitored, you may see them rise and then fall again.

• A positive pregnancy test, possibly with a faint line, that turns negative soon after.

• Mild spotting about a week before your period is due.

• Very mild abdominal cramping.

• A bleed like a period even after testing positive. Miscarriage UK says it may feel heavier or more painful than normal and you may pass small clots.

• Low pregnancy hormone (hCG) levels if a blood test is taken.

Both charities say it is thought to happen for similar reasons to many other miscarriages. Tommy's says most early pregnancy losses are due to genetic problems that stop the embryo developing. Miscarriage UK says these are usually random, one-off problems, and that the lining of the womb may not have developed as needed at the right time. Tommy's says if the lining has not developed correctly, an embryo cannot embed properly.

The RCOG, writing about early miscarriage generally, says that in most cases no reason can be given and that the most common cause is thought to be a chromosome problem. It adds that there is no evidence that stress causes miscarriage. None of these sources links it to anything the person did.

Both charities say you do not need treatment for a chemical pregnancy. The bleeding is probably similar to a normal period, though Miscarriage UK says it may feel heavier or more painful and include small clots. If bleeding is very heavy, if you are in severe pain, or if you feel faint or dizzy, the NHS and RCOG say you should seek urgent help, because bleeding and pain in early pregnancy can also come from other conditions such as ectopic pregnancy.

If you had a positive test and have pain on one side, shoulder-tip pain, or are unsure, contact your GP, an early pregnancy unit or NHS 111. The RCOG says you may be offered tests including blood tests for pregnancy hormone and an ultrasound scan to find where a pregnancy is. Whether early pregnancy units see people with a very early loss varies by area and UK nation.

Miscarriage UK says even the earliest pregnancy loss can be very distressing, because a positive test may already have sparked thoughts and plans. You may feel grief even if you only knew for a few days, especially if conception took a long time or needed fertility treatment. You might dislike the term "chemical pregnancy" because it does not match how you feel about the baby you began thinking of. Not everyone is upset, though: some people feel a little sad or relieved, and the charity says there are no right or wrong feelings.

Tommy's says that if you have been through fertility treatment, a chemical pregnancy can be very upsetting but may be a reason to be hopeful, as you have a better chance of getting pregnant than someone who has not conceived. The same page describes a free Tommy's midwife helpline and a Wellbeing after Miscarriage programme. The NHS lists Miscarriage UK and Tommy's as sources of support and says your GP or pregnancy unit can discuss counselling.

Miscarriage UK says you can try again straight away if you want to, but it is usually recommended to wait until after your next period, mainly to avoid uncertainty about dates and the size of any future pregnancy, which can cause anxiety around scans. Tommy's gives the same reason and adds that people who have miscarried before may find early scan uncertainty harder.

Miscarriage UK says a chemical pregnancy should count as a miscarriage if you had a positive test and are being assessed for recurrent loss, but that local policies vary, so it may help to ask your GP to note it on your record if you were not seen by an early pregnancy unit. The NHS says to talk to a GP if you have had 3 or more miscarriages.