What Is Biochemical Pregnancy? Symptoms, Causes, and Treatment

Pregnancy and childbirth are joyful events filled with blessings, but pseudopregnancy can easily leave expectant mothers disappointed. What is biochemical pregnancy? How common is it? What are the causes and risk factors? How should you cope with it and when can you try to conceive again? In this article, we will answer these questions and more, providing you with comprehensive and reliable information on this topic.

Table of Contents

What is biochemical pregnancy?

Biochemical pregnancy, also known as chemical pregnancy, refers to a very early miscarriage that occurs within the first 5 weeks of pregnancy, where the fertilized egg fails to successfully implant in the uterine cavity. A urine pregnancy test may show a positive result, and blood HCG levels may initially rise (above 25mIU/mL) but later decline. Ultrasound examinations cannot detect the gestational sac and fetal heart, indicating a missed miscarriage.

The term “biochemical pregnancy” comes from the fact that the only evidence of pregnancy is the presence of the pregnancy hormone HCG (human chorionic gonadotropin) in the blood or urine. HCG is produced by the cells that would form the placenta after implantation. However, in a biochemical pregnancy, the embryo does not develop properly and the pregnancy ends before it can be seen on an ultrasound.

Biochemical pregnancy is different from a clinical pregnancy, where the embryo can be detected by an ultrasound and has a heartbeat. It is also different from a blighted ovum, where the gestational sac is visible but empty, without an embryo inside.

How common is biochemical pregnancy?

Studies show that among women with natural pregnancies, the occurrence rate of biochemical pregnancy can be as high as 25%, meaning there’s a possibility of one in four pregnancies ending in biochemical pregnancy. For first pregnancies, the rate may be even higher, ranging from 50% to 60%. Some women may not even be aware they were pregnant, mistaking it for a regular menstrual period.

The rate of biochemical pregnancy may also vary depending on the method of conception. For women who undergo assisted reproductive technologies (ART), such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), the rate of biochemical pregnancy may be higher than natural conception, ranging from 30% to 50%. This is because ART involves transferring more than one embryo into the uterus, increasing the chances of implantation but also the risk of early pregnancy loss. Additionally, ART involves more frequent and sensitive testing for HCG levels, making biochemical pregnancy more likely to be detected.

The rate of biochemical pregnancy may also change with age. As women get older, the quality and quantity of their eggs decline, leading to more chromosomal abnormalities in the embryos. Chromosomal abnormalities are the most common cause of early pregnancy loss, accounting for about 50% to 70% of cases. Therefore, older women may have a higher risk of biochemical pregnancy than younger women.

According to a study published in the journal Fertility and Sterility, the rate of biochemical pregnancy increased from 22.4% in women aged 20 to 24 years, to 51.9% in women aged 40 to 44 years, and to 86.8% in women aged 45 years or older. The study also found that the rate of biochemical pregnancy was higher in women with a history of infertility, previous miscarriage, or previous ectopic pregnancy.

What are the typical symptoms of biochemical pregnancy?

Biochemical pregnancy often manifests with a slight delay in menstruation, making it challenging to detect as it overlaps with the expected menstrual cycle. Common symptoms include:

  • Vaginal bleeding: This is the most obvious sign of a biochemical pregnancy. The bleeding may start a few days to a week after your regular period was due, and may last for a few days. The blood volume may be similar to or slightly more than usual menstruation, and may have clots or tissue fragments. The bleeding may be accompanied by cramps or pain in the lower abdomen or back.
  • Pregnancy symptoms: Some women may experience mild pregnancy symptoms, such as nausea, breast tenderness, fatigue, mood swings, or food aversions, before or during the bleeding. These symptoms are also caused by the HCG hormone, and may disappear as the hormone levels decline.

Some women may not have any symptoms of a biochemical pregnancy, and may only find out about it through blood tests or ultrasound examinations. Some women may also mistake the bleeding for a normal period, and may not realize they had a biochemical pregnancy until they try to conceive again.

If you experience any of the symptoms of a biochemical pregnancy, you should contact your healthcare provider for further evaluation and support. They can confirm the diagnosis, rule out any complications, and provide you with appropriate treatment and counseling.

What are the causes and risk factors of biochemical pregnancy?

Biochemical pregnancy is a natural outcome of natural selection, and there’s no need to panic if it occurs. Clinical biochemical pregnancy is often associated with genetic factors, uterine environment, hormonal imbalances, and emotional factors.

Cause Explanation Solution
Genetic Factors Chromosomal abnormalities may lead to incomplete embryo development and natural miscarriage. It is estimated that about 50% of biochemical pregnancies are due to genetic errors in the embryo. It is recommended for both partners to undergo pre-pregnancy health checks to rule out factors related to the immune system causing infertility. Genetic testing and counseling may also help identify and prevent chromosomal disorders.
Uterine Environment Poor uterine development, conditions like uterine fibroids, endometrial polyps, intrauterine adhesions, or uterine tuberculosis can hinder successful embryo implantation. These factors may affect the blood supply, thickness, or receptivity of the endometrium. Women can undergo pelvic ultrasound and hysteroscopy to identify and treat uterine diseases, improving the chances of conception. Some studies suggest that acupuncture, herbal medicine, and dietary changes may also enhance endometrial quality.
Hormonal Imbalances Ovarian luteal phase dysfunction, insufficient progesterone secretion, abnormal endometrium, and other factors can lead to failed embryo implantation. Hormonal imbalances may also result from thyroid disorders, polycystic ovary syndrome (PCOS), or diabetes. Monitoring HCG levels closely in early pregnancy and supplementing with progesterone if necessary are recommended. Hormone therapy, medication, or lifestyle modifications may also help regulate hormonal levels and improve fertility.
Emotional Factors High expectations and excessive mental stress, anxiety, or psychological pressure due to the desire for pregnancy can lower fertility rates. Stress can affect the hypothalamic-pituitary-ovarian axis, which regulates ovulation and implantation. Sharing concerns with a partner, family, or friends, seeking professional counseling, practicing relaxation techniques, or joining a support group may help cope with emotional distress and enhance well-being.

Other possible causes of biochemical pregnancy include infections, autoimmune disorders, blood clotting disorders, environmental toxins, or lifestyle factors such as smoking, alcohol, caffeine, or obesity. Identifying and addressing the underlying cause of biochemical pregnancy can increase the chances of having a healthy pregnancy in the future.

How is biochemical pregnancy diagnosed?

A biochemical pregnancy can only be detected by a blood test or a urine test that measures the level of human chorionic gonadotropin (hCG), a hormone produced by the placenta. A biochemical pregnancy is diagnosed when the hCG level rises initially, indicating a positive pregnancy test, but then drops or disappears, indicating that the pregnancy has ended .

How is biochemical pregnancy treated?

Biochemical Pregnancy typically does not require drug treatment, as it occurs early, causing minimal impact on the female body. However, some healthcare providers may prescribe medication to help expel any remaining tissue or prevent infection.

Although Biochemical Pregnancy has minimal physical impact, it can cause emotional distress. Even in the case of a biochemical miscarriage, grief may arise, so family and friends should provide psychological support to minimize the risk of depression or anxiety. Some people may benefit from counseling or joining a support group to cope with their loss. According to a recent study, women who experienced a chemical pregnancy had higher levels of post-traumatic stress, anxiety, and depression than those who had a negative pregnancy test1. Therefore, it is important to acknowledge and validate the feelings of those who have gone through a chemical pregnancy and offer them appropriate resources and care.

How long should one wait to attempt pregnancy again after biochemical pregnancy?

Biochemical pregnancy is a natural miscarriage that does not adversely affect the endometrium like surgical abortion. Therefore, there is no need for special handling or waiting, and conception can continue.

However, if there are two consecutive biochemical pregnancies, there may be underlying issues such as parental chromosomal abnormalities, coagulation abnormalities, or inadequate luteal phase. Detailed examination and consultation are recommended before attempting another pregnancy. Some possible tests include:

Test Purpose
Karyotype analysis To check for chromosomal abnormalities in both parents that may increase the risk of miscarriage
Thrombophilia screening To detect blood clotting disorders that may impair blood flow to the placenta and cause pregnancy loss
Progesterone level To measure the hormone that supports the implantation and development of the embryo
Luteal phase biopsy To assess the quality and receptivity of the endometrium during the second half of the menstrual cycle

According to a recent study, the optimal interpregnancy interval after a biochemical pregnancy is less than three months, as it is associated with a higher live birth rate and a lower risk of recurrent miscarriage. However, this decision ultimately depends on the physical and emotional readiness of the couple, as well as the advice of their healthcare provider.

Frequently Asked Questions

  • Is a biochemical pregnancy a real pregnancy?

    • A biochemical pregnancy is a real pregnancy, as it involves the fertilization of an egg by a sperm and the implantation of the embryo in the uterus. However, it is a very early pregnancy loss that occurs before the fifth week of gestation, before the embryo can be seen on an ultrasound. A biochemical pregnancy is confirmed by a positive pregnancy test that later turns negative.

  • What are the signs of a biochemical pregnancy?

    • The signs of a biochemical pregnancy are similar to those of a normal menstrual period, such as bleeding, cramping, and low back pain. Some people may also experience spotting, breast tenderness, nausea, or fatigue before the bleeding starts. However, these symptoms are not specific to a biochemical pregnancy and may vary from person to person.

  • Does a biochemical pregnancy count as a miscarriage?

    • A biochemical pregnancy is a type of miscarriage, as it involves the loss of a pregnancy before 20 weeks of gestation. However, it is a very early miscarriage that may go unnoticed by many people who are not aware of their pregnancy. A biochemical pregnancy does not usually require any medical intervention or affect future fertility.

  • How can I prevent a biochemical pregnancy?

    • There is no definitive way to prevent a biochemical pregnancy, as most of the causes are beyond one’s control. However, some general tips to improve one’s chances of having a healthy pregnancy include:

    • Quitting smoking and avoiding alcohol and drugs
    • Taking prenatal vitamins and folic acid supplements
    • Maintaining a healthy weight and diet
    • Managing chronic conditions such as diabetes, thyroid disorders, or hypertension
    • Reducing stress and getting enough rest
    • Seeking preconception counseling and genetic testing if indicated
    • Following the recommendations of one’s healthcare provider

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