Biochemical pregnancy by G.Bertelli


Biochemical pregnancy is a miscarriage that can occur within four to five weeks of conception.

In this condition, the pregnancy test will give a positive result for the initial presence of the chorionic gonadotropin (beta-hCG) in the maternal body, but a possible ultrasound examination will not detect either the presence of the embryo or of the gestational chamber.

Women are not always aware of conception, precisely because of the very short duration of this pregnancy which ends with the arrival of menstruation.

Since the interruption of gestation is very early, biochemical pregnancy does not require surgical treatments (eg curettage) or pharmacological treatments.

What's this

What is Biochemical Pregnancy?

Biochemical pregnancy is nothing more than an extremely early abortion . Many women do not even notice this event, since it is exchanged with a simple menstrual delay or with an abundant and more annoying period than the norm.

The pregnancy test announces the implantation in the uterus due to the presence of the chorionic gonadotropin in the maternal organism. However, the gestation then does not continue and ends after a few weeks, with the resumption of the menstrual cycle.

Biochemical pregnancy is also called biochemical abortion or micro-abortion .

Why is it called "Biochemical Pregnancy"?

The term " biochemical pregnancy " is used to indicate that, a few days after implantation in the walls of the uterus, the development of the embryo has stopped. Although gestation stops after a few weeks, the maternal organism immediately produces human chorionic gonadotropin (beta-hCG). This hormone is secreted only upon conception, once the fertilized egg has implanted itself in the uterine cavity. Generally, levels of human chorionic gonadotropin progressively increase in the maternal circulation in the first 8-10 weeks of pregnancy, and then decrease and stabilize at the minimum levels throughout the rest of the gestation.

Beta-hCG is also detectable with home pregnancy tests, which can be purchased in pharmacies or at the supermarket. These sticks are based on a chemical reaction : a strip impregnated with monoclonal antibodies, or molecules capable of recognizing human chorionic gonadotropin, signals, by showing symbols, whether the hormone is present in the urine.

Pregnancy is called biochemistry based on the fact that the test will give a positive result, due to the presence of beta-hCG, but a possible ultrasound examination will not detect either the presence of the embryo or of the gestational sac.

" Biochemical pregnancy " is also intended to highlight the difference with the " clinical pregnancy ", characterized by nine months of gestation, which conclude with a natural or cesarean birth.

How does a pregnancy start?

Conception occurs when the spermatozoa, ascending the uterus, reach the mature egg cell - released from the ovary during ovulation and available for fertilization - at the level of the fallopian tubes.

The fertilized egg is transported by the movement of the ciliated cells of the tubas in the direction of the uterine cavity, where it nestles in the endometrium approximately 6-7 days after the unprotected intercourse (therefore around the 21st day of a regular menstrual cycle, if the fertilization took place on the fourteenth day).

After implantation, the production of the chorionic gonadotropin also begins, whose "beta" subunit is essential for the functioning of the pregnancy test. As long as there is a certain level of beta-hCG hormone in the body, the tests will be positive.

Causes and Risk Factors

Biochemical pregnancy consists in a spontaneous abortion at the beginning of spontaneous gestation, when the waiting stops before the fifth week. In practice, this is an early failure of the embryo implant . What basically happens is that the egg was fertilized by the male gamete and began its journey to the uterus. Once the latter is reached, the implant occurs, as happens in a normal pregnancy, but, after a few days, the embryo stops developing.

In addition to cases of natural conception, this occurrence can occur in the context of a medically assisted procreation process (such as in vitro fertilization, artificial insemination, etc.).

Biochemistry pregnancy: why does it occur?

Identifying the exact causes that led to biochemical pregnancy is complicated. Evaluation of the arrest of embryo development and spontaneous abortion is made difficult also by the fact that the body naturally eliminates the products of conception with menstruation, therefore it is not possible to recover samples to be analyzed.

Generally speaking, biochemical pregnancies occur for the same reasons as other abortions.

Therefore, among the possible factors that can explain the aetiology are:

  • Genetic anomalies of gametes (egg cell and / or sperm cell);
  • Uterine malformations;
  • Changes in the developing embryo (chromosomal abnormalities, implant defects, etc.);
  • Unhealthy living habits of parents: tobacco, alcohol, high levels of stress, etc.
  • Infections.

Physiological or pathological?

Biochemical pregnancy is often interpreted as something "pathological". In reality, the phenomenon is physiological and is part of the normal reproduction process: it can happen, in fact, that the egg is fertilized, but is unable to implant or implant itself, but does not grow adequately.

Furthermore, the episode has no influence on the possibility of becoming pregnant and the woman can successfully retry having a baby.

Symptoms and Complications

Biochemical pregnancy usually goes unnoticed, as it does not involve manifestations specifically attributable to this type of early abortion. The symptoms mimic, in fact, those of a normal menstrual cycle.

Many women do not even realize that conception has occurred, precisely because of the very short duration of this "gestation" which ends with the arrival of menstruation .

Biochemistry pregnancy: how to recognize it?

In many cases, biochemical pregnancy ends after four to five weeks after conception. Most women do not actually have time to realize or suspect they are pregnant.

Some find, instead, biochemical pregnancy only because they have a regular menstrual cycle and are faced with an "unusual" delay .

In cases of specific fertility programs, where pregnancy is followed from the time the embryo is implanted in the uterus, it is easier to notice an early abortion.

Most common signs and symptoms

Distinguishing between the bleeding caused by an abortion and that related to menstrual flow is very complicated, since there is almost no difference.

Only for the most careful eyes, when menstruation appears, biochemical pregnancy can lead to some alterations with respect to the norm.

In particular, the woman who incurs early pregnancy termination may experience the combination of these symptoms:

  • Delay in the onset of menstruation;
  • Menstrual flow more abundant than normal and / or with clots;
  • Bright red blood loss;
  • Abdominal pain, mild uterine contractions and back pain.

Biochemical pregnancy does not imply any physical problems or particular consequences, as fertility is not compromised and the woman, if she wishes, can try again to have a child. This condition, however, certainly has an important weight from a psychological point of view: women who, for example, are following a path of medically assisted procreation in order to be able to get pregnant can live the denial of a pregnancy very badly.


Biochemistry pregnancy: what tests are needed?

As anticipated, biochemical pregnancy often goes unnoticed. This type of abortion occurs so early that ultrasound findings about the embryo and / or gestational chamber cannot be obtained.

Only those who, in spite of a positive pregnancy test, are subject to a blood loss or a decrease in beta-hCG (or their lack of increase) can realize the biochemical gestation.

Treatment and Remedies

Biochemical pregnancy is a very early interruption that, precisely for this reason, does not require scrapings or drugs and resolves with the arrival of menstruation.

Biochemistry pregnancy: how to intervene?

In most cases, biochemical pregnancy does not require interventions of any kind, that is, one waits for the arrival of menstruation, leaving nature to regulate the situation.

The only intervention that may be useful to check the progress of biochemical pregnancy is to monitor the level of the beta-hCG hormone, making sure that it is reduced.

If an abortion is in progress, in fact, the chorionic gonadotropin decreases naturally. If the beta-hCG value increases or remains stable and there is no embryo in the uterus, it is necessary to undergo specific tests, in order to avoid the possibility of an ectopic pregnancy .

Psychological support

Despite the very short duration, it is possible that biochemical pregnancy has negative psychological repercussions on some women. This occurrence must be taken into consideration especially in cases where a path of medically assisted procreation had been undertaken to try to conceive a child.

In any case, it is advisable that the implication of biochemical pregnancy on the emotional state be alleviated with the support of family members or a specialist.

Drugs and surgery

Since the interruption of gestation is very early, biochemical pregnancy does not require surgery, such as curettage, to remove the retained products of conception.

Similarly, there are no specific drugs to take after a diagnosis of chemical pregnancy.

After Biochemical Pregnancy

A biochemical pregnancy does not affect fertility and the chances of getting pregnant in the future. Typically, a woman's menstrual cycle resumes within 1 to 2 weeks after early abortion. However, after biochemical pregnancy, the onset of menstruation and the resumption of normal ovulation depends on whether the chorionic gonadotropin and progesterone persist in the body. In fact, to start again normally, the menstrual cycle requires that the levels of these hormones be reduced.

How long to wait before trying to conceive again?

The period of time between biochemical pregnancy and new attempts at conception depends on each individual case. For the most part, the wait is related to the emotional state of the woman and the causes that contributed to induce the interruption of gestation. In this regard, your doctor will be able to provide the right advice about the methods and timing to be respected to try to conceive a child.

Indicatively, if the menstrual cycle restarts with the usual normality, a new pregnancy can be attempted after two to three months.