Chemical Pregnancy After Embryo Transfer

A chemical pregnancy after embryo transfer is a term used to describe an early pregnancy loss that occurs shortly after implantation.

Though it can be heartbreaking, especially for surrogates and intended parents, it is important to understand what a chemical pregnancy is, why it happens and how to handle it emotionally and medically.

In this article, we will explain what a chemical pregnancy is, how it can occur after an embryo transfer, the symptoms to watch for, and the steps to take if one happens.

Learn more about pregnancy as a surrogate here, or fill out this simple form to get help if you are considering becoming a surrogate.

What Is a Chemical Pregnancy?

A chemical pregnancy refers to an early miscarriage that happens before a fetal heartbeat can be detected. The term “chemical” refers to the fact that pregnancy hormones (like human chorionic gonadotropin or hCG) are detected in the blood or urine, but the pregnancy does not progress beyond the early stages.

Chemical pregnancies usually occur within the first 5 weeks of pregnancy, often before the woman even realizes she is pregnant, and they are more common in women undergoing fertility treatments.

Find out when to test for pregnancy  after frozen embryo transfer.

Can You Have a Chemical Pregnancy With an Embryo Transfer?

Yes, it is possible to experience a chemical pregnancy after embryo transfer.

During an embryo transfer, whether fresh or frozen, the goal is for the embryo to implant in the lining of the uterus and begin developing into a pregnancy. However, in some cases, the embryo may implant but fail to continue developing due to chromosomal abnormalities or hormonal imbalances that prevent proper growth.

When an embryo is transferred, it can initially produce the pregnancy hormone hCG, which causes a positive pregnancy test. However, if the embryo does not continue to develop, the hCG levels will begin to drop, leading to early pregnancy loss. This is often referred to as a chemical pregnancy.

Causes of Chemical Pregnancy After Embryo Transfer

A chemical pregnancy after frozen embryo transfer (FET) is a possibility, just as it is with fresh embryo transfers. Several factors can contribute to a chemical pregnancy, including:

• Chromosomal Abnormalities: One of the leading causes of early pregnancy loss, including chemical pregnancies, is chromosomal abnormalities. The embryo may have too many or too few chromosomes, which can prevent it from continuing to develop normally.
• Hormonal Imbalances: Hormonal issues, such as insufficient progesterone levels, can affect the implantation process or prevent the embryo from developing properly. Progesterone is crucial for maintaining the uterine lining and supporting early pregnancy.
• Implantation Problems: Sometimes, an embryo may implant, but the implantation process is not optimal, leading to a miscarriage in the very early stages.
• Endometrial Factors: The uterine lining needs to be receptive to implantation. If the lining is not thick or healthy enough, even with a good-quality embryo, a pregnancy may not continue.
• Immune System Factors: Certain immune system conditions or issues like antiphospholipid syndrome (APS) can increase the risk of pregnancy loss, including chemical pregnancies.

Can You Have a Chemical Pregnancy After Implantation?

Yes, a chemical pregnancy after implantation can occur. Implantation is the process where the embryo attaches to the uterine lining. After successful implantation, the body begins to produce hCG, which is detected in pregnancy tests.

However, if the embryo does not continue developing or there are issues with the pregnancy, the hCG levels will begin to fall, leading to a chemical pregnancy.

While implantation is a critical step in establishing a pregnancy, it does not guarantee the pregnancy will continue. If the embryo is not viable, it may result in an early miscarriage, even though implantation has occurred.

Symptoms of a Chemical Pregnancy After Embryo Transfer

The symptoms of a chemical pregnancy after embryo transfer can vary but are generally mild and may be mistaken for normal pregnancy symptoms. Common symptoms include:

• Light bleeding or spotting: This may appear as light pink or brown spotting, similar to what some women experience during early pregnancy. However, this bleeding may become more noticeable as the chemical pregnancy progresses.
• Cramping: Mild to moderate cramping can occur, which is often similar to menstrual cramps. Some women may experience this cramping as the body expels the pregnancy.
• A positive pregnancy test followed by a negative test: Initially, a positive pregnancy test is likely, followed by a negative result as hCG levels drop. 

What Are the Odds of a Chemical Pregnancy After Frozen Embryo Transfer?

On average, the rate of early pregnancy loss, including chemical pregnancies, is around 20-30% in ART cycles. However, it is important to note that while FET has become increasingly successful, the risk of early pregnancy loss can still occur.

The odds of a chemical pregnancy after frozen embryo transfer (FET) are similar to those after a fresh embryo transfer, though the risk can vary depending on factors such as the age of the woman, embryo quality, and any underlying fertility issues.

Factors that may influence the likelihood of a chemical pregnancy after FET include:

• Embryo quality: The quality of the embryo transferred plays a significant role in the success of the pregnancy. Poor-quality embryos are more likely to result in chemical pregnancies.
• Age: Older women and men, particularly those over 35, may have a higher risk of chromosomal abnormalities in embryos, which increase the chances of a chemical pregnancy.
• Uterine health: Conditions affecting the uterus or uterine lining, such as fibroids or endometriosis, can increase the risk of early pregnancy loss.

Learn more about the success rates of frozen embryo transfer here.

Does Late Implantation Cause Chemical Pregnancy?

Late implantation can contribute to a chemical pregnancy, although it is not necessarily the direct cause. Implantation typically occurs within 6-10 days after embryo transfer, and it’s important that the embryo implants at the right time in order for the pregnancy to have a chance to progress.

If implantation occurs too late or if there are issues with the uterine lining, the embryo may fail to receive the nutrients it needs to grow, leading to an early miscarriage. However, late implantation is just one of many potential factors that can contribute to a chemical pregnancy, and it’s not always the sole cause.

What to Do if a Chemical Pregnancy Occurs

If a chemical pregnancy occurs, it is important to take both medical and emotional steps for recovery.

Medical Steps

• Confirm the Diagnosis: Your doctor will likely perform blood tests to check hCG levels and an ultrasound to confirm the pregnancy status. If it’s confirmed that a chemical pregnancy has occurred, your doctor may monitor your hCG levels to ensure they return to baseline.
• Follow-Up Care: In most cases, no further medical intervention is required. However, your doctor will provide guidance on when to attempt another cycle of embryo transfer or other fertility treatments, if applicable.
• Physical Recovery: Physical recovery after a chemical pregnancy is typically quick. You may experience mild cramping or bleeding, similar to a period. Your healthcare provider may recommend pain relief or other supportive treatments.

Emotional Support

A chemical pregnancy can be an emotionally challenging experience, especially after an embryo transfer when hopes for a successful pregnancy are high. It’s normal to feel a mix of emotions such as sadness, disappointment, or even guilt. Support is crucial during this time, and there are several resources to help you cope:

• Counseling: Professional counseling or therapy can be beneficial for managing grief and processing emotions after a loss. Some therapists specialize in fertility-related issues, and they can offer strategies for coping with the disappointment.
• Support Groups: Connecting with others who have experienced similar losses can provide comfort and understanding. Support groups for surrogates or women experiencing fertility challenges can be found online or through local fertility clinics.
• Partner and Family Support: Lean on your partner, friends, or family for emotional support. It’s important not to isolate yourself and to allow others to offer care during this difficult time.

If you think you may be experiencing a chemical pregnancy after embryo transfer, seek medical guidance and connect with emotional support resources to help navigate this challenging time.

Learn more about pregnancy as a surrogate here, or fill out this simple form to get help if you are considering becoming a surrogate.