By Dr. Victoria Verdú (Licensed Gynaecologist No. 282847366).
In the field of fertility, a biochemical pregnancy refers to a very early pregnancy loss that occurs shortly after the embryo implants. In these cases, the body begins to produce the pregnancy hormone, human chorionic gonadotropin (hCG), which can be detected through a blood test. This is why it is called “biochemical”—because it is only detectable through this test, and there are no ultrasound signs of pregnancy or a visible gestational sac.
A biochemical pregnancy occurs when the egg is fertilized and implants in the uterus, but it does not develop properly and ends in a very early loss, usually before the fifth week of gestation. The most common cause is the presence of chromosomal abnormalities in the embryo, which prevent it from developing correctly.
These abnormalities are very common when there is advanced maternal or paternal age, or when there are inherited structural genetic defects from one or both parents.

However, a biochemical pregnancy can also be caused by problems in the woman’s uterus, such as polyps or uterine fibroids, as well as hormonal imbalances (such as low progesterone levels) or immune system issues (where the immune system may recognize the embryo as something foreign and attack it). Another possible cause could be the quality of the egg or sperm, since low-quality gametes may create a poor-quality embryo with lower chances of implantation.
The good news is that a biochemical pregnancy, although emotionally painful, is usually an isolated event and does not prevent a successful pregnancy in the future.
While it’s not always possible to determine the exact cause, known risk factors include:
Biochemical pregnancies are more frequently detected in cases of assisted reproduction. This is not because patients undergoing these treatments are more likely to experience them, but because very early tests are performed to confirm pregnancy. In contrast, in natural pregnancies, these tests are usually done only after noticing a missed period, so many biochemical pregnancies may go unnoticed and are mistaken for a delay or an irregular menstruation.
To identify a biochemical pregnancy, it is necessary to perform a blood test to measure the hCG hormone, which means it cannot be detected retrospectively. Therefore, if hCG was not measured at the appropriate time, the biochemical pregnancy leaves no clinical evidence afterward, which explains why so many go unnoticed. It can only be identified as such if the test is performed while it is happening.

A biochemical pregnancy usually does not leave physical aftereffects or affect fertility, and it does not require a uterine curettage (since no embryonic structures are identified in the cavity), so the vast majority of women who have experienced one are able to achieve a successful pregnancy afterward.
In many cases, in fact, it can be considered a sign that implantation is possible, which means that motherhood may be achieved through assisted reproduction. In general, an isolated biochemical pregnancy does not require further in-depth studies, unless it happens repeatedly or there is a history of other pregnancy losses.
The female body usually recovers quickly after this type of pregnancy loss, as the pregnancy was not very advanced. In fact, many women ovulate in the following cycle or even just a few days after the loss.
From a medical standpoint, it is possible to try again when the woman feels ready, both physically and emotionally.
In most cases, it cannot be prevented because it is usually caused by chromosomal abnormalities in the embryos, which is something beyond our control. Many non-viable pregnancies simply do not progress, and this is something that happens very commonly in nature.
However, if biochemical miscarriages are recurrent, it may be useful to investigate possible preventable causes such as hormonal imbalances, uterine problems, blood clotting disorders, or immune deficiencies. One option could be IVF with preimplantation genetic testing to detect chromosomally normal embryos.
As in many other situations, there is a general recommendation to improve reproductive health, such as maintaining a healthy lifestyle, avoiding tobacco, or managing stress—things that, while they do not guarantee pregnancy, can improve the chances.