Chemical Pregnancy

A chemical pregnancy is a very early pregnancy loss that occurs before the fifth week of gestation—too early for an ultrasound to detect a gestational sac—identified only by a brief positive pregnancy test followed by a decline in hCG levels and the onset of menstruation. Women with PCOS experience higher rates of early pregnancy loss (estimated 30-50% in the first trimester) due to factors including poor egg quality related to hormonal imbalance, insulin resistance affecting uterine receptivity, elevated inflammation, and insufficient progesterone production from compromised luteal function. While emotionally difficult, experiencing a chemical pregnancy does confirm that conception can occur, and proactive treatment of underlying PCOS factors—particularly insulin resistance—can improve outcomes in subsequent pregnancies.