Chemical pregnancy ‘management ‘ - Fertility Network UK

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Chemical pregnancy ‘management ‘

Hi all. I’ve just come back from another scan and I’ve definitely had a chemical pregnancy as the embryo hadn’t developed any further. This is my second one after six goes at IVF (2 fresh and 4 frozen). This time I’ve been referred me to my local hospital for ‘management’ of the tissue on Tue, which sounds scary?! Anyone got any experience of this? What could they do?

I bugged the clinic to let me stop the pessaries, but they said if I start to bleed heavily/get clots I need to go to A&E. However, given how much the pessaries will have built my womb up since 3 Feb, how do I know when it’s at that level?! I can get small clots on a normal cycle, let alone after something like this?! 😯 Any advice is appreciated x

13 Replies

I had chemical management after the embryo stopped developing at 8 weeks gone on my second cycle. I had tried to avoid the hospital for this but after the initial more intense crampy/clotty miscarriage part I just kept on bleeding for weeks and weeks, and still getting BFPs on tests as not all the tissue had come out. So in my case I was very glad to finally get it sorted- it was just a different pessary and some cramping and clots but not painful and was good to be surrounded by nurses who had lots of experience of caring for people in this situation. In a couple of hours it was then over with and I could then get home and rest properly.

So sorry that you’re in this situation and sending big hugs xx

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Thank you! That helps 👍🏻

Glad this was finally sorted for you, it sounds like a really difficult time 😔

My clinic didn’t explain my referral properly in person, so I had to badger them on the phone as to why I’m going to my hospital?! And then I just got scared 😧 Xx


Sorry for your loss xx Depends what u decide to do there’s natural when you just leave it your body will eventually mc, medical management where you pop tablet inside you V and wait you’ll cramp because you cervix it opening so the tissue can blood come out, I’ve had this and it didn’t work I actually didn’t need it so I’m pleased it didn’t work. There’s manual vacuum aspiration you get tablets to put in your V and bum then they put a speculum in you vagina inject your cervix with local anaesthetic then clamp it open the use a tube to gently poke and suck the pregnancy tissue out it sounds awful but out of my 3 mc this was the easiest for me. Then there’s d&c haven’t had but it’s a more invasive mva and your put to sleep.

If you start passing clots before you get to the EPU don’t be scared it’s the weirdest feeling and there is a lot of blood I wouldn’t to to A&E unless absolutely necessary they make u sit wait for hours. Sorry it’s graphic I hope your ok xx


Thanks for explaining all the options. This is SO helpful! No problem about being graphic, I’d rather know! I’m in the headspace now where it feels right to choose something proactive and manage it, rather than have the uncertainty looming over me! I was worried about going to A&E over the weekend, which is the worst time to go, but thanks for the reassurance. Hope you’re ok now xx

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Yeah I’m fine hope everything goes ok it’s awful having to go through mc xx


HI, I'm so sorry your going through this. I just wanted to get in touch as I had medical mgmt yesterday. After my 3rd transfer I got a bfp but scans showed an empty sac. I waited nearly 2 weeks hoping I'd miscarry naturally but no signs at all. I opted for medical mgmt as I had a d&c in October so they didn't recommend it encase it caused scarring.

I went into hospital yesterday at 10am after a lot of waiting around they popped 2 pessaries in vaginally and a pain killer in the back, I then had to lay for an hour for them to dissolve then was allowed home. You start bleeding about 4-6 hours later and it was honestly just like a heavy period for me. There were some clots but not big. I also luckily didn't have any pain and only took some painkillers before bed to help me sleep. I took today off work and have just had a relaxing day and the bleeding today is very light.

I was terrified as read horror stories but for me it was luckily all ok and if I had to choose again I would def look at this option. My nurse was lovely and also said that if I waited for it naturally it would be the same amount of blood/clots etc but at least this way your in control and can be home. I was scared it would start at work or out naturally.

Sorry for the long message, it's a horrible time and a horrible decision to make.

Any questions do feel feee to msg me, daytime tv is driving me mad. Xx


Thank you! Big hugs to you and I hope you’re feeling ok now? Really good to hear your experience and know it wasn’t too bad. I’ll let you know what they say on Tue. I feel like I want to push for a proactive managed option and will feel disappointed if they don’t offer one! To add to the complexity I’m meant to be going away next weekend, and I so don’t want to cancel and miss out/lose my money 😬 It’s the first thing I’ve had to look forward to since starting this process in Jan and typically I only booked it last night 🙄 xx


Hi GwinBlue

Firstly I'm so sorry you're having to go through this xx

I've had 4 miscarries, 2 natural, 2 with medical management. As Cmat and Jm82 note, it is good to be somewhere with nurses who can take care of you, provide pain relief and confirm if and when you have passed the tissue. My first miscarriage was very scary as I did not know what was happening and hadn't expected the level of pain I experienced. However some people pass clots without too much pain. If I ever needed to I would go down this route again or have a d&c as the thought of it happening somewhere public or at work is unbearable.



Thank you ☺️ It does sound so much better to be in a controlled situation. I was worried that if it happened naturally and I got clots, I wouldn’t know whether to go to A&E or not, but you guys have made me feel so much better! xx

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I am so sad for you what a roller coaster of emotions and expectations. I had a chemical pregnancy in Nov after my 1st IVF. The clots were bigger than anything I've had before. It was a lot less painful than my miscarriages. I didnt go to hospiral for any of them so would wonder like you how you know when to go. Like some people say when the bleeding goes on and on its a sign your body isn't releasing it properly.

Sending you peaceful thoughts


Hi all. Huge thanks for all your responses!! As a quick update, after three hours at the hospital today I’ve now made a decision re: next steps. I was offered either a medical management or a surgical management (vacuum), but was told the medical management probably wouldn’t work for me as the embryo is so small and really high up in the womb.

They could put me on the emergency operating list for Thursday afternoon, and all being well, I’ll have a general anaesthetic and be home in the evening. 🤞🏻🤞🏻🤞🏻 Just hope it all goes to plan! Sounds a bit scary as they do it “blind” - not sure why they can’t scan you (like during egg transfer) to make sure they get it all?!

Am so fed up of it all now. My week of annual leave has been ruined! 😓 I’ll want to go back to work for a bit of normality! 🤪 xx


Just to say good luck! Having had 2 surgical managements in the last 8 weeks I can tell you its a really simple procedure and really painless. I actually quite enjoyed having a decent sleep! I was shopping and out two nights after both of them although you are supposed to take it steady! x


Just a quick update from me. And v fed up now. My original surgical removal theatre date on Thu 21 got cancelled after I’d been waiting in hospital for hours, as there were too many general surgical emergencies. I was rearranged for nearly a week later, last Wed 27 March.

After being starved for hours and hours they couldn’t find a vein for the anaesthetic and accidentally injected it into my arm, which was so painful for days 🙊 They said the op went well, but as they do it blind they don’t know if they got it all.

Fast forward to Saturday night and I’m in agony with sudden severe abdominal pain and an onset of heavy bleeding. Spent all day yesterday at GAU and they’re not sure if it’s material leftover or an infection. First available scan is not until tomorrow, after which I may need the operation again 😠

This is despite them telling me that wouldn’t happen if it didn’t fully work?! Am now on codeine for the pain and v v fed up. If they’d just scanned my tummy whilst doing the op then they would have seen if they’d got everything out!!! But it’s not policy at my hospital 🙄 Grrrr. My miscarriage was over a month ago and I just want it sorted 😑 My poor mum didn’t even get her card and present off me as I was in hospital all day!


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