What is pregnancy test

Pregnancy is the period of time when a fetus develops inside a woman’s uterus and ends with the birth of the infant. Human chorionic gonadotropin (hCG) is a hormone produced by the placenta (when a fertilized egg implants in the uterus) of a pregnant woman. This usually happens about 10 days after conception (when the man’s sperm fertilizes the woman’s egg). The amount of human chorionic gonadotropin (hCG) builds up quickly in your body with each passing day you are pregnant. Early in pregnancy, the level of human chorionic gonadotropin (hCG) increases in the blood and is eliminated in the urine. A pregnancy test detects human chorionic gonadotropin (hCG) in the blood or urine and confirms or rules out pregnancy.

• All pregnancy tests work by detecting the pregnancy hormone, human chorionic gonadotropin (hCG), in the urine or blood. Human chorionic gonadotropin (hCG) hormone is present only when a woman is pregnant. If the pregnancy test detects human chorionic gonadotropin (hCG), it will say you are pregnant.

During the early weeks of pregnancy, human chorionic gonadotropin (hCG) is important in maintaining function of the corpus luteum. Production of human chorionic gonadotropin (hCG) increases steadily during the first trimester (8-10 weeks) of a normal pregnancy, peaking around the 10th week after the last menstrual cycle. Levels then fall slowly during the remainder of the pregnancy. Human chorionic gonadotropin (hCG) is no longer detectable within a few weeks after delivery.

Typically, human chorionic gonadotropin (hCG) levels double about every two days for the first four weeks of a normal pregnancy, then slow to every 31/2 days by six weeks.

When a pregnancy occurs outside of the uterus (ectopic pregnancy), the level of human chorionic gonadotropin (hCG) in the blood increases at a slower rate. When an ectopic pregnancy is suspected, measuring the level of human chorionic gonadotropin (hCG) in the blood (quantitative test) over time may be useful in helping to make a diagnosis of ectopic pregnancy.

Similarly, the human chorionic gonadotropin (hCG) blood level may be abnormal when the developing baby (fetus) has a chromosome defect such as Down syndrome. An human chorionic gonadotropin (hCG) test is used routinely in conjunction with a few other tests as part of screening for fetal abnormalities.

Quantitative human chorionic gonadotropin (hCG) testing, often called beta human chorionic gonadotropin (β-hCG), measures the amount of human chorionic gonadotropin (hCG) present in the blood. It may be used to confirm a pregnancy. Quantitative human chorionic gonadotropin (hCG) testing may also be used, along with a progesterone test, to help diagnose an ectopic pregnancy, to help diagnose and monitor a pregnancy that may be failing, and/or to monitor a woman after a miscarriage.

Blood measurements of human chorionic gonadotropin (hCG) may also be used, along with a few other tests, as part of screening for fetal abnormalities.

Occasionally, a human chorionic gonadotropin (hCG) test is used to screen for pregnancy if a woman is to undergo a medical treatment, be placed on certain drugs, or have other testing, such as x-rays, that might harm the developing baby. This is usually done to help confirm that the woman is not pregnant. It has become standard practice at most institutions to screen all female patients for pregnancy using a urine or blood human chorionic gonadotropin (hCG) test before a medical intervention, such as an operation, that could potentially harm a fetus.

How is the pregnancy test performed?

A pregnancy test check for the human chorionic gonadotropin (hCG) hormone in two ways – using blood or urine:

1. Urine pregnancy test. This type of pregnancy test can be done at home or at a doctor’s office.
2. Blood pregnancy test. This type of pregnancy test can only be done at a doctor’s office. It takes longer than a urine pregnancy test to get results, but it can detect a pregnancy earlier than a urine test (about 10 days after conception, compared to typically 2 weeks or more for a urine pregnancy test). Your doctor may use one or both types of blood tests:
   • A quantitative human chorionic gonadotropin (hCG) blood test (also called a beta hCG test) that measures the exact amount of hCG in your blood. It can find even tiny amounts of hCG. It can also tell you and your doctor how many weeks you are pregnant.
   • A qualitative human chorionic gonadotropin (hCG) blood test checks to see whether the pregnancy hormone is present or not. The qualitative human chorionic gonadotropin (hCG) blood test is about as accurate as a urine pregnancy test.

The blood pregnancy test is done by drawing a single tube of blood and sending it to a laboratory. You may wait anywhere from a few hours to more than a day to get the results. For the blood test, the health care provider uses a needle and syringe to draw blood from your vein into a tube. Any discomfort you might feel from the blood draw will only last a few seconds.

All home pregnancy tests come with written instructions. Depending on the brand you buy, the instructions may vary:

• You hold a stick in your urine stream.
• You pee into a cup and dip the stick into it.
• You pee into a cup and then use a dropper to put a few drops of the urine into a special container.

Different brands tell you to wait different amounts of time, although most are around 2 minutes. Depending on the brand of the test, you may see a line or a plus symbol, or the words “pregnant” or “not pregnant.” A line or plus symbol, no matter how faint, means the result is positive.

Most tests also have a “control indicator” in the result window. This control line or symbol shows whether the test is working properly. If the control line or symbol does not appear, the test is not working properly.

Look for the toll-free phone number on the package to call in case of questions about use or results.

When is hCG pregnancy test ordered?

For confirming pregnancy, the timing of testing depends on how accurate a woman is about the day she expects her menstrual period as well as the method used for testing. In general, blood human chorionic gonadotropin (hCG) tests are more sensitive than urine human chorionic gonadotropin (hCG) tests and can be done two days before a woman would expect her period to start. A urine or blood human chorionic gonadotropin (hCG) test can be done reliably by 10 days after a missed menstrual period. Even using a urine test, a woman may be able to determine whether she is pregnant the day she misses her period, but the result could be falsely negative. A false negative  pregnancy test means the test result inappropriately indicating negative result when, in fact, you’re pregnant. Testing may be repeated at a later date if the first test is negative but pregnancy is still suspected.

Quantitative blood human chorionic gonadotropin (hCG) tests may be ordered over several days when a health practitioner wants to identify or rule out an ectopic pregnancy or to monitor a woman after a miscarriage. In these cases, a woman may experience the normal signs and symptoms of pregnancy at first but then may develop others that indicate that the pregnancy is not progressing as expected.

Some signs and symptoms of ectopic pregnancy include:

• Abnormal vaginal bleeding—because a woman is pregnant, she may not have a regular period but then may have light bleeding or spotting with an ectopic pregnancy
• Low back pain
• Pain or cramping in the lower abdomen or on one side of the pelvis

If ectopic pregnancy is untreated, signs and symptoms may get worse and may include:

• Dizziness, weakness
• Feeling faint or fainting
• Low blood pressure
• Pain in the shoulder area
• Sudden, sharp pain in the pelvic area
• Fever, flu-like symptoms
• Vomiting

The area around an ectopic pregnancy may rupture and start to bleed, and, if undiagnosed, can lead to cardiac arrest and death.

An human chorionic gonadotropin (hCG) test may be ordered prior to a medical procedure or treatment that might be harmful during pregnancy.

How do you know when you’re pregnant?

You may be pregnant if:

• You miss your period.
• Your breasts are big and sore. The area around your nipples gets darker.
• You have to urinate (pee) a lot.
• You feel sick to your stomach or throw up.
• You feel tired all the time.
• You feel moody.
• You feel bloated. This means your body feels full or like it’s swollen.

If you have any of these signs and symptoms and you think you may be pregnant, take a home pregnancy test and call your health care provider. Your provider can give you a blood test and a physical exam to confirm that you’re pregnant. Home pregnancy tests can give you a false-positive result — this means the test says you’re pregnant but you’re really not. This is why it’s a good idea to see your provider to make sure you really are pregnant.

How does pregnancy happen?

Each month your ovaries release an egg about 14 days before the first day of your period. This is called ovulation. When you and your partner have unprotected sex around the time of ovulation, his sperm swim to meet your egg. Unprotected sex means you don’t use any kind of birth control to help prevent pregnancy.

When the egg and sperm meet, it’s called fertilization. The fertilized egg (also called an embryo) moves through your fallopian tubes and attaches to the wall of your uterus where it grows and develops into a baby. When the embryo attaches to the uterus, it’s called implantation.

You can get pregnant if you have unprotected sex any time from 5 days before and the day of ovulation. The more often you have sex during this time, the more likely you are to get pregnant. Your egg is fertile (can become an embryo) for 12 to 24 hours after ovulation. Your partner’s sperm can live inside you for up to 72 hours after you have sex.

How long does it usually take to get pregnant?

It’s impossible to say how long it takes to get pregnant because it’s different for each woman.

Many factors can affect a couple’s chances of conceiving, such as:

• your age
• your general health
• your reproductive health
• how often you have sex

Some women become pregnant quickly, while others take longer. This may be upsetting, but it’s normal.

Fertility

Most couples (about 84 out of every 100) will get pregnant within a year if they have regular sex and don’t use contraception. However, women become less fertile as they get older. One study found that among couples having regular unprotected sex:

• aged 19-26 – 92% will conceive after one year and 98% after two years
• aged 35-39 – 82% will conceive after one year and 90% after two years

The effect of age on men’s fertility is less clear.

What does ‘have regular sex’ mean?

Having regular sex means having sex every two to three days throughout the month.

Some couples may try to time having sex with when the woman ovulates (releases an egg). However, guidance from the National Institute for Health and Care Excellence advises that this can be stressful and is not recommended.

Fertility problems

Fertility problems affect ten to 15 percent of couples in the United States.

Lots of factors can cause fertility problems, including:

• hormonal (endocrine) disorders, such as polycystic ovary syndrome (PCOS) and problems with the thyroid or pituitary glands
• physical disorders such as obesity, anorexia nervosa or excessive exercise
• disorders of the reproductive system, such as infections, blocked fallopian tubes, endometriosis or a low sperm count

Some of these factors affect either women or men. In around 40% of infertile couples, there is a problem with both the man and woman.

The most common cause is ovulation failure (which can be caused by lots of different things) and sperm disorders. In 25% of couples, fertility problems cannot be explained.

How soon can you take a pregnancy test?

All pregnancy tests detect the hormone human chorionic gonadotrophin (hCG), which starts to be produced around six days after fertilization. When you suspect that you are pregnant, pregnancy tests are can be done reliably from the first day up to 10 days of your missed menstrual period, although some tests can detect human chorionic gonadotropin (hCG) as early as four or five days before your menstrual period is due. A urine sample collected first thing in the morning or a blood sample drawn from a vein in your arm is usually done to detect early pregnancy.

Check the packaging of your home pregnancy test kit to find out when it can be used.

If you have regular periods, you’ll probably know when your next period is due. If you’re not sure, it’s a good idea to wait at least three weeks after you think you may have conceived before doing a pregnancy test.

Pregnancy Test Preparation Needed

No test preparation is needed. However, do not drink large amounts of fluid before collecting a morning urine sample for a pregnancy test because overly diluted urine may result in a false negative; however, no preparation is needed if you’re having a pregnancy test through a blood sample drawn from a vein in your arm. A false negative pregnancy test means the test result inappropriately indicating negative pregnancy result when, in fact, you’re pregnant.

When can I take a pregnancy test?

You can carry out most pregnancy tests from the first day of a missed menstrual period. If you don’t know when your next menstrual period is due, do the test at least 21 days after you last had unprotected sex.

Some very sensitive pregnancy tests can be used even before you miss a period, from as early as eight days after conception.

You can do a pregnancy test on a sample of urine collected at any time of the day. It doesn’t have to be in the morning. However, you can improve your chances for an accurate result by using your first morning urine for the pregnancy test, because it will have more human chorionic gonadotropin (hCG) in it than in urines collected later in the day. Make sure you carefully follow the home pregnancy test kit directions. If the home pregnancy test is negative, it is often repeated several days later. Since human chorionic gonadotropin (hCG) rises rapidly, an initial negative test can turn positive within this time period. Some home pregnancy test kits come with more than one test in them to allow you to repeat the test.

I have irregular periods and don’t know when my next period will start. When should I take a pregnancy test?

Most pregnancy tests claim to be the most accurate after a missed period. But irregular periods can make it hard to predict when to take the test.

Menstrual periods are considered irregular if:

• The number of days between periods is either shorter than 21 days or longer than 35 days
• The number of days in the menstrual cycle varies from month to month. For example, your cycle may be 22 days one month and 33 days the next month.

If you have irregular periods, try counting 36 days from the start of your last menstrual cycle or four weeks from the time you had sex. At this point, if you are pregnant, your levels of human chorionic gonadotropin (hCG) should be high enough to detect the pregnancy.

If your test says you are not pregnant, but you still think you may be pregnant, wait a few more days and take another pregnancy test. Or, see your doctor for a blood test.

Home pregnancy test

A home pregnancy test kit detects the presence of human chorionic gonadotropin (hCG) and is routinely used to screen for a pregnancy. This test may be performed by a laboratory, at a doctor’s office, or at home. Methods will vary slightly but for most, a test strip is dipped into a collected cup of urine or exposed to a woman’s urine stream. A colored line (or other color change) appears within the time allotted per instructions, usually about 5 minutes. For accurate test results, it is important to carefully follow the test directions. If the home pregnancy test is negative, it is often repeated several days later. Since human chorionic gonadotropin (hCG) rises rapidly, an initial negative test can turn positive within this time period.

About home pregnancy testing

Errors can arise with any type of home test because of a number of possible mistakes people make in performing the test. These range from using an expired home pregnancy test kit to improper storage to errors in how you perform the home pregnancy test. Mistakes in the testing procedure often involve how you collect the urine sample, the time of day you collect it, or how precisely you time the test (not waiting long enough or waiting too long before reading the result). Even the impact of medications you may be taking may interfere with the home pregnancy test results and may be a source of error to be considered.

Many times, results from pregnancy tests may be invalid. Studies have found that one in four women misread traditional, line-based home pregnancy tests, where the user evaluates the appearance of a colored line to determine whether the test is positive or negative.

With the possibility of these various errors, your healthcare practitioner will most likely want to confirm the result of a home pregnancy test to ensure its validity before proceeding with any course of action or treatment. While some follow-up procedures from erroneous home pregnancy test results can be viewed simply as inconvenient, others may be costly or have serious implications. That’s why a healthcare provider will often choose to repeat even a seemingly straight-forward home pregnancy test.

How accurate are home pregnancy tests?

Most home pregnancy tests claim to be up to 99% accurate. But the accuracy depends on:

• How you use them. Be sure to check the expiration date and follow the instructions. Wait up to 10 minutes after taking the test to check the results window. Research suggests that waiting 10 minutes will give the most accurate result.
• When you use them. The amount of human chorionic gonadotropin (hCG) or pregnancy hormone in your urine increases with time. The earlier you take the test, the harder it is for the test to detect the hCG. Most home pregnancy tests can accurately detect pregnancy after a missed period. Also, testing your urine first thing in the morning can boost the accuracy.
• Who uses them. Each woman ovulates at a different time in her menstrual cycle. Plus, the fertilized egg can implant in a woman’s uterus at different times. Your body makes human chorionic gonadotropin (hCG) after implantation occurs. In up to 10% of women, implantation does not occur until after the first day of a missed period. This means home pregnancy tests can be accurate as soon as 1 day after a missed period for some women but not for others.
• The brand of the home pregnancy test kit. Some home pregnancy tests are more sensitive than others. For that reason, some tests are better than others at detecting human chorionic gonadotropin (hCG) early on. Talk to your pharmacist about which brand may be best for you.

What should I consider when buying a pregnancy test?

Make sure that the pregnancy test you are purchasing is U.S. Food and Drug Administration (FDA)-approved.

The FDA requires manufacturers to meet stringent controls for quality, precision, and accuracy. Approved pregnancy test tests must also meet U.S. Food and Drug Administration (FDA) labeling requirements.

• For all over-the-counter (OTC) U.S. Food and Drug Administration (FDA) approved home pregnancy test kits, please go here to find details about each product: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfIVD/Search.cfm

According to the U.S. Food and Drug Administration (FDA) ¹, the accuracy of home pregnancy test depends on how well you follow the instructions and interpret the results. “If you mishandle or misunderstand the home pregnancy test kit, you may get poor results. Most pregnancy tests have about the same ability to detect hCG, but their ability to show whether or not you are pregnant depends on how much hCG you are producing. If you test too early in your cycle or too close to the time you became pregnant, your placenta may not have had enough time to produce hCG. This would mean that you are pregnant but you got a negative test result. Because many women have irregular periods, and women may miscalculate when their period is due, 10 to 20 pregnant women out of every 100 will not detect their pregnancy on the first day of their missed period”.

Other things to consider when buying a home pregnancy test kit:

• Cost. Home pregnancy tests come in many different types. Most stores sell them over the counter (without a doctor’s prescription). The cost varies depending on the brand and how many tests come in the box.
• Accuracy. Most tests can be taken as soon as you miss your period. Some newer, more expensive tests say they can be used 4 or 5 days before your period. Even so, they claim the best accuracy only after the date of your expected period.

When should I take a home pregnancy test?

Many home pregnancy tests claim to be accurate as early as the first day of a missed period — or even before. You’re likely to get more accurate results, however, if you wait until after the first day of your missed period or, better yet, one week after your missed period.

Why wait?

Shortly after a fertilized egg attaches to your uterine lining (implantation), the placenta forms and produces the hormone human chorionic gonadotropin (HCG). This hormone enters your bloodstream and urine. During early pregnancy, the human chorionic gonadotropin (hCG) concentration increases rapidly — doubling every two to three days. The earlier you take the home pregnancy test, the harder it might be for the test to detect human chorionic gonadotropin (hCG). Keep in mind that the exact timing of ovulation might vary among women or even from month to month, and the fertilized egg can implant in the uterus at different times. This can affect when human chorionic gonadotropin (hCG) production begins and becomes detectable.

If it’s important to confirm your pregnancy right away, depending on how far along you are in your pregnancy, your health care provider might recommend that you have an ultrasound, repeat a urine test in the hospital or clinic lab, or have a blood test to measure your human chorionic gonadotropin (hCG).

How do you do home pregnancy test?

For most home pregnancy tests, you either hold a test strip in your urine stream or you collect your urine in a cup and dip your test strip into the cup. If you are pregnant, most test strips produce a colored line, but this will depend on the brand you purchased. Read the instructions for the test you bought and follow them carefully. Make sure you know how to get good results. The test usually takes only about 5 minutes.

The different tests for sale vary in their abilities to detect low levels of human chorionic gonadotropin (hCG). For the most reliable results, test 1-2 weeks after you miss your period. There are some tests for sale that are sensitive enough to show you are pregnant before you miss your period.

You can improve your chances for an accurate result by using your first morning urine for the test. If you are pregnant, it will have more human chorionic gonadotropin (hCG) in it than later urines. If you think you are pregnant, but your first test was negative, you can take the test again after several days. Since the amount of human chorionic gonadotropin (hCG) increases rapidly when you are pregnant, you may get a positive test on later days. Some test kits come with more than one test in them to allow you to repeat the test.

Are there different types of home pregnancy tests?

With most tests, you place the end of a dipstick in your urine stream or immerse the dipstick in a container of collected urine. A few minutes later, the dipstick reveals the test result — often as a plus or minus sign, one line or two lines, or the words “pregnant” or “not pregnant” on a strip or screen.

However, some home pregnancy tests are more sensitive than others. In other words, in some tests the amount of human chorionic gonadotropin (hCG) needed to be detected in the urine to produce a positive test result is lower.

Always check the test’s expiration date and read the instructions carefully before you take the test.

How accurate are home pregnancy tests?

Many home pregnancy tests claim to be 99 percent accurate. However, research suggests that many home pregnancy tests are not sensitive enough to diagnose pregnancy in women who have recently missed a period. For the most reliable results, wait to take the test until one week after your missed period.

Can anything affect home pregnancy test results?

Yes. If you take medicine with the pregnancy hormone human chorionic gonadotropin (hCG) as an active ingredient, you may get a false-positive test result. A false positive is when a test says you are pregnant when you are not.

Some examples of medicines with human chorionic gonadotropin (hCG) include certain medicines for infertility. If you are taking medicine to help you get pregnant, you may want to see your doctor for a pregnancy test.

Most medicines should not affect the results of a home pregnancy test. This includes over-the-counter and prescription medicines such as birth control and antibiotics. Also, alcohol and illegal drugs do not affect pregnancy test results.

Could medications interfere with pregnancy test results?

Fertility drugs or other medications that contain human chorionic gonadotropin (hCG) might interfere with home pregnancy test results. However, most medications, including antibiotics and birth control pills, don’t affect the accuracy of home pregnancy tests.

Some medications can affect home pregnancy test results, including:

• promethazine – used to treat conditions such as allergies
• medicines used to treat Parkinson’s disease
• sleeping tablets (hypnotics)
• tranquillizers
• diuretics (medicines that increase the amount of urine produced) – used to treat conditions such as heart failure
• anticonvulsants (medicines that prevent seizures or fits) – used to treat conditions such as epilepsy
• medicines used for infertility

If you’re taking any medication, the patient information leaflet that comes with it will tell you if it affects test results. You can also ask a pharmacist.

What does the home pregnancy test result mean?

A negative human chorionic gonadotropin (hCG) result means that it is unlikely that a woman is pregnant. However, pregnancy tests performed too early in a pregnancy, before there is a significant human chorionic gonadotropin (hCG) level, may give false-negative results. The pregnancy test may be repeated a few days later if there is a strong possibility of pregnancy.

• A positive human chorionic gonadotropin (hCG) means that a woman is likely pregnant. A home pregnancy test can tell whether you are pregnant with almost 99% accuracy, depending on how you use it. If a pregnancy test says you are pregnant, you should see your doctor for another test to confirm the pregnancy and talk about next steps.
• If you get a positive home pregnancy test result on the first day of your missed period, it’s probably about two weeks since you conceived.

Although rare, it’s possible to get a positive result from a home pregnancy test when you’re not actually pregnant. This is known as a false-positive.

A false-positive might happen if you had a pregnancy loss soon after the fertilized egg attached to your uterine lining (biochemical pregnancy) or you take a pregnancy test too soon after taking a fertility drug that contains human chorionic gonadotropin (hCG). An ectopic pregnancy, menopause or problems with your ovaries also might contribute to misleading test results.

The blood level of human chorionic gonadotropin (hCG) in a woman with an ectopic pregnancy usually rises at a slower rate than normal. Those with failing pregnancies will also frequently have a longer doubling time early on or may even show falling human chorionic gonadotropin (hCG) concentrations during the doubling period. Human chorionic gonadotropin (hCG) concentrations will drop rapidly following a miscarriage. If human chorionic gonadotropin (hCG) does not fall to undetectable levels, it may indicate remaining human chorionic gonadotropin (hCG)-producing tissue that will need to be removed (dilation and curettage – D&C).

Do negative test results mean that you are not pregnant?

No. It’s possible to get a negative result from a home pregnancy test when you’re actually pregnant. This is known as a false-negative and it’s much more likely to occur than is a false-positive. You might get a false-negative if you:

• Take the home pregnancy test too early. If you tested too early in your cycle, your placenta may not have had time to produce enough human chorionic gonadotropin (hCG) for the test to detect. Or, you may not have waited long enough before you took this test. The earlier after a missed period that you take a home pregnancy test, the harder it is for the test to detect human chorionic gonadotropin (hCG). For the most accurate results, take the test one week after a missed period — when the level of human chorionic gonadotropin (hCG) in your urine is most likely to be detectable. If you can’t wait that long, ask your health care provider for a blood test.
• Check home pregnancy test results too soon. Be sure to give the test time to work. Consider setting a timer according to the package instructions.
• Use diluted urine. For the most accurate results, take the test first thing in the morning — when your urine is the most concentrated.

If you have a negative result, you would be wise to consider this a tentative finding. You should not use medications and should consider avoiding potentially harmful behaviors, such as smoking or drinking alcohol, until you have greater certainty that you are not pregnant.

You will probably recognize incorrect results with the passage of time. You may detect false negatives by the unexpected onset of menses (regular vaginal bleeding associated with “periods”.) Repeat testing and/or other investigations such as ultrasound may provide corrected results.

My pregnancy test says I am not pregnant. Could I still be pregnant?

Yes, it is possible you could still be pregnant. It’s possible to be pregnant and to have a pregnancy test show that you are not pregnant.

The accuracy of home pregnancy test results varies from woman to woman because:

• Each woman ovulates at a different time in her menstrual cycle.
• The fertilized egg can implant in a woman’s uterus at different times.
• Sometimes women get false-negative results when they test too early in the pregnancy. False negative means the test says you are not pregnant when you are.
• Problems with the pregnancy can affect the amount of human chorionic gonadotropin (hCG) in the urine.

If a test says you are not pregnant, take another pregnancy test in a few days. If you are pregnant, your human chorionic gonadotropin (hCG) levels should double every 48 hours. If you think you are pregnant but more tests say you are not, see your doctor.

What if I can’t tell whether my pregnancy test is positive or negative?

Sometimes it can be hard to tell whether the pregnancy test is positive or negative. The line may be faint, or you may worry whether you peed too much or too little on the stick.

No matter how faint the line or plus sign, if you see it, you are most likely pregnant. The faintness of the line can mean you are early in your pregnancy and your human chorionic gonadotropin (hCG) levels are still low.

Also, the pregnancy test should have a control line that tells you whether the test was done correctly. If the control line is blank, then the test did not work and you should take another test.

Is there anything else I should know about home pregnancy test?

Blood or protein in the urine may cause false-positive pregnancy results. A false-positive pregnancy test means the test result inappropriately indicating a positive pregnancy test when, in fact, you’re not pregnant.

Urine human chorionic gonadotropin (hCG) tests may give a false-negative result if the urine is too diluted or if testing is done too soon in the pregnancy. A false negative pregnancy test means the test result inappropriately indicating negative pregnancy result when, in fact, you’re pregnant.

Certain drugs such as diuretics and promethazine (an antihistamine) may cause false-negative urine pregnancy test results. Other drugs such as anti-convulsants, anti-parkinson drugs, hypnotics, and tranquilizers may cause false-positive pregnancy test results. The presence of protein in the urine (proteinuria), blood in the urine (hematuria), or excess pituitary gonadotropin may also cause a false positive pregnancy test.

Furthermore, there are reports of false-positive blood human chorionic gonadotropin (hCG) results due to the presence of certain types of antibodies that some individuals produce or fragments of the human chorionic gonadotropin (hCG) molecule. Generally, if results are questionable, they may be confirmed by testing with a different method.

How does the pregnancy test that I do at home myself compare with the results of a pregnancy test done in a lab?

Home pregnancy testing is very similar to qualitative urine human chorionic gonadotropin (hCG) testing performed in the laboratory, but there are factors surrounding its use that are important to note.

• Home pregnancy test kits come with very specific directions that must be followed explicitly. If you are using a home pregnancy test kits, follow the directions extremely carefully. There can also be variability in sensitivity to detecting the presence of human chorionic gonadotropin (hCG) with different brands of home pregnancy test kits.
• Home pregnancy tests are sometimes done too soon after the missed menstrual cycle to result in a positive test. It typically takes 10 days after a missed menstrual period before the presence of human chorionic gonadotropin (hCG) can be detected by the urine pregnancy test.
• All urine human chorionic gonadotropin (hCG) tests should be done on a first morning urine sample, if possible. Urine becomes more dilute after ingestion of liquids (coffee, juice, water, etc.) and urine human chorionic gonadotropin (hCG) concentrations may become too low to register as positive.

Generally, when used correctly, the home pregnancy test should produce the same result as the urine human chorionic gonadotropin (hCG) test done by your health practitioner. Blood testing for human chorionic gonadotropin (hCG) is more sensitive than urine human chorionic gonadotropin (hCG) testing, so sometimes a blood test will indicate pregnancy when the urine test is negative.

My pregnancy test says I am pregnant. What should I do next?

If a home pregnancy test shows that you are pregnant, you should call your doctor to schedule an appointment.

Your doctor can use a blood test to tell for sure whether you are pregnant. Seeing your doctor early in your pregnancy also means you can begin prenatal care to help you and your baby stay healthy.

What happens next?

Based on your home pregnancy test results, consider taking the following steps:

• Your home pregnancy test is positive, or you’ve taken a few home pregnancy tests and gotten mixed results. Make an appointment with your health care provider. You might need a blood test or ultrasound to confirm your pregnancy. The sooner your pregnancy is confirmed, the sooner you can begin prenatal care.
• Your home pregnancy test is negative. If your period doesn’t begin, repeat the test in a few days or one week — especially if you took the test before or shortly after a missed period.
• You continue to get negative test results, but your period doesn’t begin or you still think you might be pregnant. Check with your health care provider. Many factors can lead to missed menstrual periods (amenorrhea), including thyroid disorders, low body weight, problems with your ovaries, excessive exercise and stress. If you’re not pregnant, your health care provider can help you get your menstrual cycle back on track.

Continuing with the pregnancy

If you’re pregnant and want to continue with the pregnancy, contact your doctor or a midwife to start your prenatal care. Prenatal care is the health care you get while you are pregnant. It includes medical care, education, and counseling. The earlier you get prenatal care, the better your chances are for a healthy pregnancy and baby.

Urine and blood samples will be taken on the first visit and again at later visits. Urine tests check for bacteria, high sugar levels (which can be a sign of diabetes), and high protein levels (which can be a sign for preeclampsia, a type of high blood pressure during pregnancy). Blood tests check for blood cell count, blood type, low iron levels (anemia) and infectious diseases (such as syphilis, HIV, and hepatitis).

The doctor may do other tests at your first visit. These may vary based on your background and risk for problems. Tests can include:

• A pelvic exam to check the size and shape of your uterus (womb).
• A Pap smear to screen for cervical cancer.
• An ultrasound to view your baby’s growth and position. An ultrasound uses sound waves to create an image of your baby on a video screen.

After your first visit, you will have a prenatal visit every 4 weeks. In months 7 and 8, you will have a visit every 2 weeks. In your last month of pregnancy, the visits will occur each week until you deliver your baby. At each visit, the doctor will check your weight and blood pressure and test your urine. The doctor will listen to your baby’s heartbeat and measure the height of your uterus in your abdomen after the 20th week. You should always discuss any issues or concerns you have with your doctor.

Things to consider

There are several things you should avoid while you are pregnant. Take notice to follow this list of warnings. Talk to your doctor if you need help.

• Do not smoke. Smoking raises your risk for miscarriage, preterm birth, low birth weight, and other health problems.
• Do not use drugs. Cocaine, heroin, marijuana, and other drugs increase your risk of miscarriage, preterm birth, and birth defects. Your baby could be born addicted to the drug you’ve been abusing. This is called neonatal abstinence syndrome. It can can cause severe health problems for your baby.
• Do not drink alcohol. Drinking alcohol is the major cause of preventable birth defects, including fetal alcohol disorder.
• Do not clean your cat’s litter box or eat raw or undercooked red meat. You could get toxoplasmosis, a disease that can cause birth defects.
• Do not douche. Your vagina doesn’t require cleansing in addition to normal bathing. Douching disrupts the helpful bacteria that keep your vagina clean.

When to see a doctor

See your doctor if you have:

• blood or fluid coming from your vagina
• sudden or extreme swelling of your face or fingers
• headaches that are severe or won’t go away
• nausea and vomiting that won’t go away
• dizziness
• dim or blurry vision
• severe pain or cramps in your lower abdomen
• chills or fever
• a change in your baby’s movements
• less urine or burning when you urinate
• an illness or infection
• any other symptoms that bother you.

Questions to ask your doctor:

• What medicines can I take during pregnancy?
• When should I start taking a prenatal vitamin? What kind is best?
• How much folic acid do I need to take each day?
• How can I prevent or reduce swelling?
• How much weight should I gain while pregnant?

How much weight should I gain during pregnancy?

Talk to your doctor about how much weight you should gain. It is different for everyone, but most women should gain about 25 to 30 pounds. If you are underweight when you get pregnant, you may need to gain more. If you are overweight, you may need to gain less.

What should I eat?

Eating a balanced diet is one of the best things you can do for yourself and your baby. Be careful of the following foods and drinks during pregnancy.

• Meat, eggs, and fish. Food that is not fully cooked can put you at risk for an Do not eat more than 2 or 3 servings of fish per week (including canned fish).
• Do not eat shark, swordfish, king mackerel, or tilefish. These fish have high levels of mercury, which can harm your baby. If you eat tuna, make sure it is light tuna. Do not eat more than 6 ounces of albacore tuna and tuna steaks per week. It is safe to have 12 ounces of canned light tuna per week.
• Fruit and vegetables. Wash all produce before eating it. Keep cutting boards and dishes clean.
• Dairy. Eat 4 or more servings of dairy each day. This will give you enough calcium for you and your baby. Do not drink unpasteurized milk or eat unpasteurized milk products. These may have bacteria that can cause infections. This includes soft cheeses such as Brie, feta, Camembert, and blue cheese, or Mexican-style cheeses, such as queso fresco.
• Sugar substitutes. Some artificial sweeteners are okay in moderation. These include aspartame (brand names: Equal or NutraSweet) and sucralose (brand name: Splenda). If you have phenylketonuria (PKU), do not use aspartame at all.
• Caffeine. Do not drink more than 1 or 2 cups of coffee or other drinks with caffeine each day.

Can I take medicine?

Check with your doctor before taking any medicine. This includes prescriptions, pain relievers, and over-the-counter medicines. Some medicines can cause birth defects, especially if taken during the first 3 months of pregnancy.

Can I take vitamins?

Pregnant women should take at least 400 micrograms (mcg) of folic acid (folate) each day. It can help prevent problems with your baby’s brain and spinal cord. Ask your doctor if you need more than 400 mcg.

It is best to start taking folic acid before you get pregnant. You can get folic acid from taking a prenatal vitamin. You should take this every day. Do not take other vitamins or supplements without your doctor’s approval.

How long can I keep working?

How late you work in pregnancy varies for each person. Your job and work environment play a big role. For instance, radiation, lead and other materials, such as copper and mercury, can be harmful to your baby. If your job is active, you may not be able to work as late. Desk jobs are not thought to cause harm to your baby. However, you should not rest a computer on your stomach or uterus.

Your overall health also plays a part in how late you work. If you are at risk of certain issues or preterm labor, you may be on bed rest.

What about exercise?

Unless you have issues during pregnancy, you should get regular exercise. Exercise promotes a healthy lifestyle and can help ease discomfort. Try to get at least 30 minutes of exercise each day. Talk to your doctor about any conditions that may prevent exercise.

Some women say exercising while you are pregnant makes labor and delivery easier. Walking and swimming are great choices. If you were not active before pregnancy, start slowly. Listen to your body and do not overdo it. Drink plenty of water to prevent overheating or dehydration. It is best to avoid exercises that may cause you to fall. This includes skiing and rock climbing. You also should avoid contact sports, such as soccer or basketball. If you were active before pregnancy, it is probably safe to continue. Ask your doctor if you have any concerns.

See your doctor if you have symptoms with exercise, such as:

• blurred vision
• dizziness
• chest pain
• stomach pain.

Can I have sex?

It is safe to have sex while you are pregnant. However, talk to your doctor if you have concerns or are at risk for problems. Some women’s level of interest in sex changes when they are pregnant. As you grow, you may need to try different positions, such as lying on your side or being on top.

What can I do to feel better?

Below are common side effects of pregnancy with tips on how to manage them.

• Morning sickness

Nausea or vomiting may strike anytime during the day (or night). Try eating frequent, small meals. Avoid foods that are greasy, spicy or acidic. Some women are more nauseous when their stomach is empty. Keep crackers nearby to prevent an empty stomach. Talk to your doctor if morning sickness causes you to lose weight or lasts past the first 3 months of pregnancy.

• Tiredness

Fatigue is very common when you are pregnant. Try to get enough rest or take a nap if possible. Talk to your doctor if you have symptoms with fatigue. You may have anemia.

• Leg cramps

Being active can help reduce leg cramps. Stretch the calf of your leg by flexing your foot toward your knee.

• Constipation

Drink plenty of fluids. Eat foods with lots of fiber, such as fruits, vegetables, and bran cereal. Do not take laxatives without talking to your doctor first. Stool softeners may be safer than laxatives.

• Hemorrhoids

Try to avoid becoming constipated. Do not strain during bowel movements. Clean yourself well after a bowel movement. Wet wipes may feel better than toilet paper. Take warm soaks (sitz baths) if necessary.

• Urinating more often

You may need to urinate more often when you are pregnant. Changing hormones can be a factor. As your baby grows, they will put pressure on your bladder.

• Varicose veins

Avoid clothing that fits tightly around your waist or legs. Rest and put your feet up as much as you can. Avoid sitting or standing still for long periods. Ask your doctor about support or compression hose. These can help prevent or ease varicose veins.

• Moodiness

Your hormones are on a roller coaster ride during pregnancy. Plus, your whole life is changing. Don’t be too hard on yourself. Get help right away if you feel sad or think about suicide.

• Heartburn

Eat frequent, small meals. Avoid spicy, greasy or acidic foods. Do not lie down right after eating. Ask your doctor about taking antacids.

• Yeast infections

The amount of discharge from your vagina can increase during pregnancy. Yeast (Candida) infections, which can cause discharge, are common as well. Talk to your doctor if you see any unusual discharge or if it smells.

• Bleeding gums

Brush and floss regularly, and see your dentist for cleanings. Do not avoid dental visits because you are pregnant. Be sure to tell your dentist you’re pregnant.

• Stuffy nose

Changes in the levels of the female hormone estrogen can cause a stuffy nose. You may also have nosebleeds.

• Edema (retaining fluid)

Rest with your legs up as much as you can. Lie on your left side while sleeping. This position helps blood flow from your legs back to your heart better. Do not use diuretics (water pills).

• Skin changes

Stretch marks appear as red marks on your skin. Lotion with shea butter can help keep your skin moist and reduce itchy, dry skin. Stretch marks cannot be avoided. They do often fade after pregnancy.

You may have other skin changes. These can include darkening of the skin on your face or around your nipples. Some women get a dark line below their belly button. Try to stay out of the sun or use sunscreen to help lessen these marks. Most marks will fade after pregnancy.

If you’re not sure you want to be pregnant

If you’re not sure about continuing with the pregnancy, you can discuss this confidentially with a healthcare professional. Your options are:

• continuing with the pregnancy and keeping the baby
• having an abortion
• continuing with the pregnancy and having the baby adopted

As well as a doctor or a nurse, you can also get accurate, confidential information – even if you’re under 16 – from the following:

• a community sexual health clinic
• Planned Parenthood Federation of America (https://www.plannedparenthood.org/)
• American Pregnancy Association (http://americanpregnancy.org/)
• Power to Decide (https://powertodecide.org/)

References

1. Pregnancy. https://www.fda.gov/medicaldevices/productsandmedicalprocedures/invitrodiagnostics/homeusetests/ucm126067.htm