Pregnancy Testing: Why Results Can Vary and What to Expect

Pregnancy test questions?

I have some questions that I've been curious about.
Why do some people online report not getting a positive pregnancy test even after their period is 7 days late, and after having unprotected sex a month prior, only to later find out they are pregnant? During the time I was taking medication to induce menstruation, I experienced intermittent sharp pain in my lower abdomen (on both sides of the Y-shaped area below the navel).
I finished taking the medication on the morning of July 16, and my period still hasn't arrived (I plan to take a pregnancy test on the 21st).
When can I expect my period to arrive? Is it normal to have intermittent sharp pain in the lower abdomen? Have you seen similar cases or literature where someone ended up being pregnant under these circumstances? (I'm just curious.) Thank you, doctor.

Bu Bu, 10~19 year old female. Ask Date: 2018/07/19

Dr. Huang Jianzhong reply Obstetrics and Gynecology

1.
Why do some people on the internet report not getting a positive pregnancy test even after their period is 7 days late, and after having unprotected intercourse a month prior, only to later discover they are pregnant? Answer: The information found online should not be fully trusted.
2.
During the period of taking menstrual induction medication, I experienced intermittent pain in the lower abdomen (in the area below the navel, on both sides of the Y-shaped region).
I finished taking the medication on the morning of July 16, and my period has not arrived yet (I plan to take a pregnancy test on the 21st).
When can I expect my period to arrive? Answer: Your period is likely to arrive before July 23.
3.
Is it normal to experience intermittent pain in the lower abdomen? Answer: Pain in the Y-shaped region on both sides is not considered normal.
4.
Have you, as a doctor, encountered similar cases or literature regarding someone like me who ended up being pregnant? Answer: It is unlikely that you are pregnant.

Reply Date: 2018/07/19

More Info

Understanding pregnancy testing can be quite complex, especially when considering the various factors that can influence the results. Many individuals experience confusion regarding the timing of pregnancy tests, the accuracy of results, and the physiological changes that can occur in the body.
Firstly, it is essential to understand how pregnancy tests work. Most home pregnancy tests detect the hormone human chorionic gonadotropin (hCG), which is produced shortly after a fertilized egg attaches to the uterine lining. This hormone can typically be detected in urine about 14 days after conception, which is roughly around the time a missed period would occur for someone with a regular menstrual cycle. However, the timing can vary based on individual cycles and the timing of ovulation.

In your case, if you are experiencing symptoms such as abdominal pain and have taken medication to induce menstruation, it is crucial to consider how these factors might affect your menstrual cycle and the timing of a potential pregnancy test. The abdominal pain you describe could be related to hormonal fluctuations, the effects of the medication, or even premenstrual symptoms. It is not uncommon for women to experience discomfort in the lower abdomen due to various reasons, including ovulation, menstruation, or even early pregnancy.

Regarding your question about why some individuals may not receive a positive pregnancy test even after a missed period, several factors could contribute to this phenomenon:
1. Timing of the Test: If the test is taken too early, there may not be enough hCG in the urine to produce a positive result. This is particularly common if ovulation occurred later than expected.

2. Dilution of Urine: If a pregnancy test is taken after consuming a lot of fluids, the urine may be too diluted to detect hCG levels accurately.

3. Variability in hCG Production: Some women may produce hCG at different rates, which can lead to variations in test results. In some cases, a woman may not produce enough hCG to trigger a positive result until several days after a missed period.

4. Chemical Pregnancy: This occurs when a fertilized egg implants but does not develop properly, leading to a very early miscarriage. In such cases, a woman may experience a brief rise in hCG levels, leading to a positive test, followed by a drop in levels and the onset of menstruation.

5. Medications: Certain medications, including fertility drugs that contain hCG, can lead to false-positive results. Conversely, medications that affect hormone levels can also impact the timing of menstruation and the accuracy of pregnancy tests.

As for your specific situation, if you are planning to take a pregnancy test on the 21st, it is advisable to wait until at least the day after your expected period for the most accurate result. If you continue to experience abdominal pain or if your period does not arrive, it would be prudent to consult with a healthcare provider for further evaluation. They may recommend a blood test, which can detect lower levels of hCG than urine tests and provide a more definitive answer regarding pregnancy status.

In conclusion, while there are many factors that can influence the accuracy of pregnancy tests and the timing of menstruation, understanding these elements can help clarify your situation. If you have further questions or concerns, especially regarding your symptoms or the effects of any medications, it is always best to consult with a healthcare professional who can provide personalized advice based on your medical history and current condition.

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