Pregnancy Chances: Symptoms and Testing Guidance

Possibility of Pregnancy

Hello, doctor.
I would like to ask if there is a possibility of pregnancy in the following situation: From February to April this year, I had several instances of unprotected intercourse, but there was no ejaculation.
Additionally, from March to June, I had multiple instances of protected intercourse, during which the male partner ejaculated inside the condom.
We did not thoroughly check if the condom had broken, but there was no noticeable leakage.
Concerned about sexually transmitted infections, I visited a gynecologist in mid-April and had an ultrasound; at that time, it was only five days after the last unprotected intercourse, and everything appeared normal, with no signs detected on the ultrasound.
After seeing the doctor, I had one more instance of unprotected intercourse, and since then, all encounters have been protected.
From June until now, there has been no sexual activity of any kind.
Recently, I have been feeling nauseous, particularly fatigued, and I often feel and hear gastrointestinal motility (I found online that fetal movement feels like this, and if I were pregnant, I would be at a stage where fetal movement could begin, which worries me).
However, my menstrual cycle has been regular every month, with only a slight delay the month after the first sexual encounter, but since then, it has been consistently on time, with no changes in flow or color.
Currently, my abdomen is not swollen, and there has been no significant weight gain.
I would like to know if the nausea, fatigue, and gastrointestinal motility sensations could indicate pregnancy based on the above circumstances.
Is the result of a home pregnancy test (four months after the last protected intercourse and six months after unprotected intercourse) still reliable? If the result is negative, would you recommend visiting a gynecologist for further confirmation? Since late April, I have been experiencing low-grade fevers.
After seeing a gynecologist, I was still concerned about STIs, so three months after the last unprotected intercourse, I went to a large hospital in late July and had two blood tests for HIV and syphilis (on the same day, at different hospitals), both of which were negative.
Can I trust these results? I am still frequently experiencing low-grade fevers and am worried that it might be caused by an STI or pregnancy leading to elevated body temperature.
Finally, should I see a gynecologist or another specialist for my current symptoms (nausea, fatigue, gastrointestinal issues, low-grade fever)? Is it necessary to confirm pregnancy or STIs with a gynecologist? Thank you for reading, and I appreciate your help!

Meng Meng, 20~29 year old female. Ask Date: 2019/11/05

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the early stages of pregnancy may not present specific symptoms, and subjective symptoms alone cannot be used to determine pregnancy.
If you are concerned about the accuracy of a home pregnancy test, it is advisable to consult an obstetrician-gynecologist for an ultrasound and urine test to confirm whether you are pregnant.
If you are not pregnant and symptoms persist, further evaluation by a gastroenterologist may be necessary.
Additionally, some sexually transmitted infections can have a latency period of up to six months, so it is recommended to follow up again in two months.
Thank you! Wishing you safety and health.
Dr.
Zhang

Reply Date: 2019/11/05

More Info

When considering the possibility of pregnancy, especially after engaging in unprotected sexual intercourse, it is essential to understand the various factors that can influence the outcome. Based on your description, you have had multiple instances of sexual activity, both with and without protection, and you are experiencing symptoms that could be associated with pregnancy. However, it is also crucial to consider other potential causes for these symptoms.

Firstly, the symptoms you mentioned—nausea, fatigue, and gastrointestinal sensations—can indeed be indicative of early pregnancy. However, they can also be attributed to other factors such as stress, anxiety, hormonal fluctuations, or even gastrointestinal issues unrelated to pregnancy. The fact that you have been experiencing these symptoms alongside a regular menstrual cycle is significant. A regular menstrual cycle is often a strong indicator that you are not pregnant, especially if your periods have been consistent in timing, flow, and color.

Regarding the use of a home pregnancy test, it is important to note that these tests are generally reliable when used correctly. However, the accuracy can depend on the timing of the test in relation to your menstrual cycle. Since you mentioned that it has been four months since your last unprotected sexual encounter, if you have not had any missed periods during this time, the likelihood of being pregnant is low. If you take a pregnancy test and it shows a negative result, it is usually considered accurate, especially if you follow the instructions carefully.

If you are still concerned about the possibility of pregnancy or if you continue to experience symptoms such as low-grade fever, it may be beneficial to consult a healthcare provider. They can perform a more sensitive blood test for pregnancy, which can detect lower levels of the hormone hCG (human chorionic gonadotropin) than home tests. Additionally, they can evaluate your symptoms more thoroughly to rule out any other underlying conditions, including potential sexually transmitted infections (STIs).

Given your ongoing low-grade fever and concerns about STIs, it is advisable to seek medical attention. A healthcare provider can conduct the necessary tests to ensure that you are healthy and to address any concerns you may have about infections. It is also worth noting that while your previous STI tests came back negative, if you have new symptoms or if there has been any change in your sexual health, it is prudent to get re-evaluated.

In summary, while your symptoms may suggest pregnancy, the regularity of your menstrual cycle and the negative home pregnancy test are strong indicators against it. However, given your ongoing symptoms and concerns about STIs, it is wise to consult a healthcare provider for a comprehensive evaluation. They can provide you with the necessary tests and reassurance, helping you to understand your health status better and address any potential issues.

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