Early Pregnancy Tests: What to Do When Results Are Unclear

Pregnancy test (morning urine + blood draw)

Hello, on July 2nd, I underwent a medical abortion due to the loss of my baby's heartbeat.
After that, during my follow-up appointment, the doctor said I was recovering well and could start trying to conceive again without contraception.
I had intercourse on July 20, 23, 26, 29, and August 1, 4, and 7.
On August 6, I took a morning urine pregnancy test and seemed to see a very faint second line.
On August 9, I took another morning urine pregnancy test and again seemed to see a very faint second line.
Since I really want to conceive again quickly, I went to a lab on the afternoon of August 9 to have a blood test to confirm if I was pregnant.
On August 10, I noticed a small amount of brownish discharge in the toilet, which I am unsure if it was menstrual blood or implantation bleeding.
By noon, I still had no menstruation, and the discharge did not contain any blood.
In the evening of August 10, the blood test results came back with an hCG level of only 1.6, and the technician informed me that I was not pregnant.
My question is, does this definitively mean I am not pregnant, or is there still a chance for a positive outcome? (As of now, I still have not gotten my period.)

A, 30~39 year old female. Ask Date: 2022/08/11

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, based on your description, I recommend that you consult an obstetrician-gynecologist to arrange for urine, ultrasound, or blood tests to determine if you are pregnant.
Thank you! Wishing you peace and health.
Dr.
Chang

Reply Date: 2022/08/11

More Info

When it comes to early pregnancy tests and understanding the results, it can be quite confusing, especially when the results are unclear or when there are symptoms that could indicate either pregnancy or an impending menstrual cycle. Based on your situation, let's break down the key points and provide some clarity.

Firstly, it’s important to understand how home pregnancy tests work. These tests detect the presence of human chorionic gonadotropin (hCG), a hormone produced during pregnancy. Typically, hCG levels rise rapidly in early pregnancy, doubling approximately every 48 to 72 hours. A faint line on a home pregnancy test can indicate a low level of hCG, which may suggest early pregnancy, but it can also be a sign of a chemical pregnancy or a very early miscarriage.

In your case, you mentioned that you had a very faint line on your tests on 8/6 and 8/9. This could indicate that you are in the early stages of pregnancy, but the faintness of the line suggests that the hCG levels might still be low. The fact that you had a medical abortion on 7/2 and are now trying to conceive again adds another layer of complexity, as it can take some time for your hormone levels to return to baseline after a miscarriage or abortion.

On 8/10, you reported a blood test result showing an hCG level of only 1.6. Generally, an hCG level below 5 mIU/mL is considered negative for pregnancy, while levels above 25 mIU/mL are typically considered positive. An hCG level of 1.6 indicates that you are not pregnant, as it is well below the threshold for a positive result. However, it’s worth noting that hCG levels can vary, and sometimes very early pregnancies may not register on a blood test if the levels are still too low.

The presence of a small amount of brown discharge you experienced could be related to several factors. It might be implantation bleeding, which can occur when a fertilized egg attaches to the uterine lining, but given your low hCG level, this is less likely. It could also be a sign of hormonal fluctuations as your body adjusts after the recent abortion. If your period does not arrive soon, it may be wise to consult with your healthcare provider for further evaluation.

In summary, based on the information provided, it seems that the blood test result of hCG 1.6 indicates that you are not currently pregnant. However, if you continue to experience symptoms or if your period does not arrive, it would be advisable to follow up with your healthcare provider. They may recommend further testing or monitoring to ensure that your body is healing properly and to discuss your plans for conceiving again.

In the future, if you suspect you might be pregnant, it’s best to wait a few days after a missed period to take a home pregnancy test or to have a blood test done, as this will provide a more accurate result. If you have any concerns about your menstrual cycle or fertility, don’t hesitate to reach out to a healthcare professional who can provide personalized advice and support.

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