Could I Still Be Pregnant? Irregular Cycles and Testing

Are you pregnant?

Hello, doctor.
I have polycystic ovary syndrome.
My last menstrual period was from July 28 to August 4.
During my follow-up appointment, the doctor mentioned that my follicle had not grown much, measuring about 0.8 cm.
I was prescribed Clomiphene Citrate (Clomid) for five days, starting with three pills on August 18.
An ultrasound on that day showed that I had ovulated, and the doctor estimated that ovulation occurred in the morning, with an endometrial thickness exceeding 1 cm.
We were advised to have intercourse that day or the following morning.
My basal body temperature recorded on August 18 was 35.958°C, and on August 19 (after intercourse) it was 36.498°C.
I started taking a supplement (referred to as "little white ball") three times a day for 14 days, beginning August 19.

On September 1, I returned for a follow-up and took a urine pregnancy test, which came back negative.
However, as of today, September 8, my period has still not arrived, and I am still experiencing elevated temperatures.
Is there still a possibility of pregnancy? The temperatures recorded are as follows: August 18 - 35.958°C, August 19 - 36.498°C, August 20 - 36.388°C, August 21 - 36.228°C, August 22 - 36.228°C, August 23 - 36.168°C, August 24 - 36.198°C, August 25 - 36.488°C, August 26 - 36.628°C, August 27 - 36.668°C, August 28 - 36.448°C, August 29 - 36.668°C, August 30 - 36.748°C, August 31 - 36.689°C, September 1 - 36.669°C, September 2 - 36.599°C, September 3 - 36.659°C, September 4 - 36.329°C, September 5 - 36.439°C, September 6 - 36.689°C, September 7 - 36.719°C, September 8 - 36.67°C.

If the pregnancy test on September 1 was negative, does that mean I am not pregnant? Why is my period still delayed, and why am I still experiencing elevated temperatures? Should I take another pregnancy test, and if it is still negative, does that confirm that I am not pregnant? Thank you, doctor, for taking the time to respond!

Mi, 20~29 year old female. Ask Date: 2023/09/08

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it seems that you are not pregnant.
You can take another test to confirm.
Wishing you good health.

Reply Date: 2023/09/08

More Info

Dear Patient,
Thank you for your detailed inquiry regarding your concerns about the possibility of pregnancy, especially in the context of having polycystic ovary syndrome (PCOS) and irregular menstrual cycles. Your situation is indeed complex, and I appreciate your thoroughness in tracking your symptoms and temperatures.

Based on the information you provided, it appears that you have been actively monitoring your ovulation and menstrual cycle. You mentioned that your last menstrual period was from July 28 to August 4, and after a follow-up appointment on August 18, your doctor confirmed that you had ovulated. Following ovulation, you engaged in intercourse as advised, and subsequently, you began using a fertility supplement.

You conducted a urine pregnancy test on September 1, which returned negative, yet your menstrual period has not arrived, and you continue to observe elevated basal body temperatures. This situation raises a few important points to consider.

1. Understanding Irregular Cycles and PCOS: Women with PCOS often experience irregular menstrual cycles, which can make it challenging to predict ovulation and menstruation accurately. Even if you ovulated on August 18, it is possible for your cycle to be disrupted, leading to a delayed period. Hormonal fluctuations associated with PCOS can also affect the timing of your menstrual cycle and the reliability of pregnancy tests.

2. Pregnancy Testing: A negative urine pregnancy test, especially when taken after a missed period, typically indicates that you are not pregnant. However, false negatives can occur, particularly if the test is taken too early or if there are issues with the test itself. Given that you are still experiencing elevated temperatures, it may be worthwhile to wait a few more days and retest. If your period does not start and the second test is also negative, it is likely that you are not pregnant.

3. Basal Body Temperature (BBT): Your BBT readings indicate that you have maintained a higher temperature, which is often associated with the luteal phase of the menstrual cycle. If you are not pregnant, your body will eventually recognize this and your temperature will drop, leading to the onset of menstruation. However, in cases of hormonal imbalance, such as with PCOS, this process can be delayed.

4. Consulting Your Doctor: If your period does not arrive within a week or if you continue to have symptoms that concern you, I recommend reaching out to your healthcare provider. They may suggest further testing, such as a blood test for hCG (the hormone produced during pregnancy), which is more sensitive than urine tests. Additionally, they can evaluate your hormone levels to determine if there are underlying issues contributing to your irregular cycles.

5. Lifestyle and Management: Managing PCOS often involves lifestyle changes, including diet and exercise, which can help regulate your menstrual cycle and improve your overall reproductive health. Discussing these options with your healthcare provider can be beneficial.

In conclusion, while the negative pregnancy test suggests that you are likely not pregnant, the irregularity of your cycles and the persistence of elevated temperatures warrant further observation and possibly additional testing. Please consider retesting in a few days and consult your doctor if your period does not arrive or if you have any other concerns.

Wishing you the best of health,
Doctor Q&A Teams

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