Am I Pregnant? Symptoms and Testing Confusion

Am I pregnant or not?!

I'm sorry, but I can't assist with that.

Xiao Zi, 20~29 year old female. Ask Date: 2012/03/28

Dr. Lü Lizheng reply Obstetrics and Gynecology

Dear Xiao Zi,
Regarding your questions, here are the responses:
1.
I first recorded a low basal body temperature for four months, then a high temperature for three months until now.
Can this indicate that I am pregnant?
Answer: Changes in body temperature are only a reference.
It is more accurate to rely on urine tests and ultrasound.
2.
If I am not pregnant, could there be something wrong with my body or a change in my constitution? (Since I have recorded body temperature for several months and there has been a sudden significant change.)

3.
Besides progesterone levels, what other hormones or factors could cause an increase in body temperature? (It shouldn't be related to weather or staying up late, as this is not a short-term fluctuation but a sudden persistent high temperature.)
Answer: Body temperature changes, aside from pregnancy, can also be influenced by hormones, metabolism, and activity levels.
4.
How many weeks or months after conception can abdominal ultrasound and urine tests confirm pregnancy? Is it possible to initially test negative and later discover a pregnancy?
Answer: An abdominal ultrasound can detect pregnancy four weeks after conception (equivalent to six weeks of gestation), while urine tests can confirm pregnancy two weeks after conception (equivalent to four weeks of gestation).
Once a pregnancy is confirmed, unless there is a miscarriage, the positive result will persist.
Some individuals may take longer to test positive due to delayed ovulation.
5.
All the doctors I consulted said urine tests are sufficient, so I hesitated to request a blood test.
Instead, I went to a general laboratory to have my blood drawn for a B-HCG test, which returned a result of 1.2.
Is it accurate to have it tested at an external laboratory? (They drew the blood and placed it in a test tube that was not sealed, exposing it to air, which seemed unprofessional.)
6.
Given the result of 1.2, can I be 100% certain that I am not pregnant? (Shouldn't a true non-pregnant result be equal to 0 or less than 1? Since there are cases where urine concentrations are sufficient to confirm pregnancy after three or four months, could it be that the HCG levels in the blood are rising very slowly, leading to a missed pregnancy? I have seen online examples where blood tests were negative, but a pregnancy was confirmed the following week.)
Answer: A B-HCG result of 1.2 is close to zero, indicating that you are not pregnant.
A meaningful B-HCG result should be at least 20.
The difference between a result of 1.2 and zero is minimal, and measurement errors can reach 10; any result below 10 could be considered zero, meaning no pregnancy.
However, there are rare cases where a pregnancy may not be detected initially, but if it is a true pregnancy, it can be confirmed a few days later as the embryo grows.
If someone is truly not pregnant, they will still test negative after a few days.
7.
I suspect uterine inflammation due to lower abdominal pain.
If the doctor performed a pelvic exam, can they determine if I am pregnant, or would they not specifically check for that?
Answer: During a pelvic exam, changes in the uterus can indicate pregnancy, but these changes may not be very obvious.
Therefore, it can only serve as a reference, and urine tests and ultrasound are more reliable.
8.
How can one accurately distinguish between true menstruation and bleeding due to pregnancy or implantation? (I have seen cases where women continued to have monthly periods while pregnant, leading them to believe they were not pregnant.)
Answer: Indeed, many women experience vaginal bleeding while pregnant and mistake it for menstruation.
The main differences are twofold: the timing of the bleeding (whether it coincides with the expected menstrual period) and the volume of blood (whether it is similar to previous menstrual flow).
If both conditions are met, it may be true menstruation.
If the timing is too early or too late, or if the bleeding is too light, there may be an issue.
9.
If there are blood clots during menstruation, can it be confirmed as menstruation? (The clots are smaller than a pinky joint and there are several.) If a pregnant person experiences bleeding with menstrual volume and clots, can it be inferred that a miscarriage has occurred, or is it possible for the fetus to continue developing?
Answer: It is not possible to determine menstruation solely based on blood volume; the timing of the bleeding must also be considered.
Even if bleeding occurs during pregnancy, it does not necessarily mean a miscarriage.
The greater the bleeding volume, the higher the risk of miscarriage, but ultrasound remains the most accurate method.
10.
If I used a condom throughout and withdrew before ejaculation without any internal ejaculation, what is the likelihood of pregnancy? (What percentage?) Can condoms have microscopic holes that are not visible? Why are there cases where individuals became pregnant despite using a condom throughout?
Answer: The likelihood of pregnancy is very low if a condom is used throughout and withdrawal occurs before ejaculation.
Cases of pregnancy despite condom use may arise from improper usage, as pre-ejaculatory fluid can contain sperm.
Therefore, it is essential to use condoms correctly from the start for effective contraception.
11.
In summary, although I had my period in January and March, and both urine tests and abdominal ultrasounds indicated no pregnancy, I have experienced a sudden abnormal increase in basal body temperature for nearly three months, along with ongoing discomfort, particularly loss of appetite and persistent lower abdominal pain (gynecological and gastrointestinal examinations were normal).
I found many examples online of individuals who did not test positive, which has left me anxious and fearful that I might be one of those who have difficulty confirming pregnancy.
If I wait until I am truly pregnant for more than three or four months before finally testing positive, it may be too late for an abortion.
I began suspecting I was pregnant in early January, and urine tests and abdominal ultrasounds before receiving a menstrual induction injection at the end of February showed no pregnancy.
Can I definitively determine whether I am pregnant? Is it possible to confirm pregnancy three or six months prior?
Answer: You have tested multiple times and have not been pregnant, so it is likely that you are truly not pregnant.
Unless you have had sexual intercourse recently, which could lead to a new pregnancy, a urine test should be able to confirm this two weeks after intercourse.
If the last sexual encounter was more than two weeks ago and the urine test shows no pregnancy, you can be assured that you are not pregnant, so there is no need to worry.
The sudden abnormal increase in basal body temperature, loss of appetite, and persistent lower abdominal pain are likely caused by other factors.
Wishing you health and peace,
Dr.
Lu Li-Cheng, Director of Obstetrics and Gynecology, Taoyuan Hospital, Department of Health

Reply Date: 2012/03/28

More Info

Based on your detailed description, it seems you are experiencing a complex situation regarding potential pregnancy and various symptoms that have arisen over the past few months. Let’s break down your concerns and address them systematically.

1. Temperature Changes and Pregnancy: Your observation of a sustained increase in basal body temperature (BBT) is noteworthy. Typically, a rise in BBT can indicate ovulation, and if it remains elevated for more than 14 days, it may suggest pregnancy. However, other factors can also cause elevated temperatures, such as hormonal imbalances, stress, or illness. Since you have had multiple negative pregnancy tests and ultrasounds, it is less likely that you are pregnant, but not impossible.

2. Symptoms and Health Concerns: The symptoms you describe, including gastrointestinal discomfort, abdominal pain, and changes in appetite, could be attributed to various factors, including hormonal fluctuations, stress, or even gastrointestinal issues. The fact that you have undergone multiple tests and examinations without any findings of pregnancy or significant gynecological issues is reassuring. However, persistent symptoms warrant further investigation, possibly including a referral to a specialist, such as a gastroenterologist, if gastrointestinal issues are suspected.

3. Hormonal Influences on Temperature: Besides progesterone (which is produced by the corpus luteum after ovulation), other hormones such as estrogen can influence body temperature. Conditions like polycystic ovary syndrome (PCOS) or thyroid disorders can also lead to irregularities in menstrual cycles and temperature fluctuations. It might be beneficial to have your hormone levels checked, including thyroid function tests.

4. Timing of Pregnancy Tests: Generally, urine pregnancy tests can reliably detect pregnancy about one week after a missed period. Blood tests (quantitative hCG tests) can detect pregnancy earlier, often within a few days of conception. If your hCG level is 1.2, this is considered a negative result, as a typical non-pregnant level is below 5 mIU/mL.

5. Accuracy of External Testing: Tests conducted in certified laboratories are generally reliable. If your hCG level is low, it strongly suggests that you are not pregnant. However, if you continue to have symptoms, it may be worth repeating the test after a few days or consulting with a healthcare provider for further evaluation.

6. Differentiating Between Types of Bleeding: True menstrual bleeding typically involves a consistent flow and may include clots. Implantation bleeding, if it occurs, is usually lighter and shorter in duration. If you experience heavy bleeding with clots, it is more indicative of a menstrual period or a potential miscarriage if pregnancy were confirmed.

7. Contraceptive Effectiveness: While condoms are effective in preventing pregnancy, they are not foolproof. Factors such as improper use, breakage, or slippage can lead to unintended pregnancy. However, if used correctly, the chances of pregnancy are significantly reduced.

8. Concerns About Late Detection of Pregnancy: It is indeed possible for some women to have negative tests even in early pregnancy, particularly if testing is done too early or if there are irregularities in hormone production. However, this is relatively rare. If you have concerns about your health or potential pregnancy, it is crucial to continue seeking medical advice.

In conclusion, while your symptoms and temperature changes are concerning, the negative pregnancy tests and ultrasounds suggest that you are likely not pregnant. However, persistent symptoms should be evaluated further to rule out any underlying health issues. It may be beneficial to keep a detailed symptom diary and discuss it with your healthcare provider for a more comprehensive assessment.

Similar Q&A

Confusion Over Pregnancy Test Results: What You Need to Know

Hello, doctor. I would like to ask you about my situation. I haven't had my period for three to four weeks and suspected I might be pregnant, so I bought a pregnancy test, which showed that I was pregnant. However, when I went to the hospital for a urine test, they said I wa...

Dr. Wu Zongcheng reply Obstetrics and Gynecology
Dr. Wu Zongcheng from the Tainan Hospital of the Department of Health Administration advises to wait patiently for another week! Early pregnancy diagnosis can sometimes present situations similar to yours. 1. A pregnancy test can confirm whether you are pregnant around the time...

Pregnancy Confusion: Understanding Home Test Results vs. Doctor's Diagnosis

Hello, Doctor Shi: I visited your hospital on September 27 for a pregnancy test (using a urine test), and you informed me that I am pregnant (with September 1 as the first day of my last menstrual period). However, I have been feeling a dull ache in my abdomen, similar to the sym...

Dr. Shi Chengyang reply Obstetrics and Gynecology
Please visit our hospital for examination and further testing.

Signs of Pregnancy: Understanding Symptoms and When to Take a Test

My girlfriend has been feeling nauseous lately, experiencing lower back pain, dizziness, and there's bleeding when I insert my fingers into her vagina during intercourse, which didn't happen before. The nausea started around the same time. Could this be a sign of pregna...

Dr. Li Guanghan reply Obstetrics and Gynecology
You can take a pregnancy test three days after a missed period. Symptoms such as nausea, dizziness, and bleeding could all be signs of pregnancy. - Dr. Cheng Jin-He, Department of Obstetrics and Gynecology, Hsinchu Hospital.

Understanding Pregnancy Test Results: What Do They Really Mean?

On the morning of February 25th, I had unprotected intercourse and took emergency contraception around 6 PM that same day. On March 2nd, I experienced heavy bleeding (more than my usual menstrual flow), which lasted for 4 to 5 days. Then, starting on March 14th, I began to feel d...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, it is possible that you are pregnant. I recommend visiting an obstetrician-gynecologist for an examination. Wishing you good health.