When to take pregnancy test for accurate results

If you’re trying to get pregnant, the best time to take a pregnancy test is one week after you’ve missed your period. Why? Because this is really the best way to prevent a false negative result (a negative test in someone who's actually pregnant) result.

Home pregnancy tests can be used as early as the first day after your first missed period in women with regular/predictable monthly menses. If you have irregular periods, you can administer a test 14 days after intercourse, since you likely can’t pinpoint your exact time of ovulation.

Pregnancy tests detect a hormone called human chorionic gonadotropin (HCG), which is produced in early pregnancy. The production of this hormone begins slowly and increases as the pregnancy grows. Standard urine pregnancy tests will detect the HCG level when it reaches 20-50 milliunits/milliliters.

If you take a test too soon (before you've missed your period), the levels of HCG may not be high enough to detect a pregnancy and it could cause a negative result, even though you're actually pregnant.

I advise my patients to wait at least one day after you miss your period. If you wait one week after a missed period, the chance of a false negative is very low if you have a normal monthly menstrual cycle.

Brand name versus generic pregnancy tests

Home pregnancy tests, both brand name and generic, are very accurate at detecting the HCG hormone and any positive result, even a faint line, can be considered positive. HCG is only produced by a pregnancy; any positive result indicates a pregnancy.

You don’t need a serum (blood) pregnancy test to confirm pregnancy. Both urine and blood detect HCG, although the blood test is more sensitive and can detect HCG levels at much lower levels than a urine test. In certain situations, your doctor may want to perform a blood HCG test but it’s not typically needed to confirm a pregnancy.

Although most tests advertise 99% accuracy, the ability of a particular brand to detect HCG at levels less than 50 ml may vary. Some brands may be better able to detect lower levels of HCG than others. If your HCG level is more than 50 ml, which is the detection rate of most tests, even generic tests will detect a pregnancy accurately.

Since the earliest recorded history, women have had a strong desire to know whether they are pregnant as early as possible. The body goes through countless changes in the first trimester, and one of the first indicators is a change in the hormones that leave the body through urine.

Ancient Egyptians relied on a form of urine testing to determine pregnancy status way back in 1350 BCE. A woman urinated daily on wheat or barley seeds and if the plants grew, it meant she was pregnant. Modern-day validation suggests that test was about 70% accurate in detecting human chorionic gonadotropin (hCG), a hormone produced by a woman’s body soon after implantation of a fertilized egg inside the uterus.

Thankfully, urine-based pregnancy tests have evolved substantially. Women now have access to advanced tests that can detect a pregnancy as early as eight days after ovulation. But while many home pregnancy tests are marketed as simple and effective, getting accurate results comes down to how early in your ovulation cycle you take the test.

Ovulation generally occurs around day 15 of a 28-day cycle. In a normal pregnancy, an egg is fertilized in the fallopian tube and then travels into the uterus, where it implants in the uterine wall. After implantation, production of hCG starts from cells in the developing placenta (tissue that will feed the fetus). Trace levels of hCG can be detected as early as eight days after ovulation.

That means you could get positive results several days before you expect your period to start. However, the first part of your cycle is more variable than the second, making it tricky to determine the best time for an early test.

Pregnancy test accuracy

Each type of pregnancy test is designed to detect a set minimum level of hCG. This is why pregnancy test manufacturers advertise the way they do: “Know four days sooner,” or “Accurate up to six days before a missed period.” However, while home pregnancy tests are quite accurate – many boast a 99% detection rate based on laboratory testing results – marketing claims can be misleading.

For example, a 99% detection rate means a test can detect hCG 99% of the time on the day you miss your period. These statistics also assume that women are testing at the optimal time and following all instructions correctly.

Many home pregnancy tests available today are midstream urine dip tests, which are the traditional “pee-on-a-stick” tests and are fairly easy to use. There also are tests in which you pee into a cup and dip a test strip into the urine. The New York Times published a story ranking the best home pregnancy tests, citing a midstream test with an ergonomic grip as the easiest to use and most accurate.

Research has shown that average test results when women used the dip tests matched lab test results just 70% of the time, whereas 99% of women typically can get an accurate reading from a midstream test.

When to see a doctor

Most women who have a positive pregnancy test should wait a week or two before calling the Ob/Gyn office for a pregnancy blood test or ultrasound to confirm the pregnancy. We suggest waiting because the rate of early pregnancy loss is high, and it’s possible that you might have had a chemical pregnancy.

However, women with a history of ectopic pregnancy or current abdominal pain should call the doctor right away to be examined. Ectopic pregnancies implant outside of the uterus and produce hCG, resulting in positive pregnancy tests. However, these pregnancies can cause abdominal bleeding and prompt medical care is necessary. Women who have congenital heart defects or other chronic physical or mental health conditions should also see a doctor right away because treatment plans or medications might need to be altered to protect the woman and the fetus.

Advances in home pregnancy tests give women greater insight into what’s going on in their bodies sooner than ever before. No matter what your childbearing plans might be, it’s essential to get quick, accurate results at home to plan your next steps accordingly.

How soon will a pregnancy test read positive?

How long does it take for hCG to show up in urine?