Taking a pregnancy test and the tell-tale signs you’re expecting

Written by Dr Samuel Soo
05 Feb

When you are trying to become pregnant, there can be a lot of anxiety around knowing when to take a pregnancy test.

Furthermore, if you have been trying for some time, you are no doubt aware that if you take the test too early, the test may be negative, even if you are pregnant. So, what advice do I give women?

pregnancy test

Understand how pregnancy tests work

Pregnancy tests calculate detect a hormone called human chorionic gonadotropin (hCG) through your urine or blood.

The hCG is produced after the embryo implants into the endometrium, usually on or around the 6th day after the sperm and egg fertilise. This is why home pregnancy tests will not pick up any hCG if you take the test too early, even if you are pregnant.

When should I take a home pregnancy test?

If you want to circumvent false ‘negatives’ or ‘positives’, the best time to take a pregnancy test is after your period is late. Whilst it can be tough if you’re anxious to find out whether you’re pregnant, allowing at least a week before testing after your missed period will give you a higher degree of accuracy when taking a pregnancy test, as hCG levels rise rapidly in pregnant women.

If you do not chart your cycles or your cycle is irregular, take the test after you have past the longest menstrual cycle you usually have.

Common pitfalls to avoid when taking a pregnancy test


Taking a pregnancy test too early

Many women will not get a positive pregnancy test result on the day they think is just after their missed menstrual period, even if they are pregnant, because they are testing too early.

Understanding your menstrual cycle and ensuring your period is late is important to avoid any unnecessary disappointment.

Testing too often

If you think you are pregnant and receive a negative result it’s difficult to stop yourself from wanting to test again that day or even the next. If the test is negative, try to wait at least two to three days before you retest to avoid further disappointment. 

Follow instructions carefully

If you are using a home pregnancy test, it is important to read and follow the instructions carefully. Specifics vary for different tests including collection methods, length of time you need to urinate on the stick for and the symbols used to indicate whether you are pregnant or not.

What if you are not sure about the result?

Blood tests can be done with your GP or a fertility specialist to measure the specific level of hCG in your blood.
With a blood test, we can detect very low levels of hCG that may be helpful to diagnose pregnancy and evaluate any problems during early pregnancy, such as an ectopic pregnancy or to monitor women after a miscarriage.

Pregnancy testing during IVF

If you are seeing a fertility specialist and undertaking IVF, listen to the advice from your doctor and nurses to wait until your blood test two weeks after embryo transfer.
 
We know the two week wait is hard, though some of the drugs we use in an IVF cycle contain hCG that can produce a false ‘positive’ if you test too early, which is why it is best to wait until the day of your scheduled blood test at your fertility clinic.

What are the common symptoms of early pregnancy?

If you are unsure about whether you should take a pregnancy test and find yourself wondering about some of the signs to look out for in the very early stages of pregnancy these usually include the following. Be aware, however, that not all women experience classical pregnancy symptoms and that their presence or absence is not an indicator of the viability or health of the pregnancy.

Breast tenderness

In the early stages of pregnancy, your breasts may become quite tender, swollen and start to enlarge. This is the most common and normal change to occur because of your elevating hormone levels and the implantation of the embryo.

Tiredness

It is very common to feel sluggish and overwhelming tired during the first twelve weeks of pregnancy as your body is going through significant hormonal changes to adjust to the pregnancy.

Nausea & vomiting

Some women experience nausea and vomiting as early as one week into their pregnancy. Some experience illness in the morning and others in the afternoon or continuously throughout the day.

It is important to remember that everyone is different; some women may not experience any nausea, whilst for others it can continue up to thirteen weeks and beyond.

What if I am having trouble getting pregnant?

If you are concerned about your fertility, or have been trying unsuccessfully to conceive for six months or more speak with your GP.

Your GP can perform a basic assessment including ovulation and hormone testing, and pelvic ultrasound examination for you, and a semen analysis for partner, to determine why you may be experiencing pregnancy delay. They can then recommend referral to a fertility specialist for further investigation if required.

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We hope this article was informative and useful to you. If you have any questions or feedback, feel free to get in touch at info@blogivf.com.au.



Related Articles

Conceiving in your 40s, what are the chances?

I was recently asked to comment in a Sun Herald article on 26th August (also published online here: Sydney Morning Herald) on Collette Dinnigan, who pregnant at the age of 46, has called on women not to leave it too long to try for a baby.

It is always news when a high profile personality such as Ms Dinnigan, has a child, particularly when the personality in question is a bit older.  The difficulty is that these occasions, while very happy for the people involved, give a misleading picture of the actual likelihood of conception in these circumstances.  Remember that high profile personalities such as Ms Dinnigan, are human beings who quite rightly value their privacy and so very rarely (quite understandably) talk to the press when things aren’t going so well.  It was therefore, a particularly courageous action of Ms Dinnigan, while celebrating her own happiness, to so publicly, point out the difficulties that may face other women, seeking the same fulfilment.

What then, are the issues for women in their forties who are planning to have a child?

The main difficulty is that conceiving is simply harder at that age and, even once a woman does conceive, the risk of miscarriage is higher.  Surprisingly, although we have very good data about the effects of age on IVF conception (more shortly), we don’t have very good statistics about the effects of age on conceiving naturally. The limited available data about natural conception comes from old population studies or studies of unique populations, such as the Hutterites of North America, who do not use contraception.  Interestingly these data, such as they are, seem to be entirely consistent with the more modern and abundant IVF data.  Generally, in one year of trying, 75% of women under 30 years and 66% of 35-year-old women but only 44% of 40-year-old women will achieve a live baby naturally.

The main explanation for this, is that women are born with a finite number of eggs, and from that moment onwards, the number of eggs is declining all the time, until women go through their menopause at around 50-51.  Nonetheless, women in their 40s do still ovulate each month.  What is it about their eggs that cause all these problems?

A common misunderstanding with some women is that the fact she looks and feels young, and leads a healthy lifestyle, means that her eggs will be healthier. I regularly see women who have taken enormous care with their fitness and their health.  The rest of their body is in great shape, completely fit and ready to carry that longed-for pregnancy.  Sadly, despite this, the eggs still can’t do it.  The effects of time are remorseless and, sadly, there is no wonder drug to fix it.

Scientists have shown that eggs from older women are more likely to have an abnormal makeup making pregnancy less likely, miscarriage more common and increasing the risk of Down Syndrome, a condition where a child is born with an extra chromosome number 21.

Nor is IVF a cure for this problem. For women, in their early 40s, IVF is still a good thing to try and gives significantly higher success rates than trying naturally.    However, IVF success rates fall sharply after the age of 40 and by the time a woman is 45 are close to zero.

So, what’s the good news?  Well despite all of the above, many women do conceive in their forties, either by IVF, or naturally, and have very happy healthy families.  It is obviously better to have your family earlier, if you can, but all hope is not lost, just because you’re past 40.  Conception and early miscarriage are the big problems but, if you do conceive and get past the first few weeks, by far the most likely outcome will be a healthy child.  While the risk of Down Syndrome is increased, most of the other problems that affect young children are not increased by being conceived a later maternal age.

Finally, many women worry that by having their children later, their long term health and emotional development may be affected.  On the contrary, we now know that the children of older mums grow up to be as healthy and bright as any other child.

Snapshot of Fertility in Australia

There have been a number of happy and high profile stories in the press recently about older celebrities giving birth to healthy children. Stories like this used to be extraordinary, but they certainly seem to be on the increase. While this trend is supported by data that shows the fertility rate and numbers of births are increasing for women over 30 and especially for women in their early 40s, women and couples should understand the risks associated with having children later in life.  IVF Australia, Melbourne IVF and Queensland Fertility Group, have teamed up to create their latest infographic - “Fertility and Age in Australia” which explores some of these issues.
 Fertility in Australia infographic

Paternity, Maternity, Equality

Conceiving a baby in a same sex relationship

IVFAustralia, and its partner clinics Melbourne IVF, Queensland Fertility Group and TasIVF, are proud supporters of ‘rainbow families’. IVFAustralia were an Official Supporter of Sydney’s Gay and Lesbian Mardi Gras this year, and we’ve seen the number of same sex couples accessing our donor program double in the last year.
 
In 2011, a survey of 3,835 LGBT people found 33% of women and 11% of men had children1 - but close to 40% reported wanting to have children or have more children. This so-called ‘gayby’ boom is thanks to changes in community attitudes and laws, including better access to Assisted Reproductive Treatments for lesbian and single women.
 
So, if you’re hoping to experience the joy of starting a family within a gay or lesbian relationship, what do you need to consider?

How long will it take to conceive?

Generally speaking, we’d expect a healthy woman with no fertility issues to fall pregnant through IVF or Artificial Insemination within six months. You can prepare for pregnancy by improving your diet, doing regular exercise and other lifestyle factors.
 
When you access the donor program there are a few extra decisions you need to make.
 
Do you choose a known donor, or an anonymous donor? In a lesbian relationship, do you want to implant an embryo with eggs from one mother into the other? Should you store some sperm from the same donor for later, in case you’d like a related sibling? For two dads, the process of finding a surrogate can also be complex.

How do we choose a donor?

Our fertility clinics offer access to both Australian and US* donor sperm. The access fee for US donor sperm is higher, but the waiting list is also shorter as there is a shortage of local donors (gay men, we’d love to hear from you!)
 
When you’re using donor sperm or eggs, there are a few legal, emotional and ethical factors to consider and a counsellor will help you work through these concerns so you can make the best decisions for your family’s future.

Are there any legal issues?

Each state has different laws about parental recognition and access, so it’s worth seeking specialist advice before you start.
 
For example, in Victoria, the Victorian Assisted Reproductive Treatment Act (2008) removed discrimination against lesbian and single women with regard to fertility treatment, recognised parenting status for non-birth mothers and also effectively legalised ‘altruistic’ surrogacy. It also recognises lesbian couples as equal parents of their child or children as long as they were in a de facto relationship.

What else should we be prepared for?

30 years of research2 has shown that the children of same-sex parented families do just as well as the children of heterosexual parents socially, educationally, physically and emotionally.

The issues your children will face as they get older are just the same as the issues facing any children conceived using donor sperm or eggs: Where did I come from? Should I contact my donor? You need to be prepared for these questions at some point.
 
In the meantime, we hope we can help you fulfil your dream of having a baby, and that you will experience the joys of pregnancy, birth and parenthood.

What should be my next steps?

If you would like to learn more about the fertility treatments available for same-sex couples in your regions, visit one of our websites. 


 * IVFAustralia and Queensland Fertility Group patients only.

1 Leonard et al. (2012) Private Lives 2: The Second National Survey of the Health and Wellbeing of GLBT Australians, The Australian Research Centre in Sex, Health and Society, Melbourne
2Rainbow Families Council of Victoria (2010) Rainbow Families and the Law, RFC, Melbourne, http://www.rainbowfamilies.org 

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