Pregnancy symptoms but a negative test, what else could it be?

It's common to have doubts about the reliability of a pregnancy test, especially if the woman shows signs of being pregnant but the result is negative.

In this situation, it´s normal for a woman to wonder if it´s possible for the test to show a negative result even though she actually is pregnant. This type of result is known as false negative and yes, it´s possible for it to occur in pregnancy tests

The different sections of this article have been assembled into the following table of contents.

Beta-hCG hormone

Pregnancy tests, tested both in urine or in blood, measure the human chorionic gonadotropin (hCG) hormone. This hormone is secreted by the embryo in large quantities, so it is characteristic of pregnancy,. Typically, hCG levels double every 48-72 hours in the first trimester of pregnancy. This increase in hCG levels in the mother's body is responsible for the usual pregnancy symptoms.

Among the functions of hCG is the prevention of disintegration of the ovarian corpus luteum so that it continues to produce progesterone. Furthermore, hCG is involved in immune tolerance during pregnancy, protecting the early fetus from immune rejection. However, hCG secretion begins to progressively decrease at about 3 months of gestation.

Beta hCG characteristics

If you want to know more about the pregnancy hormone, you can click here: What Are Normal hCG Hormone Levels during Pregnancy?

False negative pregnancy test

The blood pregnancy test has a higher sensitivity than the urine pregnancy test. Since the blood test can detect lower levels of hCG hormone, the likelihood of a false negative is lower than with the urine test.

Causes of a false negative

The reasons for a false negative pregnancy test are:

• The test has been done too early: if at least 8-12 days have not passed since ovulation or there is no delay in menstruation, it´s quite possible that the hormone levels are not high enough to be detected by the test.
• The test has not been done with the first urine of the day: if a urine pregnancy test is done, it´s important to do it with the first urine of the day because this is when it will contain the highest concentration of the hCG hormone.
• The woman is taking or has taken any medication that may affect the result.
• The test chosen is of low sensitivity, for example, it detects hCG levels above 20 mIU/ml. This means that the test will not be able to detect pregnancy at an early stage.
• Early pregnancy loss.
• The pregnancy test is expired or damaged.

Causes false negative pregnancy test

In case any of these situations occur, the best way to check whether or not there is indeed a pregnancy is to repeat the test 2-3 days later to confirm the result.

Why do I feel pregnant if I am not?

As mentioned above, a woman can feel pregnant and have negative pregnancy tests. However, if symptoms of pregnancy persist and doubt remains, the woman should consult her physician.

The doctor will order an hCG blood test to confirm whether or not there is a pregnancy and perform a transvaginal ultrasound to directly observe the inside of the uterus to look for the gestational sac and embryo. Furthermore, the specialist should also perform a physical examination and check the size of the uterus.

Psychological pregnancy

If the doctor rules out pregnancy, the woman could be facing a psychological pregnancy. The causes of this type of pregnancy can be diverse, for example, if the woman has a very strong desire to become a mother or a terrible fear of pregnancy.

Symptoms of psychological pregnancy include:

• Lack of menstruation (amenorrhea).
• Increase in breast size, aureole and breast pigmentation.
• Darkening of the skin.
• Increase in the size of the abdomen.
• Significant weight gain, more than in a normal pregnancy, and strong increase in appetite.
• Appearance of nausea and gastric problems such as heartburn.
• Presence of sleep disorders.
• Cravings.

Symptoms of psychological pregnancy

The physician may request additional tests to verify that these symptoms are not due to some other disorder and to confirm that it is indeed a psychological pregnancy. If this diagnosis is confirmed, the woman will need to start psychological therapy. The specialized professional may prescribe medication, as well as working at home with the couple to overcome it.

If you want to know more about psychological pregnancy, you can access this article: What Is a False Pregnancy or Pseudocyesis?

Other causes of menstrual delay

Once the possibility of pregnancy has been ruled out, delays in the menstrual period indicate the presence of irregularities in the menstrual cycle. These irregularities can occur in all women at some point in their lives.

The reasons for a menstrual delay can be varied:

Polycystic Ovaries

women with polycystic ovary syndrome may have infrequent or prolonged menstrual periods, have excessive levels of male hormone (androgen), and their most frequent symptoms are hirsutism (excess hair), centripetal obesity, and menstrual irregularity. It is one of the most common disorders in women and its prevalence is estimated between 5 and 20%.

Change of habits

changes en daily routine can influence the hormonal cycle. Women who make drastic dietary changes, severe exercise practice or a major emotional life change may experience cycles. Therefore, it is important to maintain good, balanced dietary habits.

Stress

is one of the main enemies because it increases the production of the stress hormone cortisol. This increase is reflected in subsequent estrogen and progesterone production, which again can explain a late period and the presence of nausea.

Possible causes of menstrual delay

Thyroid hormone alterations

too much (hyperthyroidism) or too little (hypothyroidism) thyroid hormones results in problems in achieving or carrying a pregnancy to term, miscarriages, pregnancy problems or premature delivery. In addition, these alterations are associated with anovulation and abnormal menstrual cycles.

Medications

the intake of certain medications can cause amenorrhea (absence of menstruation). Some examples could be antipsychotics, antidepressants and incorrect use of oral contraceptives.

Assisted reproduction treatments

in these patients, the use of vaginal progesterone sometimes delays menstrual bleeding. In addition, it can cause a delay in bowel emptying, resulting in nausea and emotional changes that are often mistaken for pregnancy symptoms.

As we have discussed, there are many causes that can lead to a late period, not just pregnancy. Therefore, if you have any doubts, please don´t hesitate to contact a specialist

FAQs from users

Can PCOS give a false positive pregnancy test?

Pregnancy tests determine the presence of the hormone (beta-hCG= human beta chorionic gonadotropin) in the urine. This is produced when pregnancy occurs. A positive test means that this hormone is present in the urine and therefore the woman is pregnant.

Polycystic ovary syndrome (PCOS) is when the ovaries produce higher than normal amounts of androgens and this can interfere with the development and release of the egg. Sometimes, instead of eggs forming and maturing, cysts develop in the ovaries. Instead of the egg being released during ovulation, as it is in a normal menstrual cycle, the cysts grow and increase in size.

Only in the case of a cyst that produces hCG, which is very rare, the hormone would show in your urine and give a false-positive result with the pregnancy test.

Can a pregnancy test fail?

Yes, the negative result can be wrong. The main reason is usually that the pregnancy test has been done too soon, but, as indicated in the article, it can happen because the test is in poor condition, because it is not highly sensitive or because there has been an early miscarriage, among other things.

I have symptoms of pregnancy after IVF, but the test was negative, what can this be due to?

The symptoms of pregnancy in its early stages are totally unspecific and are often very similar to those that occur in premenstrual syndrome. Mood swings, headaches, abdominal distension, pain in the ovaries or feeling as if a period is coming, are common to both situations and are favored by the hormonal environment in the final phases of the menstrual cycle.

In some cases there is also a psychogenic component that is impossible to establish, that can have an influence to a greater or lesser extent depending on the individual.

I think I'm pregnant but the test is negative, what's wrong with me?

Don't worry, everything is fine with you. Just repeat the test in about a week to confirm the result. If it's still negative, it's very likely that the symptoms you notice are due to another reason, not a pregnancy. If you are in doubt, it is best to contact your doctor for an ultrasound and an exploration, although if the pregnancy is very early you will not be able to see anything on the ultrasound and you should wait a few weeks.

How do I know if I'm pregnant if my test shows negative?

The first thing would be to repeat the pregnancy test after about 5 days. If the test continues to be negative, it is more likely that your period will come soon, but if it does not, it is best to consult your doctor.

Is the result of a negative urine pregnancy test before the delay in menstruation reliable?

It depends on the sensitivity of the test, i.e. the minimum amount of hCG hormone it can detect. However, for the result to be reliable, it's recommended to perform the pregnancy test once there is a missed period. This means that you should wait to take the test until there is a delay in your period with respect to the day you expected it to come. In this way, false negatives are avoided because the hormone should already be at levels detectable by the test.

Therefore, in this situation, we recommend repeating the test on the appropriate days to obtain a more reliable result.

Recommended reading

If you want to know more about pregnancy symptoms, we recommend you visit this link: What Are the Most Common Symptoms of Pregnancy?

References