Updated by Progyny Clinical Team — May 2025
For couples trying to conceive, the missed period is often the first exciting sign of a positive pregnancy. But what if the pregnancy test is negative? There are many possible explanations.
Variation in menstrual cycles
The average menstrual cycle is 28 days but can still be considered regular if arriving +/- seven days. There are many things impacting hormones that may cause cycles to vary slightly in length from month to month: stress, life events, dietary habits or nutritional conditions, over exercising, the lunar cycle, etc.
Using digital apps for menstrual cycle tracking, or Ovulation Prediction Kits (OPKs), can help people get a firm grasp on their menstrual cycle to predict when they are most likely to ovulate.
Testing too soon
Pregnancy tests will only detect pregnancy when the level of “pregnancy hormone,” also known as human chorionic gonadotropin (hCG), reaches a certain threshold.
These tests vary in how soon they can detect this hormone in urine. It is possible that an egg may be fertilized, but the body hasn’t started secreting enough hCG to register as positive on a test.
The body needs time for the hormone to rise to a high enough level to be detected. Most brands of home pregnancy tests say to wait until the first day of your missed period to test. Remember, hCG rises differently in each person. Test again in one week if pregnancy is suspected.
Anovulation (not ovulating)
When trying to conceive, it is important to determine whether one is successfully ovulating each month. That’s because anovulation or ovulatory conditions may play a role in a missed period and can affect your efforts to conceive.
There are many causes for disruption of ovulation. Just a handful of these causes include:
- Thyroid dysfunction
- Hormonal conditions impacting BMI
- Overexercise
- Stress
Primary ovarian insufficiency
In some cases of a delayed menstrual cycle, one may be evaluated for a condition known as primary ovarian insufficiency (POI).
POI is sometimes interchanged with premature ovarian failure (POF), which is reduced or loss of ovarian function prior to age 40. As the ovarian follicle count goes down, falling estrogen levels lead to hot flashes, vaginal dryness, and other symptoms.
Conclusion
If you are trying to conceive and your period is more than one week late with a negative pregnancy test, consider consulting a provider for a thorough fertility diagnostic evaluation.
If you have questions or concerns, Progyny is here for you. Please contact your Progyny Care Advocate.
Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.