Trying to Conceive

What a Missed Period and Negative Pregnancy Test Could Mean

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For couples trying to conceive, the missed period is often the first exciting sign of a positive pregnancy. But what should you think, then, when the pregnancy test is negative?

Causes of a Negative Pregnancy Test

There are a several possible explanations for a negative pregnancy test with a missed period that may occur in the absence of pregnancy.

Anovulation

When you are trying to conceive, it is important to determine whether you are successfully ovulating each month, as ovulatory dysfunction or anovulation may play a role in your missed period and can affect your ability to conceive.

There are many causes for ovulatory dysfunction or anovulation. Just a handful of these causes include:

Primary Ovarian Insufficiency (POI)

Some women may have a condition known as primary ovarian insufficiency (POI). In POI, the symptoms experienced are similar to those of menopause. As the ovarian follicle count is depleted prematurity, falling estrogen levels lead to hot flashes, vaginal dryness, and an absence of menses as the woman prematurely enters menopause.

Miscalculating Your Period

The average menstrual cycle is 28 days, but far too often we forget to note day 1 of our cycle. Additionally, cycles can sometimes vary in length from month to month. Charting Basal Body Temperature or using Ovulation Prediction Kits (OPKs) can help you get a firm grasp on your menstrual cycle to predict when you are most likely to conceive.

Second, there are a few reasons why your pregnancy test may read negative when you are, in fact, pregnant. Some reasons for this may include:

Home Pregnancy Test with a Low Sensitivity

A home pregnancy test will only detect pregnancy when the level of “pregnancy hormone,” also known as human chorionic gonadotropin (hCG), reaches a certain threshold, and it simply may not be sensitive enough to produce a positive result. Certain brands state that they can detect lower thresholds of hCG; depending on how soon you are taking the pregnancy test after the missed period, it may be worth trying again with a more sensitive brand, ensuring you are using the first morning urine for your test (hCG concentrations are highest in the first morning urine).

Taking a Home Pregnancy Test Too Soon

Another reason for a false negative pregnancy test may simply be that you took the test too early. Pregnancy tests vary in how soon they can detect hCG in your urine. It is possible that although an egg may be fertilized, your body has not started secreting enough hCG to register as positive on a test. Your body needs time for the hormone to rise to a high enough level to be detected. Most brands instruct you to wait until the first day of your missed period to test. Remember, hCG rises differently in each woman. If you suspect you are pregnant, even though the test is negative, the test should be repeated in one week.

If you are trying to conceive and your period is more than one week late with a negative pregnancy test, you should consider consultation with a fertility doctor so that you can be properly evaluated and treated, if necessary.

Dr. Jenna Friedenthal is a Fellow in Reproductive Endocrinology and Infertility at Reproductive Medicine Associates of New York. Dr. Friedenthal completed her undergraduate education at Yale University. She went on to complete her medical degree from the Albert Einstein College of Medicine with Distinction in Research. While in medical school, she received the Senior Research Fellowship award for her research accomplishments in reproductive endocrinology and immunology. Dr. Friedenthal then completed her residency training in Obstetrics and Gynecology at New York University. During her residency training, Dr. Friedenthal received the Mortimer Levitz Best Basic Science Award for her research on pre-implantation genetic testing.

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