About the Test
Purpose of the test
The main use of a pregnancy test is to evaluate if you are pregnant. Both urine and blood tests for hCG can be used for this purpose, and repeat testing may be done to confirm a pregnancy. Very early in a pregnancy, tests that measure the amount of hCG may also help assess the age of a fetus.
Less often, hcG tests can be used to:
- Identify or rule out an ectopic pregnancy, when a fertilized egg attaches or implants in an abnormal area
- Check for pregnancy prior to surgery or other medical treatments
- Screen for Down syndrome if you are pregnant as part of prenatal screening
- Monitor a pregnancy that may be at risk of a miscarriage
- Help diagnose gestational trophoblastic disease (GTD), a term for pregnancy-related tumors
What does the test measure?
A pregnancy test measures a hormone in the body called hCG, which is created at higher levels during pregnancy. There are two different ways hCG results are reported:
- Qualitative: These hCG tests give a positive or negative result depending on the presence or absence of hCG in the sample. Qualitative tests can be done using either a blood or urine sample. This type of testing is done most often to confirm a pregnancy.
- Quantitative: This type of hCG testing measures the amount of hCG present in the blood. These tests frequently use a blood sample, but some urine tests can provide a degree of quantitative measurement. Along with confirming a pregnancy, quantitative hCG tests can also be used as part of the diagnostic process for abnormal pregnancies.
When should I get a pregnancy test?
A pregnancy test is most commonly done when you believe you may be pregnant. Testing may detect a pregnancy as soon as 10 days after conception. The accuracy of pregnancy tests usually increases if taken at least one to two weeks after a missed menstrual period.
It may also be done when there are signs and symptoms that suggest an ectopic pregnancy or a pregnancy that is failing.
Signs of an ectopic pregnancy may include:
- Abnormal vaginal bleeding
- Low back pain
- Pain in the lower abdomen or pelvic area
- Cramping on one side of the pelvis
Additional and more severe symptoms may develop if an ectopic pregnancy is not identified and treated, so it is important if you’re of childbearing age to talk with a doctor if you notice these symptoms.
Pregnancy testing may also be done as a routine test prior to some medical treatments, such as surgeries or chemotherapy, that could potentially harm a fetus.
A doctor can best determine if a pregnancy test is appropriate.
Finding a Pregnancy Test
How can I get a pregnancy test?
Laboratory tests such as blood draws and urine samples generally need to be ordered by a health care professional. Either of these tests can take place in a doctor’s office, hospital, or laboratory. Urine pregnancy tests can ordered or be taken at home. If you suspect you are pregnant, talk with your health care professional about how to get a blood pregnancy test.
Can I take the test at home?
At-home pregnancy tests are a fast and convenient way to take a pregnancy test. Home pregnancy testing is very similar to qualitative urine hCG testing performed in the laboratory, but there are some important differences to be aware of:
- At-home tests have very specific instructions that must be followed exactly. When using an at-home test, follow the directions carefully. Each test’s ability to detect the presence of hCG can vary based on the brand of the test.
- Look carefully at the test instructions about how long you must wait to test after a missed menstrual period. Tests that are done too early may result in a negative result when you are actually pregnant.
- At-home pregnancy tests should typically be done using a urine sample taken the first time you urinate in the morning. This is when urine is the most concentrated and has enough hCG to be detected.
When used correctly, most at-home pregnancy tests produce the same result as the qualitative urine hCG test done by a medical provider.
If your test is positive, it is important to reach out to your health care provider to learn more about the next steps in your care, including if other tests are needed to confirm that you are pregnant.
How much does the test cost?
The cost of testing, whether it’s a blood pregnancy test or a urine pregnancy test, depends on several factors, including your insurance coverage, the type of pregnancy test, and where the test is performed.
If the pregnancy test is ordered by a doctor, insurance normally covers most of the cost, except for copays and deductibles. It’s important to check with your health insurance and health care provider for more information about specific costs.
Taking a Pregnancy Test
A pregnancy test is done using blood or urine samples.
- A blood test is done by drawing a tube of blood from a vein in your arm. This takes place in the doctor’s office, and the sample is sent to the laboratory.
- A urine test is done by urinating into a cup and then placing a drop of urine on a prepared chemical strip. This can be done in a doctor’s office or at home using an at-home test kit.
Before the test
You usually do not need to fast or do any special preparations before a urine or blood pregnancy test. However, you should always ask your doctor to clarify or confirm any pretest instructions.
During the test
When a pregnancy test is conducted in a medical facility or lab, a health care professional will instruct you on whether a blood or urine sample will be needed.
If a blood sample is needed, it will be taken with a needle inserted into a vein in your arm. Before drawing the blood, an elastic band is tied around your upper arm to increase blood in the veins. The puncture location is then wiped clean and disinfected. A needle blood draw may cause a brief sting but normally lasts less than a minute.
To collect a urine sample, you urinate into a sterile cup provided by your health care provider. In most cases, a urine sample taken the first time you urinate in the morning is best. Collecting a urine sample normally takes only a few minutes.
After the test
When the blood draw is completed, a bandage or cotton swab will be used to prevent bleeding. You will likely be advised to keep the bandage on for an hour or more.
Providing a urine sample does not require any post-test instructions or restrictions.
Pregnancy Test Results
Receiving test results
The time it takes to get the results of a pregnancy test depends on the type of test that is ordered. It may take anywhere from a few hours to more than a day to get the results of a blood test. Results from urine tests are generally available in one to two minutes.
Because both of these tests are generally done in a clinic setting, you will likely receive the results from a health care professional.
Interpreting test results
How pregnancy tests are reported depends on whether the test was qualitative or quantitative.
Qualitative test results
Qualitative test results are reported as positive or negative:
- A negative test result indicates that you are likely not pregnant. It is important to remember that tests performed too early can result in a false-negative result due to low levels of hCG. The test may need to be repeated in a week if there is a likely possibility of pregnancy.
- A positive result indicates that you are likely pregnant. False-positive results can occur if you are post-menopausal or taking hormone supplements.
Quantitative test results
Quantitative test results are reported in milli-international units per milliliter (mIU/mL). hCG should not be detectable if you are not pregnant. If you are pregnant, hCG doubles approximately every two to three days during the first one to two months of the pregnancy. The level of hCG keeps rising throughout the first trimester and declines slowly during the second and third trimesters.
The results of quantitative test results may also be considered if hCG testing is being done related to an abnormal pregnancy or other health conditions.
Talking with a health care professional is the best way to learn more about your test results and the next steps in your care. Here are some questions you can ask your doctor after taking a pregnancy test:
- Should the test be repeated if I didn’t get the expected result?
- Is it possible that the result was a false negative or a false positive?
- What can a quantitative hCG test tell me about the baby’s health?
- If the test shows I’m pregnant, what are the next steps to begin prenatal care?
