When should I freeze my eggs?

According to the American Society of Reproductive Medicine (ASRM), elective egg freezing is most successful for women younger than 38 years. Elective egg freezing is when you voluntarily choose to freeze your eggs as a type of insurance plan against natural aging — not because you have a medical condition such as cancer that might harm the eggs in your ovaries (called oocytes).

With age, the likelihood of problems with the chromosomes inside your eggs increases. Chromosomes are the building blocks of your DNA or genetic information. Egg freezing allows you to use “younger” eggs when you want to get pregnant. With age, there are:

• Higher rates of infertility
• Fewer eggs can be harvested
• Lower IVF success rates
• Increased rates of miscarriage
• Higher rates of congenital disabilities
• Higher-risk pregnancies for people who are pregnant when they are older than 35 increase

People who freeze their eggs before age 34 have the highest overall live birth rates. So, while egg freezing does help you slow down your biological clock, you can not push pause forever. Data from fertility centers indicate that most women 38 and younger can expect to harvest 10-20 eggs per cycle. The more eggs your doctor can collect, the higher your chances of a successful live birth. So, the ideal window for egg freezing is somewhere between 34-38 years old.

How much does egg freezing cost?

You can expect to pay $30,000-$40,000 to freeze your eggs. The average cost per cycle of just the medical procedure (harvesting) ranges between $10,000-$20,000. It will cost $500-$600 per year to store your eggs.

Costs will increase or decrease depending upon how many cycles you need to do to freeze the recommended number of eggs (usually around 10). The average person must go through about two cycles to reach this number. The older you are, the more likely you will need multiple cycles, and your medication costs may increase. 

Some commercial health insurance plans will cover the cost of some of the prescription medications used to stimulate your ovaries. However, without any insurance coverage, drug costs can run $2,000-$5,000 per cycle.

Where you live in the country can impact how much egg freezing will cost you, and costs vary even city by city within the same state. If you live far from medical centers, lost wages due to medical appointments and transportation costs can add up quickly.

Employer-financed egg freezing or fertility benefits changed many people’s financial calculus for egg freezing. As of 2020, about one out of every five (20 percent) US companies offered coverage for egg freezing. Apple and Facebook pay their employees up to $20,000 for egg freezing.

Egg freezing costs do not include the cost of thawing and implantation via in vitro fertilization (IVF), which as of 2019, ranged from $10,000-$15,000 per IVF cycle, according to the Society for Assisted Reproductive Technology (SART). Some people will also need to factor in the potential purchase of donor sperm (around $1,000), other assisted reproductive technologies (like assisted hatching or ICSI treatment), or embryo freezing ($200-$800 annual storage fee).

How long does the egg freezing process take?

One egg freezing cycle takes approximately 3-4 weeks. This includes:

• 1-2 weeks of birth control pills or other medication to temporarily turn off your natural hormones
• 9-10 days of hormone injections to stimulate your ovaries and ripen multiple eggs.

During the ten or so days of hormone injections, you will have to make frequent visits (usually at least five appointments in ten days) to your fertility clinic or doctor for vaginal ultrasounds to monitor your eggs and find the right time for harvesting.

The actual egg retrieval procedure takes only about 15-30 minutes, however, you will need to spend several hours after your retrieval at your clinic for observation before you can head home. People report that they usually can return to work and other normal activities within 1-2 days.

It takes most people 2-3 cycles to harvest the recommended 10-20 eggs for freezing. So, depending on your baseline fertility, age, and response to the ovulation stimulation medications, you can count on your egg freezing endeavor taking somewhere between 9-12 weeks, best case scenario.

Is egg freezing safe?

The actual procedure to harvest your eggs is a very low-risk surgical procedure. Egg harvesting carries about the same amount of risk as undergoing IVF. Surgical procedures like egg harvesting and IVF have small risks such as:

• Problems with the anesthesia (the medicines used to put you to sleep for the procedure)
• Injury from the needle passing through your vaginal wall to remove the eggs from your ovary
• Infection after the surgery

The main risks associated with egg freezing come from the regimen of fertility medications you take before egg harvesting (the ovarian stimulation protocol). These medications send your ovaries into overdrive, stimulating multiple eggs to develop simultaneously.

Fertility medications can cause something called ovarian hyperstimulation syndrome (OHSS). If the medicines over-stimulate your ovaries, they can swell, become painful, and cause fluid to build up in your belly, making you nauseous and bloated. One out of three women has symptoms of mild OHSS during controlled ovarian stimulation, but very few women go on to develop severe OHSS, which requires hospitalization.

Egg freezing also carries the emotional risk of undergoing a complicated and uncertain medical procedure. Many fertility medications can cause mood changes. The stress of navigating complex medication injections, multiple doctors’ appointments, and the unpredictability of the results can take a mental toll.

Navigating fertility or infertility can have psychological, financial, and socio-cultural consequences and it’s essential that you look out for your mental wellbeing. 

How many eggs should I store?

This calculation is based upon the biological reality that not every egg makes an embryo, not every embryo makes a pregnancy, and not every pregnancy makes a baby. Eggs are lost at each stage, from thawing, to fertilization, to development into an embryo, to transferring the embryo into a womb. And so, the chance that a single frozen egg will lead to a live birth is about 2 to 12 percent, according to the American Society for Reproductive Medicine. 

So what is the magic number? Fertility experts and clinics worldwide seem to land on the number ten. Research shows you may expect to retrieve about 14 mature eggs on average if you’re 36 and under, about ten if you’re 37-39, about nine if you’re 40-42, and about seven if you are 43 or older.

How long can eggs stay frozen?

Babies have been born from eggs frozen for as long as 14 years. Most people store eggs for five to 10 years. In vitrification, scientists remove the fluid from your eggs and replace it with a chemical version of antifreeze that increases successful fertilization, implantation, and live birth rates.E mbryos do tend to thaw better than unfertilized eggs. If there is a partner in the picture or already a plan to use donor sperm, it’s worth considering freezing embryos. It’s possible to do a mix of both embryos and unfertilized eggs.

The bigger time limits on egg freezing are age and the cost of storage. As people become older (in their 40s and 50s), IVF success rates decline, and they are at higher risk for miscarriage and other pregnancy complications. The chance of becoming pregnant after implantation is roughly 30 to 60 percent, depending on how old you are when you freeze your eggs. Some people opt for a surrogate, which carries a separate set of considerations and costs. 

Your egg freezing decision

The decision to freeze your eggs can seem almost as big as deciding whether you want to become a parent. Egg freezing is one option that can buy you some time as you consider parenthood. However, it’s not for everyone. If you’re in the process of making this decision, speak with your provider for guidance and to your community for support. 

Reviewed by the Ovia Health Clinical Team

Read more

• Should I freeze my eggs
• Egg freezing step by step

Sources

• Mesen, Tolga B et al. “Optimal timing for elective egg freezing.” Fertility and sterility vol. 103,6 (2015): 1551-6.e1-4. doi:10.1016/j.fertnstert.2015.03.002. 
• Cil AP, Bang H, Oktay K. Age-specific probability of live birth with oocyte cryopreservation: an individual patient data meta-analysis. Fertil Steril. 2013 Aug;100(2):492-9.e3. doi: 10.1016/j.fertnstert.2013.04.023. Epub 2013 May 24. PMID: 23706339; PMCID: PMC3888550.
• “Cost of Egg Freezing.” USC Fertility. University of California, San Francisco. January 27, 2019. https://uscfertility.org/egg-freezing/cost/. 
• Carnegie, Megan. “More Companies Offer Fertility Benefits. It’s Only the Beginning.” Wired. Conde Nast. December 1, 2021. https://www.wired.com/story/fertility-benefits-work/. 
• “Frequently Asked Questions.” SART. Society for Assisted Reproductive Technology, https://www.sart.org/patients/frequently-asked-questions/. 
• “Ovarian Hyperstimulation Syndrome (OHSS).” Reproductive Facts. American Society for Reproductive Medicine. 2014. https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/ovarian-hyperstimulation-syndrome-ohss/. 
• Kumar, Pratap et al. “Ovarian hyperstimulation syndrome.” Journal of human reproductive sciences vol. 4,2 (2011): 70-5. doi:10.4103/0974-1208.86080. 
• Hasanpoor-Azghdy, Seyede Batool et al. “The emotional-psychological consequences of infertility among infertile women seeking treatment: Results of a qualitative study.” Iranian journal of reproductive medicine vol. 12,2 (2014): 131-8.
• Vaughan DA, Leung A, Resetkova N, Ruthazer R, Penzias AS, Sakkas D, Alper MM. How many oocytes are optimal to achieve multiple live births with one stimulation cycle? The one-and-done approach. Fertil Steril. 2017 Feb;107(2):397-404.e3. doi: 10.1016/j.fertnstert.2016.10.037. Epub 2016 Dec 1. PMID: 27916206.
• R.H. Goldman, C. Racowsky, L.V. Farland, S. Munné, L. Ribustello, J.H. Fox, Predicting the likelihood of live birth for elective oocyte cryopreservation: a counseling tool for physicians and patients, Human Reproduction, Volume 32, Issue 4, April 2017, Pages 853–859, https://doi.org/10.1093/humrep/dex008
• Mayo Clinic Staff. “Egg Freezing.” Mayo Clinic. Mayo Foundation for Medical Education and Research. April 23, 2021. https://www.mayoclinic.org/tests-procedures/egg-freezing/about/pac-20384556. 
• “Can I Freeze My Eggs to Use Later If I’m Not Sick?” ReproductiveFacts.org. American Society for Reproductive Medicine. 2014. https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/can-i-freeze-my-eggs-to-use-later-if-im-not-sick/. 

Dear Ovia, How do I tell my hubby that he’s the one who needs to get tested now?

This is such an important issue, and a surprising challenge for many people with a male partner. It’s been ingrained in our culture for so long that infertility is very likely a woman’s “fault.” And many people are genuinely shocked to learn that about half of all known cases of infertility have what’s called a male factor. Infertility is no one’s fault, and identifying medical issues that impact your struggle to conceive shouldn’t carry stigma, but I live in the real world with you, so I know that stigma is alive and well.

My advice is to be as dry as you can about it. If this is a first attempt, go basic, “Hey, doctors say the next step is a sperm analysis, they gave me the info for a provider for you.” Even though there are big emotions involved, this is a medical and clinical step. Keeping the conversation simple and medical can help. 

That said, you know your hubby best. Would it work best to make the appointment and tell him when it is? Or maybe to have your doctor explain that it’s the next step if he’s said he doesn’t think he needs to go get tested? Or to reassure him this is what everyone does at this stage? 

Again, we live in a culture that often connects fertility and feelings of pride. If he’s having trouble believing he may need medical help to conceive, there’s probably some grieving and acceptance that has to happen. 

More from this series

• Dear Ovia, My partner isn’t sure if he wants kids
• Dreams of a big family

A failed embryo transfer

Although it’s easy to wonder what you did wrong, a failed embryo transfer is not your fault. Most people need more than one embryo transfer to bring home a baby. The good news is, your odds of success are fairly high within six cycles. About 86% of those 35 and under get pregnant within six IVF cycles and about 42% of those over the age of 40. “Most clinics will also offer PGS/PGD genetic testing, that is generally more meaningful than grading embryos visually in a lab. Higher grade embryos have a statistically higher chance of leading to viable pregnancies,” for example some research shows a 95% success rate with three normal genetically tested embryos. PGS stands for Preimplantation Genetic Screening and can be used to screen for genetic abnormalities, while PGD (or Preimplantation Genetic Diagnosis) is used when one or both parents have family histories of certain issues to search for those specific genetic abnormalities. 

Egg quality is the biggest predictor of success. Highly graded, genetically screened normal embryos are the most likely to implant. But even genetically screened normal embryos with good grades can fail to result in pregnancy. There aren’t always clear answers when it comes to why some embryos implant and others don’t. 

When you’re ready, you can try again. If you have frozen embryos, you don’t have to do another retrieval, unless you prefer to bank more embryos. If you decide to do another retrieval, your doctor may change your medication protocol to see if that changes the quantity and quality of the eggs and embryos. 

Additional testing

If you’ve had multiple failed embryo transfers, your doctor may want to perform additional tests like a hysteroscopy, which uses a scope to look inside the uterus and rule out any potential uterine issues, like polyps. Uterine masses, like polyps and fibroids, and inflammation, can make it difficult for an embryo to implant, so diagnosing these issues ahead of time is key. Your doctor may also adjust your transfer protocol to see if that leads to a better outcome. For example, they may add more progesterone or have you take a different form of progesterone. 

A mental health note

Staying busy and preparing for your next transfer can be a helpful distraction, but it’s also important that you take time to process your grief. Find people you can open up to about how you’re feeling, whether that’s a partner, friend, or mental health professional. It may also help to talk to someone who gets what you’re going through. Some fertility clinics offer support groups for their patients. If your clinic doesn’t have a support group, you can ask them to create one, or see if Resolve: The National Infertility Association offers a local or virtual support group. 

Reviewed by the Ovia Health Clinical Team

Sources

• Karayalçın, Rana, et al. “Office hysteroscopy improves pregnancy rates following IVF.” September 2012. https://pubmed.ncbi.nlm.nih.gov/22818094/ 
• Malizia, Beth A., Michele R. Hacker, and Alan S. Penzias. “Cumulative live-birth rates after in vitro fertilization.” January 2009. https://www.nejm.org/doi/full/10.1056/nejmoa0803072 
• Scott, Richard. “Normal Embryo Success Rate Based on IVF: RMA Research Study” ​​https://rmanetwork.com/blog/women-with-three-normal-embryos-have-95-chance-of-pregnancy-rma-research-shows/ 

How long does it take (on average) to get pregnant?

Many factors can influence how long it takes to get pregnant, including your cycle, general health, fertility conditions, age, and lifestyle.

Getting pregnant faster

Although it takes the average female up to six months to conceive, there are ways to improve fertility health and reduce time to pregnancy. Staying healthy through diet and exercise and taking folic acid supplements can greatly increase your chances of conceiving, relative to those who don’t do these things. Individuals who track their fertility data to pinpoint their ovulation are also able to speed up their time to conception. Even your mood might help with your fertility: some studies have found that happier emotional states correlate with faster conception.

How long is too long?

Although any female without a condition of infertility or sterility can get pregnant naturally before menopause, some may take a bit longer than others. Doctors recommend that couples who have not conceived after one year of trying seek a fertility consultation to determine if an alternative route to conception might be explored, whether it’s in vitro fertilization (IVF), surgery, or fertility medication. It’s recommended that women over 35 should seek a fertility consultation after six months of trying.

If you have any questions about trying to conceive or your fertility health in general, don’t hesitate to reach out to your healthcare provider for more information.

Read more

• Does pregnancy loss impact future conception?
• Trying to get pregnant for more than a year

Sources

• Dr. Walter Willett. “Nurses’ Health Study II.” National Institutes of Health. United States, 1989-. Web.
• “Nutrition During Pregnancy: FAQ001.” ACOG. American College of Obstetricians and Gynecologists, 4/15/2015. Web.

Gina Nebesar, Co-Founder of Ovia Health

I was so excited to speak with my two dear friends Becca and Jean Ann recently. Just this year they started on the crazy journey that is parenthood with their beautiful baby girl, Roz. They’re total badasses at home and at work, they’re incredible people, and now they have this gorgeous family. Their TTC journey took them a little while, and IVF helped them get pregnant, and I’m really grateful they could share their story – including incredible advice about choosing and buying sperm, real talk about IVF shots, and really candid conversation about adjusting to life as new moms.

IVF success stories: Two moms talk about growing their family… and how

I want to start by saying congrats! I know you just celebrated your 5 year anniversary, a big milestone. And an even bigger milestone is the birth of your baby girl! I’d love if you could start by telling us a little about your beautiful family.

Becca: We did just celebrate our five-year wedding anniversary, and in April we had our baby girl Roz. She’s almost 5 months old. And it’s been great so far!

I just left town for the first time, and left her alone this weekend with Jean Ann, her other mom. And in that 48 hours she learned how to roll over, without me there! And now she sleeps on her stomach, so I came home to a totally different baby. But I feel like she’s changing every single day, so it’s really awesome.

I love hearing about how people make the decision to start a family. Could you tell us a little bit about your journey to becoming parents?

Jean Ann: Because we’re two women, one question that I asked a lot is how we decided who will carry. And when your partner basically says, “One thing I’ve always wanted to do in my life is be pregnant and give birth, like, totally unprompted,” you’re like, “Cool, that seemed too easy.” Becca had always wanted to do that, and I’m still sort of on the fence – it doesn’t seem like something I have to do. So Becca had decided that she was excited about that a few years ago, and eventually I got more excited about it.

The first thing we had to do was choose a sperm donor. That was probably one of the biggest decisions we’ve ever made. Because you have to decide if you want an anonymous donor or someone you know. And we actually had a good friend who offered. And we took it pretty seriously, but ultimately decided it was important for us to have our own separate family unit. So then we looked at a lot of the websites for sperm. It’s basically like a KAYAK for sperm, and you can sort for different things.

Becca: It’s almost like online dating!

Jean Ann: We wanted someone that hopefully shared a lot of my characteristics. So were able to find someone who was half-Asian, he was getting a graduate degree in chemistry. We could even listen to a 45-minute interview with him where he talked about his favorite books, and he just seemed very thoughtful, quiet, serious, and nice.

Becca: We spent a lot of time looking for sperm – really thinking about these profiles and listening and narrowing it down. I remember we had all these pieces of paper on the kitchen table – we had written down the different donor numbers and which ones we liked – and then we narrowed it down.

And we actually had kind of had a long journey. It was about two and a half years from buying sperm until having Roz. Buying the sperm was step one. I remember, they were having an end-of-year sale, so we had to get it in before the end of 2015!

Were they really? Like, they were really having a sale?

Jean Ann: Yeah, it’s expensive. It’s something that there’s a lot of in the world, but it’s not cheap!

Becca: Well, it wasn’t quite a sale, but they were like, “We’ll throw in an Amazon gift card if you buy today!”

Jean Ann: “And three years of free storage!” But, yeah, we’ve actually spent several thousands of dollars on sperm, if you can believe it.

So, obviously, you found a great deal, but how did you get started with that process?

Becca: Really, we just Googled.

Jean Ann: There’s three or four big sperm cryo websites.

Becca: The one we went with is called California Cryo, one of the largest ones. For us, they felt right— it was a good website experience, and their customer service has been great. We did look at the big ones, some other small ones, and some local ones.

Jean Ann: But I think, for us, wanting a donor who was half-Asian like me was important, and that actually narrowed it down a lot. It went from like 550 to like, eight.

Becca: So then we could spend our time kind of really thinking through those people.

Jean Ann: You can definitely get a situation where there’s a run on the sperm. So we had this total disaster about a year later, where we had used up half the vials that we’d bought, and we were getting really low, and we went online, and they had sold out! And the donor had stopped donating! So we recommend you check what’s in stock a lot.

Becca: Yes, check frequently! And if you can afford it, buy more than you think you need.

Jean Ann: Buy a lot!

Becca: Because you can store it, and you can sell it back if you don’t need it.

Jean Ann: Nothing is worse than the feeling of having decided on someone to be your sperm donor and being very excited about them, and being halfway through the journey, and then realizing that if you want to have more than just one kid that you’re going to run out of sperm.

Becca: You’re going to run out and you may have to use different sperm.

Any other advice about that process for others that are just starting out with sperm donation?

Jean Ann: Just check your sperm stock frequently. And if you’re really excited and settled on someone, I would buy more than you need or just be willing to have a weekly reminder to check that it’s not running out.

Becca: I think the other thing is I would pony up for the extra access to information. Because I think, for us, the interviews with the sperm donors, that was the most impactful. You can only tell so much from a baby picture and some  generic likes and dislikes – which is the basic info you get – but I actually think you can get a pretty good feel for a person from something like an audio interview. It’s like a typical website where it’s like, “Pay to unlock this feature!” but it’s worth it to pay for that premium membership.

So, in December 2015, once you made that decision about your donor, how did things progress from there?

Becca: So that winter when we were back home from the holidays, we started trying to get pregnant, and we were doing IUI.

Jean Ann: You basically have two options, you can do IUI or IVF with donated sperm. IUI is basically artificial insemination.

Becca: Turkey baster!

Jean Ann: The turkey baster method, but at a facility. So we started with IUI.

Becca: I actually got very lucky with the first IUI try in February 2016. I was tracking my ovulation – I was using the Ovia app – and I was peeing on sticks and all of that, and when my ovulation test said I was ovulating we went in for the IUI, we did IUI, and I got pregnant that very first time. And it was amazing! We were so excited! First try!

And then in the spring at about 12 weeks I had a miscarriage. So I got almost through my first trimester, and I had a miscarriage. That sucked, that was a setback and sad, and that was really hard.

So the summer of 2016 was kind of recovering from that, and then it takes a while to get back on track, especially when you have a miscarriage when you’re that far along there’s a lot that your body has a lot to process and then re-regulate. And then we didn’t have a chance to try again until September of that year. So we got back on the horse and started trying again. And we were gonna continue to do IUI at that same facility because it had worked that first time.

And I started tracking my ovulation and going back in monthly, but something was wonky with my cycles. I would think I was ovulating, but I would go in and I wasn’t ovulating. I think one or two times we did get an ovulation, and we tried, but I didn’t get pregnant.

Jean Ann: And that’s when we started running out of sperm. And we realized that there wasn’t more. So that’s when we panicked, realized we couldn’t get anymore, and so we decided to move to IVF. But neither of our insurances, we thought, really covered IVF.  We were both on my insurance, and it wasn’t explicit. It was basically like, “Your IVF is covered, if it’s for a medical reason.”

Becca: “Medically necessary.”

Jean Ann: Yeah, “medically necessary,” that’s the phrase that’s used – and so I went down this whole rabbit hole to figure out if that means coverage if you’re gay. It took forever. But basically, no, being gay was not a “medically neccessary” reason, so it wouldn’t be covered. So I fumed about this for a while.

And then I ended up talking to our company’s head of HR kind of randomly about something else, and I just kind of mentioned this to her and didn’t expect it to go anywhere—I just figured this would sort of take some kind of lawsuit situation to change it— but she was like, “Oh, really? I didn’t know that!” Then two days later somebody that worked for her called and they were like, “Oh, we added it for same-sex couples to our insurance, so it’s covered now!” So I guess some advice would be to know that in terms of your health insurance, you may be able to change the coverage for something like this, depending on your company.

I constantly tell women to ask for those benefits, because they might end up with that exact same story. I was in a meeting recently with a health plan and an employer where we we pointed out in the language of the plan how it was alienating to same-sex couples. And the woman didn’t even realize it and was like, “I’ve gotta change it!” She had just never read the fine print before, but then took action to change it as well. I’m so glad that you asked about it, and I wish more people would!

Becca: Yeah, it was pretty awesome. So, we started IVF in the summer of 2017, and there’s a whole series of tests and all sorts of painful things they need to do to make sure you’re ready for it. And that takes months— you have to wait a few cycles, you have to get on the right timing. So I remember this being such a frustrating time in our lives. It felt like everything was going slowly and like everyday I had to be at the doctor doing some other painful thing. It was a rough period. It is funny now looking back on it, because it all feels like such a blur in retrospect, but at the time it felt really pronounced and painful.

Jean Ann: As someone that has now done IVF three times myself – and Becca has done it once – it’s not as bad as people think it is. It sucks giving yourself the shots, but it’s fast. It’s like a two week period of shots.

Becca: At this point we’ve both done it, because as the journey continues, we ended up having a baby and decided that we wanted to at least give ourselves the option to having another baby in the future with Jean Ann’s eggs.

Can you share more about that experience and what it’s like? Again, I’m sorry to hear about this part of the journey. I just can’t imagine having the 12 week miscarriage, that’s just awful, and the fear of the sperm running out, and then going through the pain of IVF. And I know you say it’s not that bad, but I think maybe you’re just tougher than many – that sounds really hard to me!

Becca: Honestly after being pregnant for nine months, you can barely remember the IVF, it’s like a blip. But I think that the shots – for us at least – I think the shots look scarier than they end up being.

Jean Ann: I feel like the first and second time you’re really just like, am I really going to stab myself in the leg with this needle?

Becca: The thought of it is tough. The first time is the hardest, because you’re just staring at this needle and you’re like looking at your leg, and you’re just like, so I’m really just going to push this in, huh? But it’s a needle, and it’s made to go in. I actually think over the two week period of shots, it gets progressively more painful toward the end. So the last few days are the worst. I think at that point you’re feeling a little bit bloated, you’re not allowed to go to the gym, you’re giving yourself shots every single night. For some reason those last few nights hurt the worst. At that point you’ve shot yourself everywhere on your legs, everywhere on your stomach, and you’re looking for a new spot. So those last few nights, you just want it to be over.

Jean Ann: And then you have the trigger shot, and everybody makes a big deal of the trigger shot. Somebody else gives you that one, and it has to be at an exact time – like, 1:45 in the morning, 10:30 p.m. – so when you go in to have your eggs be retrieved, it’s exactly 36 hours after the trigger shot.

Becca: And then for the egg retrieval process you do go under.

Jean Ann: Under some very temporary anesthesia. You’re all the way under, but it’s very short. And then you’re done!

Becca: And then there’s some anxiety as you wait to hear your egg count. For us we were doing embryos, so right when they retrieved the eggs they fertilized them with our frozen donor sperm. So after that you’re kind of waiting on eggshells – no pun intended – to hear how many of your embryos made it to day 3 or day 5, or just what the status of them is. And we’ve been on both sides of the spectrum. For me, I was really fortunate, I had a pretty high egg count, and with just one retrieval I got enough embryos that we felt comfortable and were able to freeze them. For Jean Ann, on her first and second try she didn’t get that many, and so she’s had to go through the egg retrieval process three times now.

Jean Ann: I will just add that for anybody that’s getting close to age 35, 35, you can get a blood test that will give you your AMH number. It basically tells you how many eggs, roughly, you have left. It’s a very good indicator or whether IVF is going to be a breeze and you’ll just have to do that once, or if your egg yield is going to be low and you’re going to have to do it multiple times like me. It is also a good predictor of if you will have to do IVF at all because the same number is also a good indicator of whether or not you will naturally be able to get pregnant. It’s a very easy first step.

Did you know about this AMH (or Anti-Mullerian Hormone) test before starting the IVF process, or did you learn about that after?

Jean Ann: Actually, someone at work told me about it. Because I was like, “I don’t think I want kids for a few years,” and this very matter of fact 40 year old man was like, “How old are you?” And I said, “35.” And he was like, “Just go get your AMH number. My wife had a low AMH number and it took us 5 years of trying and then we ended up adopting.” I was like, oh, my gosh!

And then I got the test, my AMH number was bad, and, indeed, it took me multiple times to do IVF. So I feel like this AMH blood test is pretty much free information.

A lot of healthcare providers might say no to that sort of testing, but I always suggest that people go to their provider and just insist on it. So, through this process, who was supporting you along the way? Obviously, you had each other. Was there anyone else in your life who was particularly helpful during this time?

Becca: Each other, for sure. I’m not a big oversharer, but it’s been really helpful for me to share, because what I’ve found is that as soon as I start talking about it, everyone has either a similar story themselves, or their friend does, or their sister does. So when I had my miscarriage, it was really helpful for me to tell people about it – even at work – and then people would share these success stories, and that made me feel better. And it was similar when going through IVF. I would talk about it with my friends, and they all had someone they knew who had been through it. At the time, I was really the first of my very good friends who was having a lot of trouble getting pregnant, and I felt a little bit alone, so their IVF success stories were helpful for me.

Jean Ann: But since then, now we know several people who’ve been through this.

Becca: We know people who’ve had miscarriages, been through IVF, and now I’ve been able to help them because we have this success story. So, for me, I would tell anyone who’d listen! And that helped me a lot.

Jean Ann: Then you had a pretty good pregnancy.

Becca: Yeah, and the IVF really worked well for us. We did an egg transfer, and I got pregnant on that first one, and then I had a pretty good pregnancy.

Jean Ann: And you have to give yourself these progesterone shots for the first 12 weeks.

Becca: No one talks about this!

Jean Ann: No one talks about this, but these are actually really terrible shots. And every night for the first 12 weeks that you’re pregnant—

Becca: You give yourself a progesterone shot in the butt.

Jean Ann: That was probably the worst part.

Becca: I think some doctors will allow you to do a suppository instead. So I went, like, running in after three nights of shots and was like, “Give me the suppository!” And they were like, “No, we highly recommend the shots.” They wouldn’t do it. So you’re giving yourself shots for 12 weeks. So much worse that the two weeks of IVF shots! It’s so much longer! So you’re basically so sore in the butt for the entire first trimester. But once we got through that, things were okay.

Jean Ann: Smooth sailing.

Becca: Yeah. I had a lot of heartburn, and that was my main symptom really.

Jean Ann: Then because you were a geriatric pregnancy, they told us that they wouldn’t let you go past one week over your due date. So we got an induction date for almost a week past your due date.

Becca: Yeah, 5 days past my due date they scheduled us for an induction. We went in, I got induced, and like these things do, it took forever to get a room, it took forever for the induction to start.

But then, like, once it started, it really started.I had pretty strong contractions for a long time, for like 15 hours. But I really wasn’t dilating. So, it was kind of sad, I kept having these big contractions and the doctor would go away and then come back a couple hours later to check my cervix and every time I was like, “Oh, I think I’m making progress!” and then she would check and be like, “Nope, still 3 cm. You’ve barely made it to 4 cm.” So I just wasn’t dilating. And then at some point, in about hour 16 or 17 of labor, I got a fever, and they said we’ve got to do a C-section. So we went in on a Thursday night, that Friday night at 11:30 p.m. she was born via C-section. And she was great!

Jean Ann: There’s so much pressure to not have a C-section and to be able to breastfeed right away and all this stuff, and, like, if you walk out with a healthy baby, that’s the goal, that is 100% success. I feel like people shouldn’t put that much pressure on how they want everything to turn out.

I know. There’s so much pressure for birth to be this perfect experience, just as planned. And I remember, too, even with me, I had a C-section, just feeling guilt, feeling like a failure, and realizing that, like, my baby’s awesome, and I really don’t care about how I got her! Do you remember what the first couple of days after Roz was born were like?

Becca: It’s funny, it’s such a blur. And I remember at the time saying to myself, I’m totally lucid and I’m recovering fine and I’m gonna remember all of this. And now I realize I don’t remember much of what those days were like!

I remember stumbling out of bed in the middle of the night and either feeding or pumping, and I remember napping a lot. Because I was recovering from a C-section, I needed a lot of help both during the days and the nights. So luckily I had Jean Ann to help, we had family, we got some help for me during the day when she went back to work. We were fortunate to be able to do that because I couldn’t lift the baby, but it’s all such a blur.

I do remember her being so cute. Like everything she did was so cute. I would feed her, and she’d fall asleep on me right after, and it was the cutest thing I’d ever seen! This weekend, actually, I saw a picture of Roz from her first few weeks. And I remember at the time looking at her and thinking, My newborn is so cute! She doesn’t look like a weird scrunched up newborn like every other one! She’s a perfect baby! And, like, five months later I realize that she definitely looked weird! But you just don’t see it at the time.

You do have an exceptionally cute baby! So what is it like now versus what it was like then?

Becca: I just feel like we’re getting more into what our life will look like for the next few years. Those first few weeks in my maternity leave I just kept thinking about how it was a temporary time – and it was wonderful, and I really enjoyed it – but now we’re trying to figure out what our real life looks like. Like how we manage the jobs and the baby, how we manage finding time for ourselves, how we manage time for the extended family who wants to visit. So, it’s different – I’m much more lucid, I’ve recovered from the C-section, all of that kind of blurriness is gone – but I’m in this, like, this half-place where I feel like, we don’t quite have enough time for everything. And I don’t know if this is just what the new normal is, or if we’re still figuring it out. So that’s kind of the phase we’re in now.

I feel like our journey has taken a lot of different turns. And where we are now – we’re so so happy and so lucky that we have this wonderful healthy baby – but it took a while. And it took a lot of different types of interventions, and along the way there were times when it felt like it wasn’t going to happen, but now she’s here, and she’s perfect, and it makes the last two and a half years feel like a blur, like just a blip. So it was all worth it.

Jean Ann: But at the time, it was tough. It can be very tough.

Becca: Yeah, and I guess some advice we would give is to try to release some of the expectations that you have and some of the perfection that you’re striving for, because you really just don’t know how things will turn out. Like, you might not always be able to hit that exact timing for getting pregnant that you want. Or we thought we wanted a boy, but we obviously love our baby girl! It turns out it doesn’t matter. So just to try to release some of that, to the extent that you can, because the journey is hard enough.

There are many factors that might have you considering alternative insemination, and using a sperm donor to help you in start (or expand) your family.

If you’re thinking about sperm donation, here’s what you should know

Your primary care provider (PCP) will be able to give you a fertility evaluation, and this will help you decide whether using donor sperm, or other reproductive assistance, is right for you. During this appointment, you’ll be asked to provide information about your lifestyle, but don’t worry, this isn’t a test. You won’t “fail” the exam if you admit to being a couch potato every once in a while, and it’s important to be honest if you want a care plan that’s specific to your family’s health and needs.

Choosing sperm

After meeting with your PCP, your mind may shift to figuring out the type of sperm you’d like to use. “Known” sperm (the sperm of someone you know) and anonymous sperm are the two options you’ll find. Both can be the right choice, but each has different emotional and legal considerations that go with them, so take your time with this decision.

Remember, all donations (anonymous or not) are screened for sexually transmitted diseases, as well as any evidence of genetic disorders. In the case of anonymous donation, the sperm is usually frozen and kept for 6 months after it is deposited, before it is then re-tested and given to patients.

In addition to deciding whose sperm to use, there is also the matter of what form of sperm you’re going to use. As with insemination procedures, there are few different options that are available:

• ICI-ready sperm: Semen in this category is used for intracervical insemination. This process is probably the closest to the movie and TV representations of sperm donation. These specimens are not “prepared” or altered before they are frozen (but of course they go through the same thorough screening process). Often, this sperm is injected into a patient at a clinic or doctor’s office, but this type of sperm can also be used for private home insemination. ICI is the least invasive form of alternative insemination, and has success rates of anywhere from 10% to 18% (tracking your cycle can help give you the best odds).
• IUI-prepared sperm: These samples are prepared for intrauterine insemination. The seminal fluid is removed or, “washed” from the donor’s semen to isolate sperm, and all dead swimmers are removed before the sample is frozen. This option is more expensive  than ICI sperm because of the process the semen goes through, and because by eliminating seminal fluid and dead sperm, there is a better chance of fertilization.The IUI procedure is also a little more invasive than ICI because the sperm is directly inserted into the uterus rather than the cervix. This process is always performed in office, and has a success rate of 18% to 30%.
• IVF-prepared sperm: This is the cheapest form of prepared sperm, but it isn’t offered by every sperm bank. These samples have a lower sperm count than ICI or IUI prepared sperm. This is because it is believed that less sperm is needed to conceive through IVF, and that saves you some money. But despite saving a couple of bucks on sperm, IVF is one of the most expensive options for alternative insemination. This process involves taking already fertilized embryos and inserting them into a uterus. And again, this increases the success rates to 13% to 41%.

The varying success rates within methods are due to a lot of situational factors including medication, health, age, and lifestyle.

Because the cost of donor insemination can range from $300 to $4,000 depending on what sperm is used, and an average cost of $12,000 per IVF cycle, be sure to ask your provider how many vials of sperm you’ll need!

Preparation

Sometimes people are prescribed medication to help prepare the body by encouraging fertilization. Every case is different, but many medications prescribed in these situations are follicle stimulating hormone (FSH) treatments. FSH is a naturally occurring hormone in your body that helps mature an egg living in the ovaries, while also causing a follicle to grow around that egg as it continues to mature before ovulation. The medications prescribed by healthcare providers encourage this process in the same way.

The day of

Traditionally ICI, IUI, and IVF are all outpatient procedures. IVF can be a little different because the process may involve two outpatient procedures. In those cases, there is a standard egg retrieval and a seperate embryo transfer performed after the eggs have been fertilized. Though all of these procedures may be a little different, a benefit of all three options is that once the insemination process is over, you’ll be able to resume your day as normal.

After insemination

After these outpatient procedures, you’ve made it! And despite popular belief, there’s no need to lay on your back with your legs in the air. You may be asked to lay down or relax for a while, but your legs won’t be airborne, and this downtime could help you process your excitement or calm your nerves. After insemination, you may experience some mild cramping or bloating. This is normal, and shouldn’t be too intense. Then, you may be able to take a pregnancy test as soon as two weeks after insemination! On the other hand, some healthcare providers may suggest waiting a longer period of time. Waiting a little longer will be hard, but if you can do it, you’ll get a more accurate reading on whether or not the insemination was successful.

The bottom line

Alternative insemination is a procedure without many physical risks, and is a great option for people looking to expand their families. Because there are varying success rates to each procedure, your PCP can offer a great deal of guidance and support when making this decision. Be sure to keep all of your personal needs in mind, and take everything at your own pace.

Sources

• Office Andrology. Illustrated Edition. Battaglia, David E. and Patton, Phillip E.. Human Press. 2010. Web. https://books.google.com/books?id=WMazHT_VXrcC&printsec=frontcover&dq=Office+Andrology&hl=en&sa=X&ved=0ahUKEwjh9tXSqJfcAhVDn-AKHZDTCcYQ6AEIJzAA#v=onepage&q=Office%20Andrology&f=false
• “Single Cycle IVF Cost Details – Advanced Fertility Center of Chicago.” Advanced Fertility Center of Chicago. Advanced Fertility Center of Chicago. 2017. https://www.advancedfertility.com/ivfprice.htm
• Mayo Clinic Staff. “Female Infertility”. Mayo Clinic. Mayo Clinic. March 8, 2018. https://www.mayoclinic.org/diseases-conditions/female-infertility/diagnosis-treatment/drc-20354313
• Seattle Sperm Bank Staff. “Demystifying IUI, ICI, IVI, and IVF”. Seattle Sperm Bank. Seattle Sperm Bank. 2015. https://www.seattlespermbank.com/demystifying-iui-ici-ivi-and-ivf/
• Seattle Sperm Bank Staff. “How to Inseminate at Home Using Donor Sperm.” Seattle Sperm Bank. Seattle Sperm Bank. 2015. https://www.seattlespermbank.com/how-to-inseminate-at-home-using-donor-sperm/
• Pacific Fertility Center Staff. “Donor Sperm.” Pacific Fertility Center. Pacific Fertility Center. 2018. https://www.pacificfertilitycenter.com/treatment-care/donor-sperm
• “In Vitro Insemination: IVF”. American Pregnancy Association. American Pregnancy Association. 2018. http://americanpregnancy.org/infertility/in-vitro-fertilization/
• “Artificial Insemination (Intrauterine Insemination, IUI)”. University of Wisconsin Hospitals and Clinics. University of Wisconsin Hospital and Clinics. 2018. https://www.uwhealth.org/infertility/intrauterine-insemination-iui/26136

Pregnancy test facts…and fiction

Here are some of the more commonly-held beliefs about taking a home pregnancy test, some of which are fact; others, fiction.

Fact or fiction? Your body starts making hCG after implantation.

Fact! After the fertilized egg implants, the placenta starts producing hCG, the pregnancy hormone. A woman’s hCG levels rise very quickly in early pregnancy, but the amount of hCG that a woman has can vary, depending on the individual. Some women have a lot of hCG right away, while others’ bodies take a little longer to start making noticeable amounts of hCG. This is why testing after a missed period can produce more accurate results.

Fact or fiction? Antibiotics can interfere with pregnancy test results.

Fiction. Certain fertility drugs that contain hCG could affect the results of a pregnancy test, but according to the Mayo Clinic, antibiotics or other hormonal medications like birth control pills don’t interfere with the results of a home pregnancy test.

Fact or fiction? You can use an ovulation test like a home pregnancy test to pick up your pregnancy early.

Fiction. In theory, you could, but it wouldn’t be worth the time or money. Basically, home pregnancy tests look for levels of hCG in a woman’s urine, and ovulation tests look for levels of luteinizing hormone (LH) in urine. Both hCG and LH show up nearly the exact same on an ovulation test, so if a woman has enough of either hormone in her body, an ovulation test could technically detect the hCG and show that she is pregnant.

The reason why you can’t use an ovulation test in place of a home pregnancy test is because home pregnancy tests are much more sensitive to hCG. Unlike ovulation tests, home pregnancy tests can pick up on the pregnancy hormone much earlier than ovulation tests. If you use an ovulation test to check for pregnancy, you have a much higher risk of a false negative (and honestly, who wants or even has time for that?).

Fact or fiction? A blood test is the only way to confirm 100% if you are pregnant.

Fiction. It’s true that blood tests are more accurate than home pregnancy tests, but only slightly. Blood tests have an accuracy rate of 99%, compared to the 97% accuracy rate of home pregnancy tests that use urine. If you get a positive pregnancy test at home, your provider will likely perform another urine test in his or her office, along with an ultrasound to confirm your pregnancy.

Fact or fiction? Tests that use pink dye are better than tests with blue dye.

Both? There’s not a ton of scientific evidence about this, but many women report that blue dye fades and blurs in a way that makes it much harder to read on a pregnancy test. No matter what test you use, if you get a positive, make sure to test again a few days later, and then schedule an appointment with your provider.

Sources

• “Pregnancy Test.” MedlinePlus. US National Library of Medicine, Oct 2016. Web. Accessed 8/18/17. Available at https://medlineplus.gov/ency/article/003432.htm.
• Liza Torborg. “Mayo Clinic Q and A: Ovulation predictor kits can be useful for couples trying to conceive.” MayoClinic. Mayo Clinic Foundation, Sep 2015. Web. Accessed 8/18/17. Available at https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-ovulation-predictor-kits-can-be-useful-for-couples-trying-to-conceive/.
• “Getting pregnant.” MayoClinic. Mayo Foundation for Medical Education and Research, Dec 2015. Web. Accessed 8/18/17. Available at http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/home-pregnancy-tests/art-20047940?pg=2.

Don’t be surprised at your next PCP appointment, here’s what to expect

But even if you’ve been to a PCP before, it may have been a while ago, or you may have never before had an appointment at a time when you were trying to conceive. So just what can you expect once you’re there? Your visit may include:

General physical exam

The general physical exam may be done by a nurse assisting your doctor, or done by the midwife. This usually consists of a height and weight check, as well as taking your blood pressure.

They may also ask you some basic questions, such as if there have been any major changes to you health since you last visited, what medications or supplements you’re currently taking, and if you have any major concerns that you’d like to discuss during the visit. They will also likely ask your the last dates of your period and about your period history.

Discussion of health history, concerns, and questions

This kind of visit also dedicates some time to speaking with your healthcare provider about your personal and family medical history. You may also discuss sexual history, options for contraception, fertility, and plans for conception.

As you discuss all of this, your provider will probably ask you a number of questions, and if you’re honest with your answers, your healthcare provider will be able to provide you with the best and most appropriate care. This is also the time for you to ask any questions you may have – no matter how personal, and even if you feel a bit embarrassed. Your healthcare provider is there to provide you with reliable medical knowledge, support, and to answer any and all questions you have.

Whether you’re actively trying to conceive or not, your provider will discuss reproductive health options that will work best for you. And if you want to try to conceive in the near future, this is the time to tell your provider about these plans so that they can share just how you can remain in good health as you TTC.

Physical exam

An accompanying nurse may or may not stay in the room with your healthcare provider during the physical exam. During this exam, you will likely be undressed and wearing a medical gown that opens in the front and a paper sheet to cover your lap, and the exam might include a pelvic exam, a bimanual exam, a breast exam, and a rectovaginal exam.

During the pelvic exam, your provider may examine the outside of your vagina, including your vulva and vaginal opening. Your provider may also examine the insider of your vagina and cervix with the help of a device called a speculum, which will hold open the vagina. They may also do an internal bimanual exam by placing gloved fingers inside your vagina as they place their other hand on your lower abdomen where your reproductive organs are located to feel them.

The provider may also do a rectovaginal exam as needed, which involves them placing one gloved finger in your vagina and another in your rectum.

The breast exam may involve your provider looking at and feeling your breasts for lumps or other abnormalities. They may also feel your neck and throat. As they do all of this, this they will aim to see and feel that you are healthy, and that they don’t observe any abnormalities.

During the physical exam you may feel some pressure or slight discomfort, but none of this should not be painful. If you do feel discomfort or pain, make sure you let your provider know.

Lab tests or screening

Based on your medical history and discussions with your provider, there is a chance they may recommend lab tests or screenings – whether routine or specialized – based on your healthcare needs. These might include a blood draw, a urine test, STD tests, or a Pap smear. These tests may happen before or after you meet with the provider.

Pap smears are done during the pelvic exam and involve your provider swiping your cervix with a small brush. (The cells taken from the swipe are then tested at a lab for cervical cancer and other abnormalities.)

No matter what type of provider you see, your healthcare provider is meant to be a partner in your care, helping you to maintain good reproductive health at every stage of your life.

Trying to conceive? What you should know about prenatal vitamins

Getting all the nutrients we need from the food we eat should be possible, but during pregnancy, there can be gaps that even the most careful person can’t avoid. According to the Dietary Guidelines for Americans, the U.S. population generally does not meet daily requirements for many nutrients.

Let’s start with a big one. Folic acid is a water-soluble vitamin that protects against neural tube defects like spina bifida. Getting enough folic acid through supplementation and diet is critical before becoming pregnant and when the neural tube is developing in the early days of pregnancy. Your supplement should have at least 400 mcg of folic acid. You can also consume foods high in folic acid, such as beans, leafy green vegetables, cereals, and enriched or fortified grains. Although you can buy prenatal vitamins that contain “folate,” folic acid is the only supplement that has been researched and shown to reduce the incidence of neural tube defects.

Iron is important for those who plan to become pregnant or who are pregnant. Iron deficiency anemia is the most common nutritional deficiency in the world, and in pregnancy, it can lead to preterm labor, low birth weight, or infant mortality. Unfortunately, getting enough iron from foods can be difficult, so your provider or midwife may suggest taking a supplement while trying to conceive and during pregnancy. Women 19 to 50 years old who are not pregnant need 18 mg of iron per day, and pregnant women need 27 mg per day. Meats, poultry, and fish are good sources of iron, as are many of the foods listed above that are high in folic acid. Having a source of vitamin C can make iron easier to absorb, so consider adding some strawberries to your spinach salad, red bell pepper to your broccoli, or taking your iron supplements with a small glass of orange juice. Iron can be constipating in supplement form, so you may need to experiment with which brand or type works best for you! When you’re ready to start TTC, you can also ask your provider to check your iron levels with a blood count and ferritin level.

Other things to consider

Each woman has individual needs, so talk with your provider or midwife before starting a supplement. You may need additional vitamins or minerals, and your provider can help identify the best options for you based on your health history and available lab work. Folic acid and iron can be found in prenatal vitamins, regular multivitamins, or sold individually. Remember, supplements are meant to do just what they say – supplement our diets. Taking vitamins shouldn’t replace healthy foods in your diet, like vegetables, fruits, whole grains, and protein. By enjoying a variety of healthy foods, you can maximize your nutrition and fertility while trying to conceive!

Sources

• Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes (DRIs): Recommended Dietary Allowances and Adequate Intakes, Vitamins Food and Nutrition Board, Institute of Medicine, National Academies. Available at: https://www.nal.usda.gov/fnic/dri-tables-and-application-reports. Accessed May 31, 2017.
• U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/.
• “Neural Tube Defects.” march of dimes. March of Dimes Foundation, April 2016. Last reviewed: February 2022. https://www.marchofdimes.org/find-support/topics/planning-baby/neural-tube-defects

No period, not pregnant: What does it mean?

The rollercoaster of emotions that come with taking a pregnancy test is often stressful, but don’t give up just yet. Here’s what it means to have no period for a while and still not be pregnant.

Reasons why a test could be wrong

Here are a couple reasons why you may have received a false negative.

• Taken before the first missed period: Pregnancy tests work by detecting levels of human chorionic gonadotropin, hCG, a hormone that the body starts to make when an egg has been fertilized. Because the tests look for the presence of this hormone, it is possible that they miss the hormone in the very early stages of pregnancy, mainly in the days leading up to the first missed period. For the most accurate readings, it’s best to wait until at least the missed period, if not a few days after.
• Fluids diluting urine: Yes, you should still be drinking lots of water! But taking a pregnancy test later in the day can sometimes mean that urine is diluted and hCG is more difficult for the test to detect. The hormone levels are highest in the morning too, so for the most accurate results try to take the test as early in the day as possible, preferably right after you wake up.
• Test directions not followed correctly: We don’t mean to suggest that you would miss a step . . . but could you have missed a step? Some tests require waiting a specific amount of time before reading the results. Pregnancy tests also have an expiration date, so we recommend buying new ones as opposed to using old ones that could be in your house.

Final thoughts

Ultimately, it’s always a good idea to read and closely follow the directions on home pregnancy tests, even if you consider yourself a pro by now. There’s also always the possibility that the negative test is accurate, and your period is simply a few days late. Home pregnancy tests are great, but after a positive result, it’s still important to visit your healthcare provider for a blood test to confirm.

Sources

• “Pregnancy test.” MedlinePlus. US National Library of Medicine, Oct 4 2016. https://medlineplus.gov/ency/article/003432.htm.
• Mayo Clinic Staff. “Home pregnancy tests: Can you trust the results?” MayoClinic. Mayo Foundation for Medical Education and Research, Dec 2015. http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/home-pregnancy-tests/art-20047940.