How to time your pregnancy test properly

Here’s what you should know about this timing – and the science behind our recommendations.

First, understand how home pregnancy tests work

In the earliest stages of pregnancy, a fertilized egg will begin to implant in the uterine lining. This happens around four to six days after conception. Once implantation starts, the placenta starts producing human chorionic gonadotropin (hCG), the pregnancy hormone. Home pregnancy tests work by determining if there is hCG present in urine – and, as you might know, home pregnancy tests ask you to pee to a stick to measure this.

Because hCG doesn’t show up until after implantation begins, if you don’t wait a few days to make sure the embryo has had a chance to implant, there’s the chance of getting a false negative – meaning that the pregnancy test reads as a “negative” even though pregnancy has occured. Implantation usually happens six to twelve days after ovulation, so the absolute earliest that you can test for pregnancy is a week after ovulation. For even more accurate results, it’s preferable to wait a few extra days so that levels of hCG can rise to more detectable levels. Waiting a few days after the first day of a missed period usually guarantees the most accurate results from a home pregnancy test.

Utilize Ovia Health to help with pregnancy testing

When it comes to pregnancy test timing, you probably know it’s best to take it at least one or more days after your next period is due. But your menstrual and ovulation cycle can fluctuate every month, meaning certain days of your cycle might change on a monthly basis and make it harder for you to know exactly when it’s time for you to take a pregnancy test. The US Department of Health and Human Services reports that nearly 20% of individuals who are pregnant get a false negative, because they’ve miscalculated their period or it arrived later than expected that month.

This is where tracking is helpful. Different ovulation symptoms can suggest that you’re in a certain part of your cycle. For example, in the luteal phase, which is when the egg implants and your body starts making the pregnancy hormone, your body releases progesterone, which can affect your moods, breast tenderness, and cervical mucus. Spotting might happen as a sign of implantation bleeding, too. These kinds of symptoms tell Ovia what phase of your cycle you’re in.

When you log your data consistently, Ovia takes all of the information you provide, like your period dates, cervical fluid consistency, basal body temperature, symptoms, and moods, and uses it to predict when you’re ovulating and when is the best time to take a pregnancy test. If Ovia tells you to test on a day that’s different from what you expected, this could be because of natural fluctuations in your cycle, as well as symptoms that suggest to Ovia that you’re at a different day in your cycle than you previously thought.

Other things to consider

Cycles fluctuate month by month, and it can be difficult to know for sure when one phase of your cycle ends and another begins. And if you’re patiently waiting for some positive news, we know you can’t get it soon enough – so we’re here to help. By consistently logging your symptoms and moods, you’re providing Ovia with important information that will help us predict the best – and most accurate – day for you to take a pregnancy test.

Sources

• “Home use tests: Pregnancy.” FDA. US Food and Drug Administration, Jun 5 2016. Web.
• Mayo Clinic Staff. “Home pregnancy tests: Can you trust the results?” MayoClinic. Mayo Foundation for Medical Education and Research, Dec 2 2015. Web.
• Connie Matthiessen. “Week 01 to Week 04 of Pregnancy.” HealthDay. HealthDay, Jan 20 2017. Web.

Things to consider about sex after a miscarriage

Individuals and couples who have experienced a miscarriage often report feelings of hesitancy towards resuming sexual activity, for both physical and emotional reasons. What is most important is that you take care of yourself, and keep the lines of communication open.

What factors influence when someone can start having sex again?

Sex after miscarriage is a very personal and individualized situation. That being said, there are some physical and mental factors that most people will want to take into consideration after experiencing any kind of pregnancy loss.

• Physical factors:

After a pregnancy loss, women are generally advised to maintain ‘pelvic rest’, including no tampon use or sexual activity, for two weeks after miscarriage. This is partially due to the fact that the cervix and uterus are more dilated in the weeks following a miscarriage, which makes infection more likely. A pelvic exam from a provider is the best way to know for sure if you’re medically ready to have sex again. Sexual activity can typically be resumed after this time. However, a healthcare provider may give different recommendations about when it’s safe to resume sexual activity based on their assessment and your experience.

• Emotional factors:

Many people don’t feel quite ready to start having sex again for some time after a miscarriage. This is very normal. Open, honest conversation between partners should be encouraged in order to remain connected and work through these feelings.

Your healthcare provider is a valuable resource to help you determine when it is safe to resume sexual activity and, if you’re ready, to try and conceive again if that is something you want. Your provider will base their recommendation on multiple factors including the type of loss, the gestational age at the time of loss, and the your personal experience.

When does the menstrual cycle return?

You may ovulate as soon as two weeks after a miscarriage, but it is also normal for ovulation to take longer to resume.  Healthcare providers usually recommend waiting at least one menstrual cycle before trying to conceive again, and that people not try to conceive until they feel emotionally healed. These recommendations may be different for those who have had more than one miscarriage. As always, it’s a good idea to ask your healthcare provider for their opinion about when it’s safe to start trying again. In the meantime add a safe method of protection, if that’s necessary for you, until you’re cleared.

Long-term grief

It’s normal to experience a shift in mood, or strain in a relationship after a miscarriage. While short- and medium-term grief and sadness are expected, if you’re experiencing grief or depression lasting for months and it’s impacting your  ability to perform daily activities, seek the help of a specialist. There are many options to get the help you need. This could be a therapist, a psychiatrist, a support group, or a combination of them; the most important thing is that you feel comfortable talking to your healthcare provider about how you’re feeling and any concerns you may have. Sexual activity after loss might be emotionally or physically difficult at first, but as long as both partners are respectful of one another and understand where each other are at in the healing process, things will get easier over time.

Sources

• “When can I resume sex after a miscarriage or pregnancy loss?” UTMBHealth. The University of Texas Medical Branch at Galveston, 2016. Web.
• “How soon can couples have sex again after a miscarriage?” ISSM. International Society for Sexual Medicine, 2016. Web.
• “Getting pregnant: when is the best time to get pregnant after a miscarriage?” MayoClinic. Mayo Foundation for Medical Education and Research, May 17 2016. Web.

Pregnancy implantation signs and symptoms

Timeline

The first difference is in the timing of the symptoms. Implantation happens any time between about 5-10 days after you ovulate, while PMS usually sets in closer to two weeks after. So if symptoms start and it feels a little early to you for it to be menstruation, it might be a successful implantation.

Cramping

Mild cramping can be a sign of successful implantation, as the fertilized egg attaches to your uterine lining. These cramps don’t happen in every case, and they’re not, on their own, enough to say for sure that implantation has happened. When they do occur though, they’re different from menstrual cramps in that they only last for short periods of time, rather than continuously like menstrual cramps. The pain they cause also tends to be much more mild than that from menstrual cramps.

Spotting

Implantation bleeding produces a lot less blood than a menstrual period. Instead, it’s more like spotting, and is more likely to range from pinkish to brownish, instead of red like menstrual blood. If you have heavier-than-period bleeding, especially with extreme cramping, you should contact your healthcare provider.

Soreness

Both implantation and PMS can cause soreness in your breasts. The two types of soreness won’t necessarily feel that different from one another, but soreness from a period will usually go away after a few days, whereas soreness from implantation might stick around through your pregnancy. In fact, the elevated presence of progesterone and other hormones during pregnancy can cause several different changes in your breasts. Another change that you might notice around the time of implantation is a darkening of your areolas.

Other signs

There are other signs of implantation that don’t correspond to menstrual symptoms, like nausea and morning sickness, increased urination, and, of course, missing your period. Since everyone’s body is different though, you may not notice some or all of these signs. At-home pregnancy tests can provide a bit more confirmation, though they won’t reach their full accuracy until around your expected period date.

Sources

• “Is It Implantation Bleeding — Or Just My Period?” WhattoExpect. What to Expect, Apr 12 2016. Web.
• Margaret Scott. “Signs Of Successful Implantation: Why It Is Important To Stay Optimistic.” ImplantationSpotting. All About Implantation Bleeding, 2014. Web.

Popular questions and answers about your period and birth control

Your unanswered questions about periods, birth control, and ovulation.

Do you still ovulate on birth control?

It’s unlikely. Hormones play important roles in many of our bodily systems. The pill, the patch, the ring, and the birth control shot all suppress ovulation by blocking certain hormone signals that cause an egg to be released every month. This is why hormonal birth control is so effective at preventing pregnancy. 

If you’re on the IUD, however, you typically will ovulate. Hormonal IUDs work by making the uterine lining a hostile environment for a fertilized egg to implant into and copper IUDs are simply toxic to sperm.

Is it really safe to control if and when you get your periods?

In many cases, yes, it’s safe to skip a period. However, it’s best to speak with your healthcare provider before doing so.

Anyone who has chosen to skip a family reunion can back us up on this: just because something regularly happens, doesn’t mean you’re obligated to participate. Periods often are no exception. Menstruation is part of how the body prepares for pregnancy, so if you’re not trying to get pregnant, you might not need to shed your uterine lining every month.

Some healthcare providers discourage (or at least don’t recommend) purposefully skipping periods, so it’s important to speak with your provider about whether or not this would be right for you.

Are IUDs and pelvic infections linked?

Pelvic inflammatory disease (PID) occurs when bacteria enter and infect the reproductive organs. Though individuals are at risk for bacteria to enter their vagina after an IUD has been inserted, the risk is lower than commonly believed. Undetected and untreated STDs are more likely to put someone at risk for PID than an IUD insertion.

Do you need birth control while breastfeeding?

Wasn’t pregnancy fun? Want to do it again? Like, in a month? If your answer is no and your baby is still breastfeeding, it’s a good idea to get on some form of birth control. Even though you may not be menstruating, as soon as three weeks after labor your body could start releasing an egg again. This makes you fertile! Speak to your healthcare provider to decide what’s best for you.

Sources

• Murry, Mary. “Birth control after pregnancy: Think ahead.” Mayo Clinic. Mayo Clinic. December 14, 2010. Web.
• “Pelvic Inflammatory Disease (PID) – CDC Fact Sheet.” Centers for Disease Control and Prevention. U.S. Department of Health & Human Services. May 23, 2016. Web.
• Mayo Clinic Staff. “Choosing a birth control pill.” Mayo Clinic. Mayo Clinic. January 22, 2015. Web.
• Lopez, L.M.; Grimes, D.A.; Chen-Mok, M.; Westhoff, C.; Edelman, A.; Helmerhorst, F.M. “Hormonal contraceptives for contraception in overweight or obese women.” PubMed. NCMI. 2013. Web.
• Mayo Clinic Staff. “Mirena (hormonal IUD).” Mayo Clinic. Mayo Clinic. January 10, 2015. Web.
• Mayo Clinic Staff. “Delaying your period with birth control pills.” Mayo Clinic. Mayo Clinic. February 10, 2015. Web.

Here are the TTC acronyms you should know about

AF:

Aunt Flow. Your period.

Thanks for the invite, but my Aunt Flow’s in town. I’m gonna go home and treat her to some wine and reruns.

BBT:

Basal Body Temperature. BBT may spike right before ovulation, so many women track it to help them pinpoint their ovulation.

The very first thing I did this morning was grab my thermometer and take my BBT.

BCP:

Birth Control Pills.

In almost no time after I stopped taking BCP, I was pregnant.

BD:

Baby Dance. Sexual intercourse, usually done on the most fertile days of your cycle. (Can also mean baby dust, which is a phrase you use to wish someone good luck.)

My ovulation test is positive, which makes me want to dance – the BD, that is!

BFN/BFP:

Big Fat Negative/Big Fat Positive (on your pregnancy test).

Every time I buy a pregnancy test, I think about how it could be the one to show the BFP.

BOB:

Baby on the Brain!

I’m having a hard time shopping with BOB. All I can think about is tiny socks and pacifiers, which makes it impossible to keep track of my grocery list.

CD:

Cycle Day. A specific day in your menstrual cycle (or fertility treatment cycle). To track it, start by counting from the first day of your last menstrual cycle.

It varies each cycle, but normally I ovulate on CD 13, or 13 days after the first day of my period.

CM or CF:

Cervical Mucus or Cervical Fluid. Changes in cervical fluid indicate that a woman is at different stages of her cycle.

At the most fertile point of each cycle, my CM is clear and super stretchy.

CP:

Chemical pregnancy. A very early miscarriage.

My doctor recommended that I put off trying again until one cycle after my last CP.

DD:

Darling daughter. A daughter you already have.

DH, DD, and I go on vacation next week.

DH:

Dear husband.

I’m 42 and DH is 43.

DPO:

Days Past Ovulation, or Cycle Date Post Ovulation.

By 7DPO of the TWW, I’m already wondering if every little cramp is a sign of pregnancy.

DS:

Darling son.

It’s a challenge to care for DD and DS while also TTC.

ENDO:

Endometriosis. A chronic disease in which tissue that is supposed to grow in the uterus grows outside of it. Millions of women experience this condition and it can affect fertility.

After getting diagnosed with ENDO, I was able to find a huge and supportive online community of other women who had the same condition.

EWCM:

Egg White Cervical Mucus. When your cervical mucus looks like egg whites, it may mean that you’re at your most fertile point.

Nothing is as exciting as seeing EWCM when TTC!

FMU:

First Morning Urine. Most pregnancy tests require that women take them the very first time they pee in the morning. In the morning, urine typically has the highest concentration of Human Chorionic Gonadotropin, or hCG, an early pregnancy hormone.

I tested with FMU and got a faint BFP.

FP:

Follicular Phase. The phase of the menstrual cycle when follicles mature in the ovary. This phase begins on day 1 of your period, and ends with ovulation.

I’m so excited to try and get pregnant, I just want my FP to be over!

hCG:

Human Chorionic Gonadotropin. A hormone produced during early pregnancy that helps the baby grow.

I had a positive test, which means there was enough hCG in my urine to detect a pregnancy.

HPT:

Home Pregnancy Test. A pregnancy test that you can take at home. This morning my HPT showed a BFP – but I’m going to my doctor’s to take a blood test to confirm.

IUI:

Intrauterine Insemination. A specific kind of fertility treatment where sperm is placed directly into a woman’s uterus during ovulation.

After 2 years of TTC, we’ve decided to try IUI.

IVF:

In Vitro Fertilization. A procedure in which an egg is fertilized in a lab and then implanted.

We went through several rounds of IVF before getting a BFP.

LMP:

Last Menstrual Period. The first day of your last period.

I started my LMP on June 6th.

LPD:

Luteal Phase Defect. If the corpus luteum didn’t form properly, a luteal phase defect may occur, causing a short luteal phase. This can make it hard for a woman to get pregnant.

I’ve been really accurate with my charting, because I suspect I might have LPD and I want to have a lot of information to show my provider.

LSC:

Low Sperm Count. Commonly the cause of male infertility.

A semen analysis showed that my partner has an LSC.

M/C:

Miscarriage.

I got my first BFP a year ago, which ended in a really upsetting MC.

MF:

Male Factor Infertility.

To help with the MF issues, we found an infertility counselor who was covered by our insurance.

NTNP:

Not trying for pregnancy, not preventing pregnancy.

I just stopped taking BCP, so I guess that we’re NTNP.

O or OV:

Ovulation.

I O’ed on CD15 and BD on days 13 and 15.

OPK or OPT:

Ovulation Predictor Kit or Ovulation Predictor Test. These tests tell you when your body has a surge of luteinizing hormone (LH), which indicates the onset of ovulation.

I just got a positive OPK, which means BD as soon as possible!

PCO, PCOS, or PCOD:

Polycystic Ovaries, Polycystic Ovary Syndrome, or Polycystic Ovary Syndrome Disease. A condition in which a woman’s levels of estrogen and progesterone are unbalanced. Women with PCOS develop cysts on their ovaries, and the condition can cause infertility.

My doctor thinks I have PCOS, so I’m waiting to hear back about my blood work.

POAS:

Pee On Stick. Taking a pregnancy test (peeing on a stick), usually at home.

I’m 7DPO and it’s so hard to wait to POAS!

RE:

Reproductive Endocrinologist. A type of fertility specialist.

I’m meeting with an RE tomorrow to go over my fertility test results.

SA:

Semen Analysis. This is a test that providers can use to determine the quality and quantity of a man’s sperm.

The results of his SA show he has low sperm count, low motility, and poor morphology.

SO:

 Significant other.

My SO and I have decided that next month we’ll start TTC.

TWW or 2WW: Two Week Wait. The time period between when you ovulate and can take a pregnancy test.

 just started my TWW and I need to find some ways to distract myself!

TTC:

Trying to Conceive.

I haven’t decided who I want to tell that we’re TTC.

U/S:

Ultrasound.

Our first U/S is scheduled for the end of the month.

Should I take an ovulation test?

However, most ovulation predictor kits are not infallible, and there are positives and negatives to their usage. Ovulation kits are best used alongside other fertility trackers, like Ovia, to make sure you have the best shot at conception.

How they work

Ovulation is triggered by a surge of luteinizing hormone (LH) about 24-36 hours prior to ovulation. OPKs search for the presence of LH in the urine, allowing you to fairly accurately identify the day of ovulation. They range in price from $5-$50, and come in both digital and simple pee-on-a stick forms.

Benefits

There are many benefits to using an ovulation kit, including convenience, availability, and precision. The kits can be purchased in drug stores and online, and are simple to use. They may be less burdensome than other tracking methods that require daily monitoring throughout the month. In comparison to other methods of monitoring ovulation, ovulation kits are generally considered to be more precise, because they are over 97 percent effective in detecting an LH surge.

Drawbacks

On the other hand, OPKs cannot confirm whether or not you’ve actually ovulated and can be far more expensive than other methods, like cervical fluid, basal body temperature, or Ovia(!). The kits often don’t work when fertility drugs are in your system, or on women over 40 who have increased LH levels due to proximity to menopause. Most importantly, ovulation predictor kits only test LH, leaving other important symptoms such as cervical fluid untested, which means that ovulation tests can only tell you about two of the six total fertile window days.

Read more

• Tracking your ovulation and ovulation tests
• What is anovulation?

Sources

• Miller PB, Soules MR. “The usefulness of a urinary LH kit for ovulation prediction during menstrual cycles of normal women.” Obstetrics & Gynecology. 87(1):13-7. Web. Jan-96.
• Roger W. Harms, M.D. “Should I look for any particular ovulation signs if I’m hoping to conceive?” Mayo Clinic. Mayo Clinic, 2/13/2014. Web.

What’s the lifespan of sperm after intercourse?

An important aspect of fertility and pregnancy is sperm, and the lifespan of sperm after ejaculation completely depends on where it’s living.

Inside the vagina

How long sperm live depends on where the sperm are deposited. Sperm inside the vagina can live within cervical mucus or the upper genital tract for three to five days, allowing fertilization to occur so long as the sperm are living. This is why the fertile window is six days long — it includes the five days leading up to ovulation and the day of ovulation. Once an egg is released, it is viable for 24 hours.

Outside of the body

Outside of the body, sperm can survive in semen for up to a few hours because they require precise conditions of warmth and humidity to survive. Sperm can be preserved for weeks when semen is stored at a lowered temperature, and for years when semen is frozen.

Read more

• Can I use lube while TTC?
• Could I have a sperm allergy?

Sources

• Landon Trost, MD. “How long do sperm live after ejaculation?” MayoClinic. Mayo Foundation for Medical Education and Research, May 1 2015. Web.
• Eileen Bailey. “How long does sperm live outside the body?” HealthCentral. Remedy Health Media, LLC., Jul 13 2016. Web.

Why might I have tested negative?

One of the most common reasons women test negatively inaccurately is by taking a pregnancy test too early. You may be able to test as early as 10 days after ovulation, but it usually takes an average of 13-15 days after ovulation and fertilization for a pregnancy test to turn positive. Many women test too early, use a test with low sensitivity, or use the test incorrectly, which can lead to false negatives.

Other causes of false negative pregnancy tests include diluted urine, expired tests, improper testing, and ectopic pregnancy. If you test negative but have not gotten your period, make sure to take multiple tests throughout the week, and consult your healthcare provider with further questions.

Getting proper results

Women who do not use fertility and ovulation trackers often miscalculate the date of their next periods, meaning that it is possible they have not missed their period but simply haven’t started it yet. Knowing exactly if and when you’ve ovulated, using Ovia’s tools, can help you avoid false negatives and make sure you take a pregnancy test at the right time.

Five ovulation signs to look for

And if you’re TTC with a partner, being aware of when you’re ovulating can be immensely important – since it’s during your fertile window surrounding ovulation when conception is possible – and let you know whether you’ll want to plan to set aside some time for baby-making. Getting pregnant isn’t always especially easy, but to be able to identify when you’re ovulating can help you on your journey toward pregnancy – and hopefully help you conceive that much faster.

1) Low basal body temperature

Basal body temperature, your lowest body temperature in any given day, tends to dip slightly just prior to ovulation and spike sharply immediately afterwards. If you’ve kept a careful log of your BBT, a dip in temperature is one of the best indicators that ovulation is imminent. The best way to tell if a dip has occurred is by carefully tracking your BBT every morning, and Ovia can help with that!

2) Mittelschmerz pains

Many women notice these “middle pains” on one side of the lower abdomen before and during ovulation. The cause of mittelschmerz is not entirely known, but most doctors believe it has to do with the rupturing follicle that houses the egg. Keep in mind that these are minor pains, and can be confused with period cramps. If major pain occurs consult a doctor immediately.

3) Feeling frisky

Believe it or not, many women report increased sex drive and feelings of excitement and confidence during or just before ovulation. While emotional symptoms are subjective and can be indicative of other bodily situations, being turned on while ovulating is your body’s way of telling you that babies might be on the horizon.

4) Fertile cervical fluid

Ever wondered about the fluids inside your cervix? Produced naturally by your body, cervical fluid starts out dry or thick at the beginning of the cycle, then becomes thin and stretchy while you’re ovulating. To determine if your cervical fluid indicates fertility, insert a clean finger into your vagina and observe the fluid you pick up by rubbing it between your fingers.

5) Positive ovulation tests

Ovulation tests, which search your urine for the presence of the hormone that instructs your ovary to release an egg, are taken by urinating on a cup or test directly. While taking ovulation tests can help let you know when you’re ovulating, relying on them effectively halves your fertile window because they do not notify you of ovulation more than a day or two in advance. As with all of the above signs, ovulation tests work best in conjunction with other ovulation tracking techniques.

Read more

• Tracking during the fertile window
• The effects of travel on ovulation

Sources

• Bruno Scarpa, David B Dunson, Bernardo Colombo. “Cervical mucus secretions on the day of intercourse: An accurate marker of highly fertile days.” European Journal of Obstetrics & Gynecology and Reproductive Biology. Volume 125, Issue 1, Pages 72-78. Web. 3/1/2006.
• Samantha J. Dawson MSc, Kelly D. Suschinsky PhD, Martin L. Lalumiere PhD. “Habituation of Sexual Responses in Men and Women: A Test of the Preparation Hypothesis of Women’s Genital Responses.” The Journal of Sexual Medicine. Volume 10, Issue 4, pages 990-1000. Web. 4/13/2015.
• Stephen R. Pallone, MD and George R. Bergus, MD. “Fertility Awareness-Based Methods: Another Option for Family Planning.” Journal of the American Board of Family Medicine. vol. 22 no. 2 147-157. Web. March-April 2009.
• “Ovulation Detection.” ASRM. American Society for Reproductive Medicine, 2006. Web.