There are several signs that signify that pregnancy may have occurred, with the main one being the absence of monthly bleeding, that is delayed and missing menstruation.
For some women it is possible to have shorter, smaller menstrual bleeding even during pregnancy. Also, for women whose menstrual cycle is irregular, it is sometimes difficult to ascertain when the next menstruation should take place.
If there is a dilemma, the only right way to be sure whether pregnancy has set is to do a pregnancy test. These tests detect one hormone - Human Chorionic Gonadotropin (hCG) – produced by the women’s body shortly after she gets pregnant – that is after the fertilised egg is implanted in the placenta. As the pregnancy progresses, the production of this hormone increases.
After the pregnancy test gives a positive result, the pregnancy is confirmed via ultrasound scan at the physician.
Urinary test that is available at the pharmacies:
This test establishes whether there is Human Chorionic Gonadotropin (hCG) in urine.
When is this test done: Contemporary tests are very sensitive and can be done on the very first day of the missed period, but their accuracy increases as days pass. If you can not wait you are free to do it on the first day but even if the result is negative, you should repeat the test on the third day. If your first test is done on the third day after you missed your period, there is no need to repeat it, it will be accurate.
The other way is to do the blood test by submitting your blood for analysis.
How the test is done: It is best to first carefully read the guidelines that come in the box. They usually come with images so that everything is clear. Usually, all you have to do is urinate on the stick or test-strip. Some manufacturers recommend collecting urine in a small plastic cup and to then submerge the test stick or strip into the urine for 10-15 seconds. Then the stick or strip is to be left on a flat surface for five minutes and then the results can be read.
Many manufacturers suggest using the first morning urine for testing, because hCG’s concentration in urine increases over night, however, any urine from any time of the day will fit the bill.
Analysing results: This is only relevant for the type of tests commonly available in our country. For the particular test you are using please refer to the guidelines you found in the box.
Results should usually be analysed after five minutes of the strip/ stick lying on the flat surface. The results should not be analysed after 30 minutes have passed.
Positive result: there are two separate red lines, one in the field labelled with the letter C (control) and the other in the field labelled with the letter T (test). This result means that your urine contains hCG and that you are most probably pregnant. For any further steps, confirmation of your pregnancy and making any further decisions (maintaining or terminating pregnancy), please make sure to visit your gynaecologist and have examination and conversation there.
Negative result: there is only one red line on the strip in the field with the letter C while the field with the letter T remains empty. If you tested yourself immediately after missing your period, it is recommended to do it again after three days. If your first test is done three days after you’ve missed your period, the negative result is conclusive – there is no hCG in your urine and you most probably are not pregnant. If your period is still late (7 to 10 days), you can do another test and visit your physician.
Inconclusive result: There is no line in the field labelled with the letter C. This means that the test was unsuccessful due to insufficient quantity of urine or due to some malfunction of the test itself. If this happens to you, repeat the test with another stick/ strip.
The intensity of the red line depends on the concentration of hCG hormone so its shade may vary from pale, pinkish to intense red.
How accurate/ reliable are urinary tests?
If used according to the guidelines, these tests are very reliable, although somewhat vary from one manufacturer to the other. Some are more sensitive and can detect lesser quantities of hCG. How sensitive the particular test is is usually printed on the packaging or in the guidelines.
These tests can also be done in laboratories.
Pregnancy tests via blood sample analysis
This test establishes whether there is Human Chorionic Gonadotropin (hCG) hormone in the blood. This test is more reliable than the urinary test and this is what medical doctors use to establish whether the patient is pregnant before they can use ultrasound to scan for the foetus.
You can also have this test done at a laboratory on demand.
If this test gives positive results and you have hCG in your blood, you are most probably pregnant, also there are other states that can produce hCG, such as molar pregnancy.
Ultrasound pregnancy test
The best way to establish whether the pregnancy has happened is to do an ultrasound scan. This scan is done using a probe scanning through the lower abdomen or through vagina and the doctor can see the inside of the uterus and whether there is an embryo in the womb.
In order to see the embryo, it should be some four weeks since conception and this is the period the doctors will wait out until they do the scan. In some cases, of course, the embryo can be seen earlier and in some cases it is not visible even after four weeks so the scan needs to be repeated.
hCG Hormone and its values
Chorionic Gonadotropin (hCG) hormone is produced during pregnancy and this is why it is commonly referred to as pregnancy hormone. This is why it is used in pregnancy tests, especially in the early stages when the ultrasound scan is not feasible.
hCG can be registered one day after the embryo is implanted in the uterus wall, which usually happens some six days after fertilisation of the egg cell. On the day when most women do the test – the first day of their missed period – hCG level in blood is around 100IU/l but can vary in both directions. In case the woman is pregnant with twins or triplets, the levels can be significantly higher.
In a normal course of the pregnancy, hCG level is doubled every two days. This is why doctors sometimes ask pregnant women to recheck the levels several times in the early stages, to confirm that the development of pregnancy is normal. The highest hCG level is reached in the ninth week of pregnancy and it can go u to 120,000 IU/l, after which it declines until 20th week when it stabilises at 20,000 IU/l.