Is it common to have a negative pregnancy test with twins

"A week before my period was due, an early pregnancy test came out positive, as did three more tests over the next three days. Why? I heard hCG levels are higher with twins. Could I be pregnant with more than one baby?"

Table of Contents Show

• More on Home Pregnancy Tests
• Are You Taking Your Pregnancy Test Correctly?
• Can You Be Pregnant and Have a Negative Pregnancy Test?
• What Causes False Negative Pregnancy Tests?
• You’re testing too early
• You’re misinterpreting the lines on the test
• Your body doesn’t make as much hCG
• You’re pregnant with multiples
• Your pregnancy isn’t viable
• If You Retest and Still Get a Negative Pregnancy Test…
• When to See Your Doctor or Midwife
• How About You?

First of all, congratulations! Those early positives might be one clue that you're having twins, but don't count on it.

Here's why: Home pregnancy tests look for the presence of human chorionic gonadotropin (hCG) in your urine, and levels of that hormone are indeed higher in multiple pregnancies — but not right away. It takes a few days for the hCG production of twins to outpace the hCG production of one baby.

In fact, on the first day of your first missed period, there might be no difference at all. Since you tested yourself even earlier than that, it's just as likely that what you measured is simply a normal variation in hormone production; your early positives may mean you have two more babies on the way (which research indicates is more common among women over the age of 35), or they may mean that you have just one. The only thing for sure right now is that you're pregnant.

Why such an iffy answer? It's because home pregnancy tests must account for several big variables. First, hCG starts getting manufactured by the cells of the placenta a few days after the embryo implants itself in your uterine wall, and then doubles every two to three days for about 10 weeks. Your egg can survive in the fallopian tube for up to 24 hours after ovulation, though you can become pregnant if you have sex up to five days before ovulation in addiition to up to a day after.

Since hCG doesn't get produced until implantation, you may have no measurable levels of it until just before you miss your period, or you may have a stash of nearly two weeks' worth. In addition to this variation (or perhaps because of it), the amount of hCG can differ wildly from person to person and pregnancy to pregnancy.

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More on Home Pregnancy Tests

Finally, pregnancy tests themselves vary in sensitivity, not just from brand to brand but from batch to batch. Very few home tests are sensitive enough to use reliably before the first day your period is due; not until then do most women have hCG levels high enough to produce a plus sign (some experts recommend waiting a few extra days, to be sure there's enough hormone to measure; that said, any positive result is accurate no matter what day you use the test on). But if your levels were on the high side and you used an especially sensitive home pregnancy test, you certainly could have gotten early positives and not be having twins.

By the way, blood tests for hCG are more accurate than home pregnancy tests (especially earlier on). A quantitative hCG test specifically measures the amount of the hormone you're producing.

Few practitioners order blood tests for pregnancy anyway, since home pregnancy tests are so accurate once a period is missed. However, since you did have such early positives, your doctor might want to order one. He or she might also order an ultrasound, which will let you see if you've got more than one baby on board.

Here's to a super pregnancy!

• What to Expect When You're Expecting, 5th edition, Heidi Murkoff and Sharon Mazel.
• WhatToExpect.com, HCG Levels During Pregnancy: What Is Normal?, November 2019.
• U.S. National Library of Medicine, Pregnancy Test, December 2019.
• American Journal of Obstetrics and Gynecology, The Role of Maternal Age in Twin Pregnancy Outcomes, July 2017.
• American Journal of Obstetrics and Gynecology, Fertility Awareness-Based Methods of Family Planning, January 2019.

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A negative pregnancy test is much more common than a positive one, so could you still be pregnant? Find out what can cause a negative pregnancy test.

You’re experiencing all the early signs of pregnancy. You missed your period. You’re moody, nauseous or just have a hunch that you’re pregnant, but you keep getting a negative pregnancy test. What gives?! Believe it or not: It’s possible to get a negative pregnancy test result and still be pregnant.

I have one friend who tested at five weeks and got a negative pregnancy test. All signs pointed to pregnancy… except the tests. Then, at eight weeks, sure enough, she got a positive pregnancy test! While she never figured out why those initial tests were negative, there are some common explanations for why this might happen.

Are You Taking Your Pregnancy Test Correctly?

First, let’s cover the basics. Taking your pregnancy test incorrectly can cause a false negative pregnancy test. Oops!

Even if you think you know how to take a pregnancy test, be sure to follow all of the instructions in the box. I know it sounds so obvious, but specific steps for each brand can vary. Here are a few general tips:

• Read the results within the recommended time frame. Timing is so important—if you don’t wait long enough, the second line may not show up; if you wait too long, the second line could dry up. Bring a stopwatch or a watch with a second hand into the bathroom.
• Have a full bladder. If there’s not enough urine on the applicator, the test won’t work properly—some tests specify urinating on the test for a full 20 seconds or more!
• Use first morning urine. Though most instructions will tell you this is not necessary, there’s some evidence that it may help you get an accurate result. First morning urine often contains a greater concentration of hCG, the hormone at-home pregnancy tests detect.
• Check the expiration date. An expired or faulty pregnancy test might not work properly.

Can You Be Pregnant and Have a Negative Pregnancy Test?

If you know you took the pregnancy test correctly, but you’re still getting a negative result, you may be wondering how accurate the reading is and whether it could be wrong. Though pregnancy tests are 99% accurate when used correctly, it’s possible you’ll fall into that 1%.

A false negative is more common than a false positive, so there’s a chance you could be pregnant—especially if you already missed your period. (source)

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What Causes False Negative Pregnancy Tests?

You’re testing too early

You want to rip open the package, pee on the stick, and see that second line. But if you test too early, your body won’t yet be producing enough hCG—the hormone produced once an embryo implants—for the test to recognize it, and you’ll get a false result.

A good rule of thumb:

• Take a pregnancy test on the day of your missed period.
• If it’s negative, try again 2-3 days later.
• If it’s still negative, test once more a week after your missed period—when pregnancy tests are most accurate.

You’re misinterpreting the lines on the test

How many of us have held a pregnancy test up to the light, searching for any sign of a line? Sometimes the line is too faint to know for sure, and it’s easy to misinterpret the lines. Check out my pregnancy tests below, and read this post on pregnancy tests for more help deciphering those faint lines. And if you’re really having trouble, buy a digital pregnancy test that says ‘pregnant’ or ‘not pregnant’ after you test.

Is Your Positive Pregnancy Test For Real Find Out Now – Mama Natural – Genevieve

Your body doesn’t make as much hCG

While it’s rare, some women don’t produce enough hCG to ever get a positive at-home pregnancy test. If hCG levels double every 48-72 hours in 85 percent of pregnancies, that means they follow a different pattern in 15 percent of pregnancies. You can read more about this phenomenon in this post about hCG levels. In these circumstances, a blood test that detects hCG might be better since it’s more sensitive at picking up increased levels.

You’re pregnant with multiples

Even though most women have higher levels of hCG when pregnant with twins, there’s something called the high dose hook effect that can cause the test to be negative. (source)

This happens when hCG levels are unusually high. Why? A normal hCG test works by surrounding the hCG molecules with antibodies. The hook effect happens when the hCG levels are so high—like in a pregnancy with multiples—that the hormone saturates the antibodies and they don’t form around the hCG. Thus, you’ll get a negative pregnancy test, despite being pregnant—with twins!

Your pregnancy isn’t viable

Sadly, 10 to 20 percent of pregnancies end in early miscarriage. If you are far enough along, but still get a negative pregnancy test, there’s a chance there’s a complication with the pregnancy. This happens during:

• An ectopic pregnancy: With an ectopic pregnancy, the fertilized egg plants itself in the fallopian tube rather than the uterus. You’re technically pregnant, but because the egg implanted in the wrong location, it won’t register on an at-home pregnancy test. Unfortunately, it’s not possible to carry an ectopic pregnancy to term and could lead to serious internal bleeding if not treated. Call your healthcare provider right away if you suspect you have one.
• Gestational trophoblastic disease (GTD) or molar pregnancy: Caused by a fertilization error, a (GTD) or molar pregnancy causes the rapid growth of abnormal tissue. It rarely involves a developing embryo, but your body does begin to produce hCG. This leads to a false positive on a pregnancy test.

If your healthcare provider confirms an early miscarriage as the cause of your negative pregnancy test, know that you are not alone. There are so many women out there who share your pain, and the majority of them go on to have healthy pregnancies in the future. Take the time you need to grieve before trying again.

If You Retest and Still Get a Negative Pregnancy Test…

In most cases, this means you are simply not pregnant. Lifestyle factors that can cause a missed period include:

• Stress
• Weight loss
• Breastfeeding
• Medications
• Illness
• Travel
• Hormonal birth control

You can read more about why this happens in this post about why your period may be late.

When to See Your Doctor or Midwife

After a negative pregnancy test, wait a few days or up to a week to test again. If you still get a negative pregnancy test and you haven’t gotten your period, see your healthcare provider. They can help you rule out any other conditions that can cause a late or missed period.

If everything checks out and you’re still not pregnant but want to be, work with your healthcare provider to rule out any imbalances. You can also implement these strategies to increase your fertility.

How About You?

Have you ever had a false negative on a pregnancy test? How did you eventually find out you were pregnant? Share your stories below!

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