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Carrying out a pregnancy test is one of the most anxious times for a woman because it depends on whether she wants or does not want to get pregnant. Despite how easy and quick these kits are, the news that they bring is always a life-changing moment for every woman. Most of the pregnancy test kits detect the presence of a pregnancy hormone called hCG (human Chorionic Gonadotropin). There are various types of pregnancy tests, which, depending on the procedure involved, are used by people and health professionals.

To perform the urine pregnancy test, a strip, cassette, or a midstream device may be used. After this, the interpretation of the results is done according to the manufacturer's guidelines. Since the pregnancy test kits do not have a 100% accuracy, a confirmatory pregnancy test is performed in a healthcare facility by either using a blood sample or by doing an ultrasound.

What does a pregnancy test involve?

The detection of the pregnancy hormone, hCG (human Chorionic Gonadotropin), in the urine or the blood is the underlying principle of pregnancy tests. Hence, the term "pregnancy test" is a misnomer because the test includes detection of the hormone and not the fetus. This hormone is released from the placenta shortly after the early embryo attaches itself to the inner lining of the uterus.

Hence, it is an important marker of pregnancy. Besides the urine test, the pregnancy test performed in a healthcare facility detects the presence of hCG in the blood while an ultrasound uses sound waves to check the presence of the foetus in the womb.

  1. Types of pregnancy tests
  2. When to take a pregnancy test
  3. Pregnancy test at home
  4. How to use pregnancy test kit
  5. Pregnancy test kit results
  6. How accurate are pregnancy tests
  7. Precautions while performing a pregnancy test at home
  8. Pregnancy test kit price
  9. Pregnancy tests at clinics
  10. Clinical pregnancy test cost
  11. Doctors for Pregnancy tests: home test kit, clinical test, cost and results

The pregnancy tests are divided based on the use of hCG and ultrasonography (USG) as follows:

Based on hCG

  • Blood tests
    These tests are done to detect serum hCG and are usually performed three weeks after the last menstrual period (LMP). A pregnancy test with blood serum is performed only at healthcare facilities.
  • Urine test
    These tests are meant to detect the presence of hCG hormones in the urine sample of the woman and are performed five weeks after the last menstrual period. Pregnancy test using the woman’s urine may be done at home or at a healthcare facility.

Based on USG

These tests are performed by a gynaecologist using a probe that sends and receives the sound waves.

  • Transvaginal
    In transvaginal USG, the probe is inserted 2-3 inches into the woman’s vagina and the internal reproductive organs are examined. This test is usually done after five weeks of the last menstrual period and helps in confirming an early pregnancy.
  • Transabdominal
    In transabdominal USG, a jelly is applied over the skin of the lower abdomen and the pelvic area. This helps in a better transmission of the sound waves. After that, the probe is glided over the jelly and an image is created on the monitor. A transvaginal USG is usually performed six weeks after the last menstrual period.

In order to know when to take a pregnancy test, it is important to learn a bit about the menstrual cycle in women. In a menstrual cycle, the ovum (egg) is released within a period of two to three days before or after the 14th last day (14 days from the end of the cycle). These are known as fertile days. If you have sex during this period, the chances of conception or getting pregnant are higher as compared to the other days of the cycle.

If the egg gets fertilised, the placenta starts producing hCG after one week of the attachment of the embryo to the inner lining of the uterus. This hormone starts appearing in the urine and blood after the 9th day and reaches its peak between the seventh and ninth week of pregnancy.

Hence, if you are suspecting that you’re pregnant, you may take a pregnancy test at home using a pregnancy kit after the third week of the last menstrual period. You may also go to a gynaecologist to get the ultrasound done to confirm your results.

(Read more - Period pain treatment)

There are several over-the-counter (OTC) pregnancy test kits available at the drugstores at affordable prices. However, the price also depends on the brand and the number of tests available in the kit. You may buy a kit from the options available and use them at home to do a pregnancy test yourself.

Doctors advise that it is better to do the test at least three times to ensure the results are matching. The test should always be done early in the morning because the first urination has a good amount of hCG in it. Hence, the chances of getting a true result are better.

(Read more - Painful urination treatment)

The OTC pregnancy kits are mostly easy to use and self-diagnostic. However, a correct technique should be applied in order to get the actual results and avoid false interpretations. To start with, the test should be performed only if the kit is at room temperature and follow these steps:

  • Wash your hands with soap and read the instructions given on the kit.
  • Take out the sterile container to collect the urine. Most of the tests advise that a midstream sample (taken in the middle of urination) be collected because the concentration of the urine at the beginning of urination is high.
  • Place the container on a stable flat surface, take out the test strips from the kit and hold them from the coloured end. The other side of the strip is the test site and is not supposed to be touched.
  • Dip the strip into the container up to a quarter inch. There is also a stop line which means that you should not dip the strip into the urine sample beyond it.
  • Wait for a few minutes as recommended by the manufacturer and read your results.
  • In some kits, instead of strips, there is a small device which has a sample well to dispense the urine. Place the test kit on a flat surface and using the dropper provided, put a few drops of the urine in the sample well. Wait for some time as instructed by the manufacturer and notice the appearance of lines on the other end of the strip.
  • Some kits do not have a container and a dropper. In fact, they have an absorbent pad on one end and a test window at the other. You need to directly pee on the absorbent pad, wait for a few minutes and interpret the results.

(Read more: Can you get pregnant on your periods)

Some test kits which have an attached digital screen interpret the results for you and you don’t end up getting confused about how to do it. The results appear in words as “Pregnant” and “Not Pregnant”. However, the most widely used kits have to be self-interpreted and the test results are either negative or positive. Sometimes, you may also get confused when you only see a faded line.

  • Positive pregnancy test
    A single line represents that the test has been performed correctly and is known as control (C) while the other line is the test line (T). The appearance of both the lines signifies that you are pregnant. These lines usually have bright colours like red, green, or blue.
  • Negative pregnancy test
    If only the control line appears and there is no sign of the second line, it means you’re not pregnant and the test result is interpreted as negative.
  • Faint line
    Some women get confused when they see a faint line on the test window. Manufacturers suggest that a faded line also signifies that you are pregnant because such a line most probably appears when the level of hCG hormone in the urine is very low.

(Read more - How to get pregnant)

Many gynaecologists suggest that the results of a self-diagnostic pregnancy test may vary depending on various factors such as

  • How the test is performed.
  • If the strip/ sample well/ absorbent pad is contaminated.
  • The digital screen is faulty.
  • The amount of urine sample used.
  • The duration for which the woman waits before interpreting the results.
  • Personal bias towards the kits that they might be right or wrong.

Hence, most doctors suggest taking the test at least three times before coming to a conclusion. They also suggest that a final diagnosis by a doctor should be done to confirm whether the woman is actually pregnant or not. The result that you get may be true or false and they tell about the specificity and sensitivity of the tests, such as

  • True negative result
    A true negative result means that the result is negative and the woman is not pregnant.
  • False positive result
    A false positive result is when the test has failed in detecting that the woman is not pregnant and still shows that she is. Hence, it is a false positive result. It can happen in certain conditions and diseases such as a recent miscarriage or an abortion during early pregnancy (the hormone may appear in the blood serum for a period of at least six weeks), interpretation error (a completely colourless visible line may be interpreted as a positive result), medications for stress, mental health problems, seizures, high blood pressure, and Parkinson’s disease. Medical conditions such as UTI (urinary tract infections), kidney diseases, cancer, and ovary problems may also show a false positive test.
  • True positive result
    A true positive result signifies that the test was positive and the woman is also pregnant.
  • False negative result
    A false negative result means that the woman is actually pregnant but the test failed to show any such results. Some conditions and factors which result in a false negative result include testing yourself before the foetus has attached itself to the uterine lining, expired test kit or low-quality test strips, taking the test late during the day, among others.

Sometimes, despite taking precautions, you might end up getting the wrong result while testing yourself for pregnancy. Hence, here are a few tips on the things that you need to take care of before performing the test such as:

  • Do your research before buying a pregnancy test kit and only buy those which have been proven to provide the true results.
  • Check the expiry date of the test kit.
  • Bring the test kit to room temperature before starting the test.
  • Always test yourself early in the morning because the level of hCG is highest in the morning.
  • Do not touch the urine sample with dirty hands.
  • Collect the midstream sample.
  • Do not dip the strips too much.
  • Do not overfill the sample well.
  • Always wait for the recommended amount of time.
  • Whenever in doubt, take the pregnancy test again.

Most of the widely used kits are inexpensive and the average price is 50 INR. However, depending on the number of tests in the kit and the brand, the price of the test kit may range from 45 to 300 INR.

As mentioned above, the pregnancy tests done at home are not always 100% accurate, and one should, therefore, visit a gynaecologist to confirm the test results. It will not only help in detecting an early pregnancy but also in diagnosing an ectopic pregnancy (attachment of the embryo at abnormal places such as the fallopian tubes and the ovaries).

The gynaecologists may either advise a blood test or an ultrasound. Depending on that, either a blood sample may be taken, or a transvaginal or transabdominal ultrasound may be performed. The results of a blood test may require from three days to a week to be confirmed, but an ultrasound gives immediate results.

Depending on the type of hCG pregnancy test (urine or blood) done at the healthcare facility, the cost may range from 200 to 500 INR. An ultrasound costs more than the hormonal tests and may range from 600 to 1200 INR.

Dr. Kavita Singh

Dr. Kavita Singh

प्रसूति एवं स्त्री रोग

Dr. Nidhi Bothaju

Dr. Nidhi Bothaju

प्रसूति एवं स्त्री रोग

Dr K Supriya

Dr K Supriya

प्रसूति एवं स्त्री रोग

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  2. U. S Food and Drug Association. [Internet]. Pregnancy
  3. Better health channel. Department of Health and Human Services [internet]. State government of Victoria; Pregnancy testing
  4. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Pregnancy test
  5. Chard T. Pregnancy tests: a review. Hum Reprod. 1992 May;7(5):701-10. PMID: 1639991
  6. C. Gnoth, S. Johnson. Strips of Hope: Accuracy of Home Pregnancy Tests and New Developments. Geburtshilfe Frauenheilkd. 2014 Jul; 74(7): 661–669. PMID: 25100881
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