Trying to Conceive Again

While there is no clear, researched evidence on how long a couple should wait to try to conceive after having treatment for ectopic pregnancy, we and other medical professionals advise that it may be best to wait for at least three months or two full menstrual cycles (periods) before trying to conceive for both physical and emotional reasons. The bleed that occurs in the first week or so of treatment for an ectopic pregnancy is not your first period. It is the bleed that occurs in response to falling hormones associated with the lost pregnancy.

Physically, this timeframe is to allow your cycle to return to normal and for there to be a clear period to date a new pregnancy from. The date of the first day of the period is what is used to decide when to scan a new pregnancy; information that is invaluable in ensuring you are not suffering from another ectopic pregnancy.

The first proper period you have after an ectopic pregnancy may be heavier than usual. A normal period would suggest you are hormonally ready to be able to try to conceive. Having two periods can also give an idea of menstrual cycle length, which may be different for a few months after your ectopic before settling back into its usual rhythm.

This wait allows the internal swelling or bruising from the ectopic and any associated treatment to heal.

Women often lose confidence in themselves after an ectopic pregnancy (for example, thinking that their body is not able to have a baby). The return of the menstrual period can be a good reminder that your body is ready to try again, after allowing time for healing.

In addition to the physical aspects of ectopic pregnancy, many people also feel an intense emotional impact. Taking time before trying to conceive again enables the necessary process of grief to surface and be worked through. The emotional recovery that is often needed can be significant and many underestimate this aspect. 

If you have had either one or two injections of methotrexate, you should wait until your hCG levels have fallen to below 5mIU/mL (your doctor will advise you when this is through blood or urine tests) and then take a folic acid supplement for 12 weeks before you try to conceive.

This is because the drug may have reduced the level of folate in your body which is needed to ensure a baby develops healthily. The methotrexate is metabolised quickly but it can affect the quality of your cells, including those of your eggs, and the quality of your blood for up to three months after it has been given. The medicine can also affect the way your liver works and so you need to give your body time to recover properly before a new pregnancy is considered. A shortage of folate could result in a greater chance of a baby having a neural tube defect such as cleft lip and palate, or even spina bifida or other neural tube defects.

If you have had medical management followed by surgery, you can start taking a folic acid supplement again once your doctors have confirmed that all of the pregnancy has resolved. This is particularly important if you have been having blood tests to check hCG levels after your surgery. You can start to try to conceive again 12 weeks after the date that the methotrexate was administered.

The NHS website has more information on vitamins, supplements, and nutrition before and during pregnancy. 

It is important to use contraception until it is safe to try for pregnancy again. Some women with ectopic pregnancy did not actually want to become pregnant in the first place and may not want to be pregnant again. For others, they may want to try again but not yet.

Contraception should be started as soon as you are having sex again after the ectopic pregnancy, because an egg can be released (ovulation) BEFORE you have a first period.

Before the first period arrives, most women will have ovulated (released an egg from the ovary). The period when it returns will indicate that you are ovulating again. There are rare conditions such as polycystic ovaries syndrome where ovulation may have not occurred.

Generally, it is possible to ovulate 14 days after surgical treatment and during methotrexate treatment, so it is important to be aware that it is possible to become pregnant without having a period first, if you are not using some form of contraception.

When a person has only one Fallopian tube, they are still able to get pregnant from an egg released by the opposite ovary as an egg from one ovary can travel down the Fallopian tube on the other side and the Fallopian tubes can pick up eggs from either ovary. Approximately one-third of pregnancies are a result of pick-up of the egg from the ovary on the opposite side to the remaining Fallopian tube. This may be reassuring as it tells you that, when you release an egg from the ovary on the side where the removed Fallopian tube may have been removed for a previous ectopic pregnancy, it is not a ‘wasted’ cycle.

An ovulation predictor kit measures Luteinising Hormone (LH). A surge in LH means that ovulation (release of an egg) is likely within the next 12 hours. The egg does not always get released from the ovary in spite of a surge but it is a very good marker of the likelihood of it happening. A positive pregnancy test around 14 days after you think ovulation occurred is the one way of knowing that it actually did.

Urinary ovulation predictor kits are used typically daily around the time ovulation may be expected. A conversion from a negative to a positive reading would suggest that ovulation is about to occur within 24–48 hours, giving two days to engage in sexual intercourse or artificial insemination with the intention of conceiving.

As sperm can stay viable in the female reproductive system for several days, LH tests are not recommended for contraception, as the LH surge typically occurs after the beginning of the fertile window.

We naturally assume that we will ovulate from alternate ovaries each month (left ovary, right ovary, left, right etc.) This is not true and in fact the side varies. Some people will ovulate from the same side each month with an occasional ovulation from the other side, while others will ovulate randomly from side to side.

Both ovaries compete each month to produce an egg and usually, the one that is ‘pulling ahead in the race’ continues while the other one gives up (but not always – sometimes ovulation occurs from both ovaries in one cycle or twice from one ovary – this explains how we get non-identical twins naturally). It depends on which ovary contains the egg that is at the right stage of development at the point in time at the time of ovulation and is nothing to do with a set pattern.

The side we ovulate from does not strictly matter as an egg from one ovary can travel down the Fallopian tube on either side.

The menstrual cycle lasts somewhere about 28 days for most and ovulation usually happens 10 to 16 days before the start of your next period. When you’re ovulating, you are at your most fertile so it is the best time of the month to have sex. Physical signs of ovulation include an increase in vaginal discharge. The discharge tends to change from white, creamy or non-existent to clear, stretchy and slippery (like egg-white consistency) when you ovulate.

The Fallopian tubes and uterus are lined with little receptor cells that, at the point of ovulation, are sent a chemical signal that ‘switches’ them on and a signal is also emitted that attracts a similar receptor in the egg and in the sperm to come and meet in the same place, i.e. the Fallopian tube. The Fallopian tubes are not attached to the ovaries and, at the point of ovulation, some very delicate structures called the fimbriae on the end of the Fallopian tube begin to move gently drawing the egg toward the end of the Fallopian tube (like lots of little fingers waving and drawing the egg towards it). Once in the Fallopian tube, the egg is moved along by microscopic antenna like structures called ‘cilia’. These ‘waft’ the egg along by creating a ‘fluid flow’ within the tube. In a similar way, once the egg has been fertilised by the sperm, the cilia then move the embryo further along towards the uterus.

The DNA that makes up the strands for hCG, which is the hormone associated with pregnancy, is only one strand different to the luteinising hormone (LH) which detects ovulation. These hormones, at a molecular level, are nearly identical. hCG has a beta sub-unit, meaning that it has an extra molecular twist. This means that it is possible, on occasion, for an OPK to detect pregnancy, although this is not always reliable. It is not, however, possible to use an HPT to detect ovulation.

Home tests are not completely reliable. Some people may have slightly higher natural LH levels (for example with polycystic ovaries syndrome) so the test may not notice a change so clearly.

Using a mobile computing app to track menstrual cycles and the fertile window is becoming increasingly popular while trying to conceive and may be suitable for some people. A study looked at various apps that are used to track the menstrual cycle and analysed whether they helped influence chances of conception. The study showed that the use of such apps was associated with increased chances of conception ranging from 12% to 20% per cycle of attempt. 

However apps only work for some people – those with polycystic ovaries syndrome (PCOS) or irregular cycles may not find they work.

If you have a naturally regular cycle of 26-39 days and having sex regularly every two to three days, then an app may not necessarily help you to get pregnant sooner than you would anyway.

Apps may also have the risk of making you overly focused on a specific day, which some couples find stressful. You do not necessarily have to have sex on the day of ovulation itself as sperm can live for up to five days and the egg for up to two days.

Alcohol affects fertility by disrupting the delicate balance of the menstrual cycle. Clinical research data suggests that women, who drank socially, 1-5 drinks per week, may be at a greater risk of decreased fertility when compared to women who remained abstinent. These findings underscore the importance of remaining abstinent while attempting to conceive.

The National Institute for Health and Clinical Excellence (NICE) looks at the available evidence on the best way of treating or managing a condition and makes recommendations based on evidence. Doctors, nurses and other healthcare professionals in the NHS are expected to follow NICE’s clinical guidelines. Current NICE guidance states:

“Pregnant women and women planning a pregnancy should be advised to avoid drinking alcohol in the first 3 months of pregnancy if possible because it may be associated with an increased risk of miscarriage.”

Research also suggests that alcohol disrupts the hormonal imbalance of the female reproductive system, leading to menstrual irregularities, and even anovulatory cycles (menstrual cycles where ovulation fails to occur). These changes can drastically decrease the chances of becoming pregnant and thus affect fertility.

Despite this, we know that many people become pregnant without planning it and so may have been drinking alcohol. Do not worry if this is the case but do stop drinking once you have a positive pregnancy test.

The NHS website provides information on drinking alcohol once you are pregnant and states that the safest approach is not to drink at all while pregnant.

It can be hard to stop smoking cigarettes but if you are thinking of trying to conceive, this is one of the best things that you can do. Evidence shows that smoking impacts both male and female fertility. 

According to NICE Guidance on Fertility Problems, for men, there is a link between smoking and lower semen quality. Smoking is also likely to reduce fertility. Breathing in someone else’s cigarette smoke (passive smoking) is also likely to reduce the chances of getting pregnant. 

Research from Edinburgh University has found that a chemical found in cigarette smoke (Cotinine) triggers a reaction which increases a protein in the Fallopian tubes. This protein, called PROKR1 raises the risk of an egg implanting outside the womb, leading to an ectopic pregnancy. The study results vary but smoking probably increases the risk of developing an ectopic pregnancy by between 50% and 200%.

Although it may be difficult, stopping smoking will not only help the fertility of you and your partner but it will also improve the general health of your baby/children and reduce the chance of you experiencing another ectopic pregnancy.

If you smoke, your doctor/GP should offer you help to stop if you wish. The NHS Smoking Helpline can also provide advice and support via phone and the website.

Unfortunately, nothing can guarantee a pregnancy or a pregnancy in the right place, but if you have a history of abdominal pain which continues after the ectopic pregnancy, you should see your doctor/GP to make sure you do not have a persistent infection or other problems with your pelvis that might impact future fertility.

Having regular sexual intercourse (eg every 2-3 days between day 10-20 of your cycle if you have regular periods) is a good way to approach future conception.

You should also take a folic acid supplement when trying for a baby (ideally for 12 weeks before you get pregnant) because it reduces the chance of a problem with the development of the baby’s brain and spine (spina bifida). You can buy folic acid from any pharmacist.

The EPT is a charity that has the backing of medical specialists and prides itself in providing accurate, research-based medical information. While we understand that many people are interested in the use of alternative and complementary therapies, we do not endorse these on our site. 

We, therefore, remind you that, should you wish to make use of these therapies, you exercise caution and avoid recommending them to users of the EPT forums. Many complementary medicines are powerful and can have harmful side effects if misused. They may also interact with medicines that you may already be taking or intend to take. Please remember that “natural” does not always mean safe – indeed some of the medicines that are prescribed today (including some controlled drugs) are derived from natural products. Many “natural” or “herbal” preparations can interfere with prescribed medicines or even make an existing condition or illness worse.

Buying medicines on the internet is far from safe and you can never be 100% sure that they do what they say they do or contain what they say they do. Unfortunately, there are unscrupulous people who have no issues with making money from people who are trying to conceive or who have suffered a loss, making claims that cannot be substantiated about products and services they aim to supply. Please do be aware of this and seek guidance and or alternative treatment only from appropriately qualified and registered individuals.

We believe as an organisation that it is wrong to give people information that is not evidence based or may give false hopes and so we monitor this on our forum and social media channels.

Sadly, there are no tests or investigations that can be done to assure you that you will not experience an ectopic pregnancy again. Ectopic pregnancy occurs because of some underlying damage to a Fallopian tube or problems in the way that it functions and the cause of this damage may never be established. Assisted reproductive techniques, like IVF treatment where the embryo is placed in the uterus, can also result in an ectopic pregnancy (as the embryo does not always stay where it is placed) unfortunately, so is not a guaranteed way of ensuring it will never happen again.Very rarely if you need to have IVF to get pregnant, the specialist may discuss with you whether your Fallopian tube/s should be clipped or removed before the IVF procedure.

Doctors would usually, after an ectopic pregnancy, want you to wait to try again for three months, after which, your doctor will probably encourage you to try again naturally for 12 months if you are less than 35 or 6 months if you are over 35. Only if you do not conceive within those times would they then recommend further tests and investigations. This is because most women will conceive naturally. The exception to this might be if the surgeon saw something during the surgical procedure to treat your ectopic pregnancy that they felt warranted further investigation more quickly.

If you feel that you may have ongoing problems of pelvic infection, you can take a chlamydia test. Chlamydia is usually symptomless and if left untreated, the infection can spread to other parts of your body and lead to long-term health problems, such as pelvic inflammatory disease (PID) and infertility. Testing for and taking antibiotic treatment if required might help to reduce the risk of these problems. 

A tubal patency test might be available if you have been trying to conceive for a year and are not pregnant if you are under the age of 35, or six months if you are over the age of 35. You should visit your health care provider to discuss this.

Hysterosalpingography (HIS-tur-oh-sal-ping-GOG-ru-fee) or HSG test or a Hystero Contrast Sonography (HyCoSy) are procedures to investigate the shape of the uterine cavity and the shape and patency of the Fallopian tubes (whether they may be blocked or obstructed). Both tests involve having a speculum inserted (like a during a smear test) and an x-ray or an ultrasound of the uterus and the Fallopian tubes. The doctors inject a special radiographic dye or contrast fluid into the uterine cavity through the vagina and cervix which shows up on the x-ray or ultrasound. They then watch to see if the dye moves freely through the uterus and Fallopian tubes to look for a block that may be causing fertility problems.

If the Fallopian tubes are open, the special dye will fill the tubes and spill out into the abdomen. If the Fallopian tubes are full or partially blocked the dye will not flow freely and whether the blockage is located at the junction of the Fallopian tube and the uterus (proximal) or whether it is at the end of the Fallopian tube (distal) can also be determined. 

People must not have any chance of pregnancy in the cycle before the test (as the test may interfere with a pregnancy developing) but are able to try to conceive again during their next menstrual cycle after a tubal patency test unless medical professionals suggest a longer wait time. It has been claimed that pregnancy rates may be slightly increased in a cycle when a tubal patency test has been performed but the evidence on this is not clear.

Unfortunately, tubal patency tests cannot provide complete peace of mind. Even if a tubal patency test shows an open Fallopian tube or tubes, it does not show whether it will work – only a normally located pregnancy can show that at least one Fallopian tube worked. 

The test is not 100% accurate as the Fallopian tubes can go into spasm during the test and can appear blocked even though this is not the case. This can cause unnecessary anxiety if the Fallopian tube is affected by spasm but in fact is not blocked. 

The test cannot determine whether the Fallopian tube is working normally (whether the microscopic cilia inside are encouraging an egg or embryo to flow along the tube) even if it is not blocked.

The tubal patency test can be painful, so analgesia (pain relief) may be recommended before and/or after the procedure to reduce pain.

Overall there is a 1% chance of getting an infection from a tubal patency test and, of that 1% chance of infection, 20% would need hospitalisation. This means there is 99.8% chance of not causing damage to a Fallopian tube and 0.2% chance of damage.

Many doctors will therefore prescribe an antibiotic just before to the procedure to reduce the small risk of an infection. Medical professionals prescribe the antibiotics taking the viewpoint that prevention is better than cure and it is better to prevent an infection in your Fallopian tubes rather than treat it after it may have already caused some harm to the Fallopian tube. However, antibiotics cannot give 100% guarantee that you will not get an infection.

It would be likely that you would know if you got an infection through symptoms like: fever, abnormal vaginal discharge, abdominal or lower back pain, painful menstrual periods, painful or uncomfortable sexual intercourse, abdominal pain affecting both sides, frequent urination, spotting between periods, or pain during ovulation.

Doctors prefer not to use a tubal patency test unless they really need to because it is not a 100% accurate test and because of the small infection risk. For example, if the Fallopian tubes go into spasm during the test they can appear blocked even though this is not the case. The test can also not determine what the internal cilia of the Fallopian tube look like. As it is an invasive test and there is a small (1%) chance that it can cause infection of the Fallopian tubes hence their preference to only perform the test when it is definitely required and when the results of the test are likely to change the medical advice they give you.

If an ectopic pregnancy has been treated surgically, the remaining Fallopian tube (the one without the ectopic pregnancy in it) is usually examined and the doctor would usually have told you if they had seen any problems with it at that time. If you would like peace of mind about this you could ask for a post-operative follow up appointment to ask whether they had looked at the condition of your Fallopian tubes during the operation. You can also request a copy of your medical notes for your operation. Contact your Patient Advice and Liaison Service (PALS) to find out how to request and you will usually have to pay an administrative cost for the records to be sent to you.

The examination at surgery is a pretty good indicator about the condition of your remaining Fallopian tube(s) because it looks at:

• The fimbriae – The Fallopian tubes are not attached to the ovaries and, at the point of ovulation, some very delicate structures called the fimbriae begin to move gently to attract the egg toward the end of the Fallopian tube it is nearest to (like lots of little fingers waving and drawing the egg towards it).
• Whether there are any adhesions (scar tissue), affecting the Fallopian tube meaning it cannot move freely
• Whether there is any thickening of the Fallopian tube, which might suggest it has been infected or inflamed in the past
• Whether the shape of the Fallopian tube suggests it is blocked and filled with fluid (hydrosalpinx) which means it is unlikely to be able to transport an egg or embryo

Selective salpingography is a procedure to assess and open up a Fallopian tube which is thought to be blocked. It not available in every centre but can have good success rates. It is used for people who have been found to have a blocked Fallopian tube during a tubal patency test (HSG or HyCoSy). It is normally done under mild sedation with pain relief.

During the selective salpingography procedure, the doctor will attempt to open up any blockages so in the future the egg can be fertilised in the Fallopian tube and the embyro then to move along to hopefully implant in the uterus.

It is carried out under fluoroscopic guidance which is a type of X-ray imaging that shows a continuous live X-ray image on screen. A very thin flexible catheter (tube) is threaded through the uterus and right into the opening of the Fallopian tube. Once this is done, dye can be introduced directly into the Fallopian tube. With this technique, it is possible to demonstrate whether the Fallopian tube was not in fact blocked but in spasm. Fallopian tubes with a true obstruction can commonly be opened by the higher pressures which can be achieved with selective salpingography.

The possible risks with selective salpingography are a small risk of Fallopian tube perforation (hole in the Fallopian tube) which will usually heal by itself and the chance the procedure may not be successful in opening the Fallopian tube/s. It cannot guarantee that you will not have an ectopic pregnancy again and there is also the chance of developing an infection so you would usually be given antibiotics just before the procedure to try to prevent this.

Clomiphene (or Clomid) and letrozole are extremely powerful, oral (taken by mouth), medications that may be prescribed to help those trying to get pregnant if their menstrual (period) cycle is so irregular that they cannot be sure when or if they are ovulating. The medication would aim to cause regular ovulation to happen at a predictable time and so let you know when to have sex or intrauterine insemination. The medication works by blocking estrogen receptors in the brain, stimulating them to release Follicle Stimulating Hormone (FSH), and Luteinizing Hormone (LH). These are the naturally occurring ovarian stimulants that also prompt ovulation in a normal cycle.

Typically, you will take the tablets each day for five days early in your cycle. During this time, some will notice hot flushes, moodiness, or sleep pattern changes but most notice no symptoms at all. Ovulation will typically occur 7-8 days following completion of the treatment. Because the ovaries are stimulated there may be some bloating, or discomfort with intercourse.

The chance of multiple ovulations (releasing several eggs at the same time) is slightly higher than with your normal menstrual cycle. The chance of twins resulting from clomiphene is 6-8%. However doctors will monitor your dose and possibly carry out scans before ovulation to try and avoid more than one or two eggs being released. The chance is slightly lower with letrozole.

Rarely hyperstimulation of the ovaries can occur as a result of Clomid use. In this case you can become unwell when the ovaries become enlarged with multiple follicles and the release of fluid into the abdomen. Other rare side effects include visual changes, reversible hair thinning, dizziness, or hives.

If your Fallopian tubes were removed or both have been deemed completely blocked, it is still possible to get pregnant but only with IVF because it means that the Fallopian tubes are not needed because the eggs are collected from the ovaries with a needle, are fertilised outside the body, and then the embryos are placed directly into the uterus.

The Human Fertilisation & Embryology Authority (HFEA) is the UK’s fertility regulator. It provides impartial, accurate information about IVF, clinics, and other fertility treatments.

The HFEA website provides the following information and you can read more here:

• In 2023, 52,400 patients had over 77,500 in vitro fertilisation (IVF) cycles at licensed fertility clinics in the UK.
• Babies born from IVF increased from about 8,700 in 2000 to 20,700 in 2023.
• IVF births are making up a higher proportion of all UK births over time, increasing to over 3% in 2023 from less than 1.5% in 2000. This is around 1 in 32 UK births or roughly one child conceived through IVF in every classroom.
• In 2023, 11% of all UK births to those aged between 40-44 were a result of IVF, increasing from 4% in 2000 and accounting for 0.5% of all UK births.
• The average IVF pregnancy rate using fresh embryo transfers increased nationally to 31% per embryo transferred in 2023 with the highest pregnancy rate among patients aged 18-34 at 41%.
• The preliminary average IVF birth rate using fresh embryo transfers was 25% nationally, with 35% for patients aged 18-34 and 5% for patients aged 43-44 when using their own eggs in 2023.
• In 2023, the average pregnancy rate using frozen embryo transfers was 39% per embryo transferred and the average preliminary birth rate was 33% per embryo transferred.
• Births from donor treatments made up around 1 in 5 of all donor insemination (DI) and IVF births, accounting for around 1 in 153 of all UK births.
• Single patients increasingly used both DI and IVF from 2019 to 2023,  particularly in IVF use (+83%).
• Multiple births from IVF have continued to fall to 3.4% in 2023, one of the lowest rates in the world.
• The average proportion of National Health Service (NHS) funded IVF cycles declined from 35% in 2019 to 27% in 2023, decreasing most in England.
• National differences in the proportion of NHS-funded cycles continued, ranging from 24% in England, 33% in Wales, to 49% in Northern Ireland and 54% in Scotland in 2023.

The NHS website summarises that, in 2013, the National Institute for Health and Care Excellence (NICE) published guidelines about who should have access to IVF treatment on the NHS in England and Wales. These guidelines were updated in 2017.

Individual NHS boards make the final decision about who can have NHS-funded IVF in their local area and their criteria may be stricter than those recommended by NICE.

According to the NICE guidelines, women aged under 40 should be offered three cycles of IVF treatment on the NHS if they have been trying to get pregnant through regular unprotected intercourse for two years, or have not been able to get pregnant after 12 cycles of artificial insemination (directly inserting sperm into the womb). The guideline also states that if tests show IVF is the only treatment likely to help you get pregnant, you should be referred for IVF straight away. If you turn 40 during treatment, the current cycle will be completed, but further cycles should not be offered.

For women aged 40 to 42, the guidelines also say women should be offered one cycle of IVF on the NHS if they have been trying to get pregnant through regular unprotected intercourse for two years, or have not been able to get pregnant after 12 cycles of artificial insemination; They have never had IVF treatment before; They show no evidence of a shortage of eggs and they have been informed of the additional implications of IVF and pregnancy at this age. Again, if tests show IVF is the only treatment likely to help you get pregnant, you should be referred for IVF straight away.

The reality is somewhat different to this guideline though and NHS trusts across England and Wales offer different levels of service. The provision of IVF treatment varies across the country and often depends on local policies.

Generally couples who already have at least one child will not be able to have NHS-funded IVF and this will usually be hard when you do not have a baby but you are told you are not eligible because your partner has a child from a previous relationship. Sometimes people are also advised thst to be eligible for IVF they need to lose weight. This is because this increases the likelihood of successful treatment and therefore funding is spent when it is most likely to be helpful. However this can be extremely challenging for some.

People who have immigrated to the UK need to check their visas very carefully as, because they may be eligible for most NHS care, fertility treatment may be excluded.

If you are not entitled to NHS-funded IVF or choose to have private care, you can go to a private fertility clinic. However this can be costly and there is no more guarantee of success having treatment privately.

There can be a number of reasons for this:

As the hormones in our bodies change in the later stages of the menstrual cycle, a special cyst called the corpus luteum cyst stimulates an ovary to produce progesterone. Progesterone has many actions on the body but, along with the other changes in your body, it can leave you feeling bloated, with tender breasts and sometimes feeling headachy and nauseated (sick). These can sometimes be interpreted as the feelings you might get in early pregnancy and can leave you feeling disappointed when a period arrives a few days late.

It is also possible that you may be doing a pregnancy test a few days too early. Ovulation can occur later in the cycle than day 14. This might especially be the case if you normally have cycles which are longer than 28 days. If you ovulate later in the cycle, then the hCG hormone (which is what a home pregnancy test detects) may not be at a level where a home pregnancy test detects it.

It is rare that pregnancy tests are faulty but if you persistently feel pregnant then do test again with a test from a different batch.

Home pregnancy tests must be read within the time frame specified in the individual instructions on each pack. These times vary a little but any result which appears after 10 minutes cannot be relied upon to be an accurate result. It is not unheard of for people to do a test which is negative, leave it on the bathroom window sill until sometime later, and then when they look at it again a new line has appeared in the test window. This is invariably an evaporation line and not a positive result.

To get an accurate result, it is essential you follow the instructions on the Home Pregnancy Test pack. You should preferably test with the first urine of the day and in urine which has been in your bladder for at least four hours. Finally, you should always read the test result within the time frame clearly stated on the test pack’s instructions.

If the test is done in the surgery using a reagent stick, just like the home pregnancy test you have already done, there is the possibility that the test the doctor is using is not as sensitive as your home pregnancy test. If this is the case, then they may send a blood sample to the laboratory for testing to be sure.

However it is more likely that the pregnancy may have ended at an early stage so that it did produce pregnancy hormones (hCG) for a short time but it is not producing them anymore. Therefore the test has become negative and you are sadly not pregnant any more. We suggest that you repeat the test a couple of days later at home to be sure it remains negative.