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We recommend testing for a positive pregnancy test 12 days after the embryo transfer. In some cases, it can be done even a couple of days before, especially if you’re doing a blood test. If you are doing a urine pregnancy test, if you do it only 10 days after the embryo transfer, the risk of having a false negative is going to be high. Sometimes, patients tend to do a pregnancy test 5-6 days after the embryo transfer, and they claim that the test was positive, and then on the due date for a real pregnancy test, the result is negative. In IVF cases, it can be caused because you have used an hCG drug-like Ovitrelle or any other drug to trigger the ovulation, and the hCG lasts for a few days in the bloodstream. The test is positive because the patient may still have some hormone levels, which have been used to trigger ovulation, not because they are pregnant.
I wouldn’t recommend carrying out the test in the next week of the embryo transfer. 10-12 days, so somewhere in between should be fine. If the urine test is negative, you still need to confirm it via a blood test. The urine tests are designed to become positive for 5-6 days after the lack of the period in a normal cycle, and here we are almost always doing the pregnancy test on the 1st day in which it could be positive. That’s why sometimes, the levels of hCG in urine may not be too high, and you may get a false negative, but it will be positive if you do the blood test.
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The best time to do a pregnancy test depends on the stage of the embryo which is replaced. So on day 5, which is a blastocyst, we recommend 14 days from the day of the transfer. However, if it is day 3, then we can add another 2 days so it will be around 16 days. If it is day 2, it will be like 17 days. One thing that you should be careful of is to have a pregnancy test just before the recommended time. This can act in a worrying way: if you are not pregnant, you start to be getting worried. However, if you are pregnant or faintly positive, it can create some confusion.
Having the pregnancy test too much delayed after the recommended time is also not recommended. Why? Because we need to know exactly if you are pregnant or not so we can stop the medication. If you are pregnant by a simple urine test, we would like to confirm it with a blood test. And the reason we confirm it with a blood test is to have a quantified number for the pregnancy hormone. As you know, in the embryo transfer – although the majority is going to be intrauterine – there is a very slight minority which can be an ectopic pregnancy. So despite having an embryo transfer inside the womb and even witnessed by the ultrasound guidance, it can still retrograde itself in the tube and produce an ectopic pregnancy. So the quantitive beta hCG is very helpful in that sense that we can try to have earlier detection of any possibility or risk of an ectopic pregnancy. That’s why we always recommend having both: a urine test and then a blood test.
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We advise our patients to perform the HCG test either via blood test or perhaps on a test purchased from pharmacy two weeks after the transfer, meaning 14 days after the insertion of the embryo. The increased HCG level representing the pregnancy could possibly be detected a little earlier but if you perform the test too early, you may see some false positive results based on the medications that you’re taking or false negative results which might cause unnecessary stress. All the crucial decisions regarding the medications and the further steps are actually performed only based on the test on day 14 after the transfer.
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Most clinics performed the first pregnancy test uh 10 to 15 days after the embryo transfer and really or technically the test can be done earlier but the earlier we perform a pregnancy test the higher the chances of getting a false negative result. From the clinical point of view, we suggest that the first pregnancy test should be performed 10 days after the embryo transfer.
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Testing after embryo transfer such as blood test or blood ACG is more precise. I recommend doing it 10-12 days after embryo transfer. The test can be positive from the eighth day after transfer, but the levels can be very low, and patients are stressed that it’s too low and think that it should be better.
My recommendation is to test from 10 to 12 days. Urine tests are very sensitive now. So the positivity is the same. But if it is negative, I recommend my patients to have a blood test for confirmation. There is only one medication that is used, and which can make false positivity, it is Ovidrel. Sometimes we use Ovidrel for the induction of ovulation before embryo transfer. So if you test very early, for example, on the second day after transfer, it can be some false positive because of this medication. But 10 days after transfer, there is no false positive, and it can be, and I saw it many times, false negative. So if urine test is negative, it’s better to confirm with both tests.
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For more than 95% of the patients here, we test for pregnancy on the fifth day of the transfer. Sometimes, for maybe less than 5% of patients, we do it on the third day. If we do it on the fifth-day transfer, ten days after the embryo transfer we advise patients to go to the laboratory and take the beta HCG test. For the third-day transfer, 12 days after, we advise the patients to go to the biochemistry laboratory. According to the test results, if we see less than 80, two days after, we advise the patients to repeat the blood test in the same laboratory. If we see any number over 80, we describe how to use the medication during this period and two weeks after the blood test we advise the patients to have a vaginal ultrasound, to see the gestational sac and the heartbeat of the baby.
In the urine test, there are some problems because those tests are sensible on a certain limit of the hormone, approx. 50-100. If such a test is sensible to 200, and the blood test of the patient is 80, you will see that this is negative but normally it’s positive. This is a qualitative test, and we need quantitative tests. A conclusive answer can be given by the doctor only after the blood test.
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That very much depends on the policy of the unit or the centre where you are followed. In my experience, if you do a blood test, for example, you could already have an early blood test done 12 days after the egg collection. It also very much depends on the time of the embryo transfer. If the embryo is day 3, day 4 or day 5 embryo, it can produce a different amount of ECG. But normally, at our unit, we would recommend doing a urinary test as usual two weeks after the embryo transfer.
The majority of our embryo transfers are blastocyst transfers, so that would be two weeks after. But, to be honest, if you do a blood test, probably 12 days after the collection, you might be able to have a positive test. It might be a good idea to repeat the blood test after 48 hours, to see if the levels are doubling. That is a good sign of a potential viable pregnancy.
Some clinics recommend blood tests, some clinics recommend urine tests. The urine tests are very sensitive, but obviously, with a urine test, you’ll have to wait a little bit longer, because the blood hormones have to build up to go out in the urine. We are going for two weeks, so just to give the extra couple of days to pick any potential false negative. But, yes, with a blood test, you can test much earlier.
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Your clinician will tell you when you can take a home pregnancy test or attend the clinic for a blood test to detect the pregnancy hormone level. This is usually 10-14 days after embryo transfer, and may depend on the stage at which your embryos were replaced. It is important to not test early as you may get a false result, and to continue to take all medication up until your given test date. If you do a home pregnancy test, please do contact your clinic and let them know the outcome. Irrespective of what it may be, they will want to hear from you and follow up to provide you with information on the next steps for you to take.
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This varies from clinic to clinic and I would go with whatever your clinic recommends. The reason why is, they have different ways of managing things and if you test too early, you can get what’s called a “false positive” so, you get a positive result and the reason why is that most people when they take their trigger shot or their injection before egg collection, that actually contains the hormone that’s picked up in a pregnancy test. So if you do a pregnancy test the day of your egg collection, is going to be positive and it’s not because you’re pregnant it is because it’s picking up that injection that you had a couple of days before. So you need to leave a good fair amount of time for that to get out of your system and also for an embryo to start producing enough HCG which is what a pregnancy test picks up a bit further on. Our clinic, for example, recommends doing an pregnancy test two weeks after the egg collection which if you’re doing an embryo transfer and you do a day 5 transfer, the frozen embryo, it means doing it nine days after the transfer and if the transfer is a Day 3 embryo, it would mean doing it 11 days after that, so 14 days after an egg collection is when you can do a pregnancy test. Some clinics will do a blood test, others will do urine pregnancy tests and you may have bleeding beforehand and then a negative test which probably suggests that it’s not been successful. Other times you might see a really faint line and it’s worth repeating it because I’ve heard times when people tested too early, they thought that they’re not pregnant but then they go on and have a pregnancy. So there’s no kind of hard and fast rules – it’s worthwhile making sure you get a decent pregnancy test that’s reliable and one that you know how to use and also you might want to have another one as a backup because if you’ve done the test you might want to repeat it.
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It depends if you have a day 3 embryo that was transferred or day 5 embryo transfer. We do say implantations happen around day 9 to 11. For example, if you had a day 5 transfer, then you should wait about three to four days before you can take a pregnancy test. While if the transfer was done on day 3, it’s a bit more than that and it would be about six days to wait before you can take the pregnancy test.
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It is advisable to do the test between 10 to 15 days after the transfer is done. We don’t recommend doing it earlier because the pregnancy hormone increases progressively so if we do the pregnancy test very early, perhaps we are taking a false negative test and it is a false negative. There are two ways to do the pregnancy test: one in urine and one in blood. The blood test is more sensitive and it allows us to quantify the pregnancy hormone and it helps us to monitor the pregnancy on the following days. But it is true that the urine test is easier for the patient because she can do it herself at home. In our clinic, we recommend doing the pregnancy test in blood to quantify it and two weeks after the transfer because sometimes on the 10th day the pregnancy hormone is positive but, in the days after it decreases so we have a false positive. We don’t like having false positives because we become very happy in the first days but it is worse the days after when it becomes negative.
