Pregnancy diagnosis: how to tell early and what to do next

Think you might be pregnant? A missed period is the most common clue, but there are other early signs to watch for: nausea, breast tenderness, fatigue, frequent urination, or light spotting. None of these prove pregnancy by themselves, but they’re good reasons to test and take action.

How tests work and when to use them

Pregnancy tests detect the hormone hCG (human chorionic gonadotropin). After ovulation and fertilization, implantation usually happens 6–12 days later. A sensitive blood test can pick up hCG about 8–11 days after ovulation; most home urine tests work best 12–14 days after ovulation or on the day of your missed period.

Use first-morning urine for the strongest reading. Follow the test instructions exactly and read results within the time window the manufacturer specifies—reading a result after that window can give a false positive. If you test too early you can get a false negative because hCG hasn’t risen enough yet.

Types of tests and what results mean

Qualitative urine tests (home kits) give a yes/no result. Modern sensitive kits detect around 20–25 mIU/mL of hCG; some detect as low as 10 mIU/mL. Quantitative blood tests (beta-hCG) measure the exact amount of hormone and can detect pregnancy earlier—levels as low as 5 mIU/mL are often picked up. Providers use serial beta-hCG tests to check if levels are rising appropriately—typically doubling every 48–72 hours in early pregnancy.

If a home test is positive: call your healthcare provider to confirm with a blood test and to set up first prenatal care. Start a prenatal vitamin with 400–800 mcg folic acid right away if you aren’t already taking one. Avoid alcohol, tobacco, and recreational drugs, and check any prescription or over-the-counter meds with your doctor or pharmacist.

If a home test is negative but you still suspect pregnancy: repeat the test in 2–3 days or get a blood test. Reasons for a false negative include testing too early, diluted urine, or improper test use. False positives are rare but can happen after recent pregnancy loss, fertility treatments with hCG, or very rarely with certain tumors.

Early ultrasound (usually transvaginal) is the next step when dating or confirming location of pregnancy. A gestational sac can often be seen around 5 weeks, and a fetal heartbeat may be detectable by 6–7 weeks. If hCG levels are low or the ultrasound is unclear, your provider may repeat blood tests and scans to rule out miscarriage or ectopic pregnancy.

Seek urgent care or call emergency services if you have severe abdominal pain, heavy bleeding, fainting, shoulder pain, or severe dizziness—these can indicate an ectopic pregnancy or another emergency.

At your first prenatal visit expect confirmation with a blood test, a review of medications and health history, and a plan for prenatal care. Early answers help you make safe choices for your health and the pregnancy—so test, confirm, and reach out to a provider as soon as you can.