What Does it Mean When One Pregnancy Test is Positive and the Other is Negative?

It is not unusual to have one pregnancy test show up positive and another one show negative. But, what do you do — and are you actually pregnant? Most often any pregnancy test that shows positive means you are pregnant. While there are rare instances of false positives they don’t happen often. However, let’s talk about why one might be positive and the other one negative.

First of all — how do I know so much about pregnancy tests? Hi, I’m Hilary — The Pregnancy Nurse 👩‍⚕️. I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind Pulling Curls and The Online Prenatal Class for Couples. 🩺​ I also struggled with infertility for about 3 years with my last child, so I took a LOT of pregnancy tests. 🙂 I also understand a bit more about how this type of at home testing works. So, let’s jump in.

What does it mean when one pregnancy test is positive and the other is negative?

Most often it means you’re pregnant. Perhaps the “negative” test wasn’t as accurate, or your urine didn’t have the HCG (human chorionic gonadotropin) as concentrated.

There are some very unusual reasons that you would have a positive test without being pregnant, and we’ll talk about those.

But, here is the reality of pregnancy tests:

There are very few false positive pregnancy tests

So, what does that mean?

That means that if you get a positive pregnancy test, you are likely pregnant — OR a few other things could’ve happened:

• You’ve recently been pregnant and are miscarrying.
• You have an ectopic pregnancy (a pregnancy that isn’t in your uterus — it’s rare but possible).
• Other serious hormonal issues that would likely be causing other issues.

All of those things (especially if you’re not bleeding) are fairly rare — but possible. And we’ll go into them more towards the end of this article.

So, it’s not quite time to make all the plans yet — but if you have an actual positive pregnancy test, you are likely pregnant.

Pro Tip: An actual positive test should be pretty visible to everyone, not that super faint line that only you can see (that may be an evaporation line).

Oh, and if you’re early, there are still things you should and should NOT be eating — so grab this guide while you’re here

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Why Would a 2nd Pregnancy Test Come-Up Negative?

Most often a test comes up as negative (unless you’re not pregnant, obviously) because of one of the following reasons:

• Morning first thing urine will have the hormone most concentrated (and is more likely to show positive earlier) — if you test later in the day, the hormone might not be enough hcg to trigger the test.
• The test isn’t as sensitive to hormones as the other one (but would show positive in a few days).
• The test is expired (make sure that the control line came up to show that you’ve done the test correctly).

Ultimately, this shows that if you’ve had a positive pregnancy test you are likely pregnant and should make an appointment with a healthcare provider, even if the 2nd one comes up negative.

Pro Tip: Your at-home test is likely checking your HCG levels — a pregnancy hormone that is released by the placenta into your blood and urine stream when you are pregnant.

Will My Doctor’s Test Be Better than At-Home Pregnancy Tests?

Most doctors rely on a urine test for pregnancy in the office. It’s much faster, and easier for them (no blood draw).

However, they can send a blood test sample into the lab if there is any question. The lab returns a VALUE (rather than just a positive or negative) — and you can also test a week later to see if the values are increasing (and the pregnancy is thriving) or decreasing (which would likely mean a miscarriage).

Also, if you are far enough along, they can use an ultrasound machine to check for a gestational sac (although I think they prefer to do this after a positive pregnancy test). I thought this article was pretty interesting on what they expect to see on an ultrasound.

If you think you ARE pregnant, now is 100% the best time to join my FREE pregnancy series, I’m going to give you SO much helpful info for your pregnancy (and you can always unsubscribe if you don’t love it):

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What Should I Do When One Pregnancy Test is Positive and the Other is Negative?

Have patience.

The good news is that you likely don’t need a week of patience. You can test again tomorrow morning.

I understand how hard waiting that day can be when you want to know now. Pregnancy is definitely a life-changing event, and no matter how you feel about it — waiting that one day is just what you need to know.

Remember, pregnancy tests have the most accurate results when you take them after the day your missed period should have started. If you haven’t had a period for a while, you’d want to take it about 15 days from the last day you had unprotected sex.

Make sure you’re using the test strip correctly and the taste is not past its expiration date.

Reasons You May Get a False-Positive Pregnancy Test Result

A chemical pregnancy — this is where an egg is fertilized, but for some reason does not result in an embryo (these are usually shed pretty early on).

Ectopic pregnancy — These fertilized eggs implant somewhere else, often the fallopian tube. An ectopic pregnancy can be dangerous and will most likely not lead to a baby being born.

Other hormone or medication use — if you’re using other hormones (and sometimes fertility drugs), they can sometimes make a pregnancy test positive.

Diseases — some diseases can mimic the HCG of pregnancy, but you’d definitely want to see your doctor if this is the case

You are miscarrying — if your body is already shedding a non-viable baby from your uterine wall you may get a positive and a negative, or a false-positive.

Hopeful thinking — as a person with the word “pregnancy” on their name on social media I get a LOT of pregnancy tests sent to me via DM with people really HOPING they’re pregnant, but it doesn’t really look like a line to me. Be it the evaporation line, or use error.

We had about 4 years of infertility before getting pregnant with our last baby (who is now 14), and I’ve dipped a LOT of urine in my time. Just be sure that you:

• Take the test first thing
• Wait to take another test if you’re not sure about #1 — like a day or two
• If you get a positive call your provider (you’re likely pregnant, but if not you want to double check everything is fine).
• Use cheaper (like dollar store) pregnancy tests, they’re just fine!

And, of course, if you have ANY questions, make sure you ask your provider. That’s what they’re there for!

Those questions are actually something I found REALLY hard to manage during pregnancy — and I love that this pregnancy planner has a spot to manage them all. It’s perfect to start it as early as possible! Come grab it at a STEAL of a price!

Sources:

• Taking HCG pregnancy test: https://www.uofmhealth.org/health-library/hw42062
• Reasons you might have a positive test but not be pregnant: Oyatogun O, Sandhu M, Barata-Kirby S, Tuller E, Schust DJ. A rational diagnostic approach to the “phantom hCG” and other clinical scenarios in which a patient is thought to be pregnant but is not. Therapeutic Advances in Reproductive Health. 2021;15. doi:10.1177/26334941211016412

• About the Author
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Hilary Erickson, BSN, RN( Registered Nurse | Prenatal Educator )

A nurse since 1997, she has worked in various fields including pediatrics, geriatrics & hospice.  She has  20 years of labor and delivery experience in the San Jose, CA and Phoenix, AZ areas.

As an evidence-based prenatal educator Hilary has delivered thousands of babies and has educated hundreds of thousands of parents from a diverse patient population to help them have a confident birth.

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