Dear Eggsperts—How early can I start pregnancy testing? I see some people ‘test out their trigger’ for IUI. I am doing IVF now and wondering how soon after transfer I can test! Waiting on a beta seems like cruel and unusual punishment.—Impatient in Idaho
Dear Impatient—We get it. We really do. You wanted to be pregnant, not yesterday, not last week, not last month, but LAST YEAR. Every minute, every day, waiting is pure agony. But, we would encourage you to have patience. Testing daily to to find will only increase your anxiety and stress levels. While waiting for the test, there is little that you can do to change the outcome and you will drive yourself crazy with all of the “what ifs.”
Human Chorionic Gonadotropin (HCG) is produced by the cells that make the placenta in pregnancy. If you received HCG for ovulation leading to Intrauterine Insemination (IUI) or IVF is planning a fresh embryo transfer, this means that the HCG was given about 36 hours before ovulation, 7-9 days before implantation.
Let’s talk about HCG decline first. HCG has a half-life of about a day. This is the time it takes for half the HCG to be out of your system. The remaining HCG is divided in half again in the next day, and so-on. The absolute amount of reduction in HCG level is less every day. If, for example, you were given 5,000 units of HCG:
- 5,000 to 2,500 on HCG +1
- 2,500 to 1,250 on HCG +2
- 1,250 to 625 on HCG +3
- 8 days after HCG, you have about 20 units remaining (9 days if you were given 10,000 units) This is approximately implantation day.
The numbers above are total units of medicine. Pregnancy tests detect HCG values based on the number of units/mL. Depending on the pregnancy test being used, HCG levels may be detectable at low levels of 20 units/mL or may require 100 units/mL to be detected. Your HCG may become undetectable 6-8 days after receiving the trigger shot.
Now, let’s talk about the rise in HCG.
Implantation occurs about the time the HCG remnants from trigger may be about 20 units, the lower limits of detection on home tests. This is:
- 5-7 days after ovulation
- 1-2 days after embryo transfer of a blastocyst
- 7-8 days before a missed period
OK … now the same thing happens after implantation, whether or not you had a natural ovulation, HCG for IUI/IVF, or a frozen embryo transfer programmed with Estrogen and Progesterone. If you receive HCG 9 days before implantation, and it takes about 3-4 days for HCG levels to first begin to rise, that means that the soonest HCG levels would rise is about:
- 12-13 days after HCG
- 10-11 days after IUI/egg retrieval
- 4-6 days after embryo transfer of a blastocyst
- 3-5 days before you should expect to miss your period.
Now, the reverse happens … HCG increases 50-100% about every 2 days. HCG may start out very low.
- Let’s say … 10 units on first day of HCG (This would be about 4-5 days before anticipated missed period)
- Day 3 HCG is 15-20 (1-2 days before anticipated missed period)
- Day 5 HCG is 22.5 to 40 (day of anticipated missed period)
If the limit of the home test is 20 units/mL, then you might expect a positive result the day before your missed period. If the limit of the home test is higher, your first blood test may be positive even if your home test is negative. Now, of course, HCG levels may start higher or rise faster, but how much anxiety will you have if they don’t … and we won’t know until the first blood test.
The home pregnancy tests look at the concentration of HCG in your urine. If your urine is really concentrated one day, the test may look really positive at very low levels of HCG. If you are really well hydrated, the HCG will be diluted and may look low, or negative.
So, as you can tell, “testing out the beta” or early testing after embryo transfer won’t necessarily give you the reassurance you are hoping for, but it will give you stress. My best advice is to keep yourself busy and distracted. Do anything to keep your mind busy. The test date will come soon enough. Take good care of yourself, physically and mentally:
- Keep up with your normal regular activities
- Don’t skip work
- Get a mani/pedi or facial
- Have brunch with your girlfriends
- Go see a movie
- Binge watch your favorite TV show
- Take a local trip for a few days
- Walk your dog, or your friend’s dog, at the park
- Read a good book
- Organize your closet
- Take a day class (ie. cooking, art, etc.)
We know this isn’t really the answer you wanted to hear. But seriously, besides taking good care of yourself, maintaining a healthy lifestyle, and following the advice of your doctor, there isn’t really anything you can do to change the outcome of the test. Worrying about the result may only increase your stress hormone levels and that isn’t good for you, either.
We hope we met your Eggspectations—An Eggspert
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Disclaimer: All of the comments on this page are for basic information only. They are based on the opinions and expertise of the authors and are not meant to provide a substitute for medical care or specific treatment recommendations. Each person is unique and requires individualized diagnosis and treatment plans. Any specific questions should be directed to your personal healthcare provider.