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Blood tests for checking the beta HCG level are better than home urine pregnancy tests for the following reasons.

1. They are more accurate , sensitive and reliable. A negative test ( HCG level of less than 10 mIU/ml) can reliably rule out a pregnancy with 100% accuracy. Urine tests are not as reliable or accurate. This is because they can have false negatives. A false negative is the situation when a woman is pregnant, but the urine pregnancy test comes back as negative. This can be because her HCG levels are low, so that they cannot be picked up by the urine test ( which becomes positive only after the blood HCG levels cross more than about 30-50 mIU/ml). Other reasons the urine test can be incorrectly negative is when it’s not done properly by the patient ( who is not an expert, after all, and can make errors !); and if the urine is too dilute ( so that the concentration of the HCG in the urine is too low for it to be picked up by the urine test). This is why an IVF clinic will never rely on a urine pregnancy test and will insist that the patient do a blood test to check their HCG level.

2. They are quantitative. The other major advantage of a blood test over a urine test is that a urine test is only qualitative – it just gives a yes or no ( positive or negative) result. The blood test, on the other hand, provides a number. This is especially useful when the doctor needs to do serial tests to monitor the health of the pregnancy. Thus, in a healthy pregnancy, the HCG level should double every 48 hours. If it fails to do so, this gives the doctor an idea that there maybe a problem with the pregnancy. Similarly, a very high level can help the doctor to suspect a multiple pregnancy !

If you need help in interpreting your HCG levels, please send me your medical details by filling in the free second opinion form at www.drmalpani.com/malpaniform.htm and I'll be happy to help !

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One of the most frustrating things an infertile woman can experience is having a late period and a negative pregnancy test! If you are trying-to-conceive , every time you miss your period, your hopes that you are now finally pregnant go up. You do the pregnancy test with a lot of hope - and lots of prayers. You are scared to do it, because you do not want to get your hopes up, and you are worried that it maybe negative once again . You finally screw up your courage - even if the news is bad, it's best to know the truth, you tell yourself - and then do the test.

When it's negative, you are depressed, disappointed and disheartened. But then you start hoping against hope ! Maybe I didn't do the test properly ? Maybe I drank too much water and the HCG is not showing up in the urine ? Maybe I did the test too early ? Maybe I ovulated late this cycle ? Maybe this brand is not reliable ? Aren't these tests fallible ? Maybe the test kits have expired ? Should I test again ? Should I use another brand ?

What happens if the test is repeatedly negative ? A late period and recurring negative pregnancy test results can lead to a great deal of stress, worry, confusion, and conjecture on what might be happening.... If I'm not pregnant, then where is my period?!? Have I stopped ovulating all together ? What's happened to my eggs ? Is my body going crazy ?

One possibility is that you are in fact pregnant , but the urine test result comes back negative. This is called a "false negative pregnancy test"? First, read all the instructions again and make sure you are doing the test properly. If you are, then a false negative result can occur if the test kit you are using is of low sensitivity. This means that the test is capable of detecting pregnancy only when the level of hCG reaches a certain threshold, and the test is simply not sensitive enough to yield the positive result.The best option is to do a blood test for checking your HCG level. This is very reliable ! If this is less than 10 mIU/ml, this confirms you are definitely not pregnant.If the test is negative , this means the reason you missed your periods is because you did not ovulate. This is called anovulation. You can read more about this at www.drmalpani.com/anovulation.htm !

Many factors can cause a missed period because they disrupt your hormonal balance. These include increased stress, anxiety, travel, jet-lag, weight loss, exercise and sleeplessness. The doctor may need to do an ultrasound scan to find out why you have missed your period. This vaginal ultrasound scan should check for the following.

a. ovarian volume
b. antral follicle count
c. uterus morphology
d. endometrial thickness and texture.

Based on these results, your doctor may prescribe medications for you to induce a period.