Brief Answer: yes, pregnancy usually occurs before the implant Detailed Answer: Hi, Thanks for the query. I understand that the lady has had an implant inserted and is now having a period and the pregnancy test is positive. This is indeed unfortunate but not impossible. There are few possibilities: 1. She was pregnant before the implant was inserted. Sometimes the implant is not inserted on the first day of the menses. A backup method of contraception is advised in such cases for 7 days after which the effect of implant begins. If no contraception is used in the first 7 days, pregnancy is possible. The bleeding may result from abortion or implantation bleed. 2. It seems that she had an abortion earlier: Sometimes the abortion is incomplete and a few products remain inside the uterus giving rise to bleeding and positive urine test. 3. false positive test as may happen due to problems with test kit, use of certain medicines, certain tumors like lung liver and many other rare tumors [She is too young for them]. Check if the hair growth medicine causes a false positive. I suggest that you repeat the test with a morning first urine sample. If it is positive, get an ultrasound done to look for pregnancy. Ectopic pregnancies [pregnancies in locations other than the uterus like the tubes and ovaries may occur while on birth control]. The ultrasound will help in confirming things. Hope this satisfies your query. Thanks for using HCM. Feel free to ask any more questions that you may have. I will be happy to help. Dr Madhuri Bagde Consultant Obstetrician and Gynecologist

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Brief Answer: If bleeding is heavy pregnancy cannot be ruled out Detailed Answer: Thanks for the follow up query, I understand the issue. She had an abortion a few months ago. Did she have normal periods after that? Anyway, if the test is positive with implants and she is bleeding it indicates that she may have had a pregnancy and may be aborting or having an implantation bleed. Other cause is a false positive test and heavy bleed is due to the implant. From your description it seems that the bleeding is heavy, So it is better that you visit the ER and see your doctor. Pregnancy with implant is extremely rare, but as I have said earlier if it occurs chances of ectopic pregnancy are higher. Better get a examination and an ultrasound [preferable a transvaginal one] done to look for cause. Hope this helped. Take care. I am here to help if needed. Dr Madhuri

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