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Dr. Andrew Rynne

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Is negative urine pregnancy test at 3 weeks after intercourse accurate?

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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3066 Questions

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Posted on Wed, 8 Aug 2018 in Women's Health
Question: I am on the pill, and had protected (condom) sex multiple times a day from 12/29 through 1/4. On two occasions the condom broke, but my partner did not ejaculate inside me. One time during this pill pack I forgot to take a pill (one of my sugar pills during the last week of the pack) but took it the next day when I realized. Following that pack I had my normal breakthrough bleeding from 1/9 - 1/13. This past week I have been experiencing some dizziness, nausea without vomiting, very slight breast tenderness yesterday starting experiencing slight pinkish red blood only visible when I wipe. It seems like it would be too late to be implantation bleeding but I have never bled mid cycle before while on the pill and I have been so stressed out about these symptoms the past week. The last test I took this morning was negative but I feel as though that was too early to test especially now with the bleeding. I am still bleeding this morning but still it is only noticeable when I wipe. Also I have been having pressure on my lower back for the past 2 days. What is the likelihood I may be pregnant and when could I test as it is now 3 weeks post the last date of intercourse.

doctor
Answered by Dr. Bonnie Berger-Durnbaugh 1 hour later
Brief Answer:
Thoughts on this.

Detailed Answer:
Hello,

There is little chance of being pregnant from the history you described here. If it were me, I would be reassured by:

1. Negative urine pregnancy test at 3 weeks after intercourse:
Urine pregnancy tests are highly accurate by 3 weeks after possible conception.

2. Your diligence in taking the Pill is adequate to provide protection even if you forgot to take one sugar pill.

3. Your partner did not ejaculate in you.

The symptoms you are experiencing may be due to something else. I can understand that you would be concerned by this constellation of symptoms but the chances of being pregnant are highly unlikely. You can go in to your doctor to have a blood (serum) pregnancy test to be sure you did not conceive the month before, but I think it is unlikely.

How long have you been on this current Pill and what is the name of it (I'm asking to see if it is a progestin only or a combination pill). Because sometimes with progestin only pills, there can be a bit of irregularity with spotting, breast tenderness, etc.


Hope I have answered your query.
Let me know if I can assist you further.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 34 minutes later
Thank you for your thorough answer. I believe I am on progestin only. And I have been on it since March / April of 2017. This was another cause for concern as I have never experienced all of these symptoms while being on this pill.The specific birth control is Blisovi Fe 1/20 (norethindrone acetate and ethinyl estradiol tablets USP and ferrous fumarate tablets) 28 pills.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 3 hours later
Brief Answer:
Thoughts on this.

Detailed Answer:

Hi,

What you are taking is a combination pill - the ethanol estradiol is the estrogen part.

You have been on the pill long enough for it to provide protection (1 month) but also long enough where irregularity isn't typical. Still, occasionally women can have symptoms.

Given that your partner did not ejaculate in you and was wearing a condom although ruptured, your chances of pregnancy are minuscule. Pre-ejaculatory fluid has few and in some cases no viable sperm. Withdrawal method isn't a good form of birth control more because men can't always predict when they will ejaculate rather than because of a high risk from viable motile sperm in the pre-ejaculatory fluid. The chance of them causing pregnancy, while it may not be zero, is low.

And you have been on the pill.

So - I still think the cause of your symptoms may be something else. Possibly a low grade viral infection.

But if you want to be absolutely sure, you can go in for a serum pregnancy test.

I'm attaching here an article about sperm content in pre-ejaculatory fluid. To see it you'll have to copy and paste the link in your address bar:
https://www.yyy.nlm.yyy.gov/pmc/artyyyyys/PMC0000/

Hope I have answered your query.
Let me know if I can assist you further.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 2 days later
In the past two days my nipples and areolas have gotten darker and the back pressure I’ve had has stayed constant. I took a test this morning (though not first thing) and it was negative. Could anything aside from pregnancy be causing the changes in my breasts? My period is due in 8-9 days so it’s too early to attribute to pre menstrual correct?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 2 hours later
Brief Answer:
Thoughts on this

Detailed Answer:

Hello,

Darkened nipples are due to increased levels of hormones, and you are right that this often happens with pregnancy but it can happen anytime there is a rise in these hormones, such as at puberty. Why your hormones would rise now if you are on the same pill and very little chance of pregnancy based on your activity I can't say for sure.

If the home pregnancy tests were taken at least 14 days after possible date of conception and were not too dilute (first morning urine is best to use to test) then it should be accurate. Sometimes (rarely), an ectopic pregnancy will not show up as positive (elevated hCG) in early stages of pregnancy.

So I do think it would be good for you to get a serum pregnancy test.

Is there any way you can go in to have a serum pregnancy test done, as it will help sort this out.

Hope I have answered your query.
Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 5 minutes later
I have an appointment with my doctor on Wednesday of this week and I request a serum test be done.

Another thing I have thought of, I missed multiple pills in November’s pack, but took them all at a later date. Would this have any effect on the effectiveness of the pill in late December / early January?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 13 minutes later
Brief Answer:
Information

Detailed Answer:

Hi,

The progestin only is more touchy about missed pills or not taking them at the same time of day, but the combination pill is not as much. Still, once a person misses 2 in a row it gets less reliable.

But you are saying that happened in November. If you took your entire pack consistently in December, then you should be ok in late December and early January.

Hope I have answered your query.
Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 11 hours later
I have upload a photo of some discharge I have noticed today. I have a video but it isn’t uploading as well. Not sure if it’s pre menstrual 8-9 days out or early pregnancy discharge.I have the blood serum test scheduled for later this week but I appreciate your thoughts on the photos and I apologize if they are too much, I’m just concerned.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 6 hours later
Brief Answer:
Call today for a serum test to have the info when you see your dr.

Detailed Answer:

Hello,


If it is not itchy or irritating (which could go more with yeast overgrowth) it can be from increased progesterone. That can be from pregnancy or just having increased hormones from an imbalance this month (and I am not sure why that would be unless you did have ovulation this month, or the pill has too much progestin for you).

I know you have an appointment with your doctor on Wednesday, but perhaps his or her nurse might be willing to have you get a serum pregnancy test now/today. You can call his/her office and ask for a call back from their nurse. Tell the nurse the symptoms you are having, the stress it is causing, and that you are going to see the doctor on Wednesday and would like to have the results ready to be able to discuss them when you see the doctor.

You do have many symptoms of pregnancy although the typical early pregnancy symptoms are usually considerable fatigue and breast tenderness (I do note that you did say you are having a little of the latter). And you have had negative urine pregnancy tests 3 weeks after possible conception, and not much risk for conception (i.e. you are on a reliable contraceptive and no significantly risky sexual events). So, the chances of pregnancy are quite low. But still needs sorting out.

Take Care!

Dr. Bonnie Berger-Durnbaugh,
General & Family Physician
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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