hello this week we are talking about something i get
asked all the time and that is how early can you take a pregnancy test
yes and what are some of those first signs of implantation and early pregnancy
if this is your first time meeting us i'm sarah i am a board-certified ob gyn and first-time mom
i am kurt i'm a board-certified pediatrician and first-time dad and we are the doctors bjorkman
all right welcome back to our channel yeah over the past two years we've shared our
journey with getting pregnant sarah's first pregnancy our parenthood journey
and all of these evidence-based tips and tricks along the way yeah we recently have been talking
about trying to have baby number two and our ivf journey and struggles with secondary infertility
and this week we're going to be talking about how soon you can find out if you're pregnant whether
you've used ivf or trying to conceive naturally some signs of implantation and those super early
pregnancies signs and symptoms yes i've taken so many pregnancy tests over the past year every two
week wait i was testing too early and even though i am an ob gyn i was looking at all those forums
to see how early other people were getting their big fat positives and over analyzing every symptom
yeah you may have caught it we've talked all about what's happening with egg and embryo during this
first two week wait in our video that we're going to link here yes as a quick recap so around day
14 of the menstrual cycle the ovary releases an egg that is captured by the fallopian tube that
is ovulation and that's the big event that you are trying to time sex with in order to optimize your
chances of getting pregnant at this time the fallopian tube kind of sweeps around the ovary
to grab that egg when it's released pulling it into the ampulla or upper portion of the fallopian
tube in just two to three minutes and there in the upper end of the fallopian tube this egg
meets the sperm for fertilization which usually occurs within 24 hours of the egg being released
the fertilized egg then hangs out there in the ampule for about three days before making its epic
three-day trip down the tube to the uterus yes and those first six days aren't just about hanging out
in the ampulla and then working your way to the uterus so that fertilized egg while it's making
that journey it is also preparing for implantation by growing and dividing and growing and dividing
so this allows that fertilized egg to become two cells and then four and so on until it becomes you
know a 64 cell blastocyst and continues dividing um which is and at that point it's already
starting to differentiate into what will become the placenta and what will become the baby yeah
then over the next week a complex series of events matures this blastocyst while it's implanting into
the uterine lining there's been studies that have shown that this happens on average around day 9
but could be anywhere from day 6 to day 12. it is also around this time that the outer layers
of cells of the blastocyst start secreting human chorionic gonadotropin or hcg this is the hormone
you've been waiting for because hcg is what makes your home pregnancy test turn positive yeah so
what is exactly happening with implantation this whole time well basically that tiny embryo is
burrowing into the uterine lining and kind of has to chew away at the uterus a little bit
to be able to establish a connection and establish that blood flow gotcha so as you
can see here that final step of implantation is invasion implantation is not perfectly understood
but it is a very complex process where that embryo must invade into the cells of the uterus
to establish blood flow connection between mom and baby via the placenta and you can imagine
this isn't necessarily a comfortable process often women will have some cramping um
seven to nine days post ovulation or days post ovulation um as that embryo is really starting
to burrow in as the connections are being made there might be a little bleeding or spotting too
so sometimes 10 to 14 or so days post ovulation women may have some bleeding or spotting and
wonder is this implantation bleeding or is it the start of your next period now the other
big hormone at play during this time is called progesterone and progesterone is a pro-gestation
hormone yes so when you ovulate the follicle that the egg was released from becomes something called
a corpus luteum and the corpus luteum is actually a very metabolically active little follicle and
it is responsible for secreting hormones to support implantation and in early pregnancy
now the corpus luteum secretes progesterone to help the endometrium become receptive
for an embryo and if you get pregnant this corpus luteum is going to continue to discrete
progesterone until the placenta takes over making more progesterone which that transition usually
happens around eight weeks of gestation correct so early pregnancy symptoms are often caused by that
rising progesterone and hcg yeah and some of those high progesterone symptoms can be things like
breast tenderness feeling like your boobs are getting bigger food sensitivities nauseas or
you may be more sensitive to certain smells yeah you may have appetite changes or bowel changes
bloating constipation diarrhea or also headaches mood changes or just a general feeling of fatigue
now sometimes it can be really tough to tease out if these symptoms are from real pregnancy or if
it's just part of your normal menstrual cycle or if you're on progesterone as prescribed by your
doctor as a part of an ivf treatment some patients experience all of these symptoms cramping bloating
bowel changes headaches but some experience none at all right so this brings us to the question you
know how early can you get a positive pregnancy test yeah and the answer to that really seems to
depend on how sensitive your home pregnancy test is right yes the sensitivity of home pregnancy
tests vary by brand some are supposed to detect an hcg as low as 6 to 10 and some are more like
in the 25 to 50 range as we explained before the embryo does not even start secreting hcg until it
implants in the uterus which is usually somewhere between six and nine days after you ovulate so
even if fertilization has occurred and everything is going perfectly there won't be any hcg in your
bloodstream or urine until a day or two after implantation because of this the earliest we
usually see a positive on a home pregnancy test is around eight days after you ovulate so any testing
much before that is usually not recommended and it's really just kind of a waste of money
and it can be totally unnecessarily disappointing yeah the other thing to think about is if you are
doing any kind of fertility treatments or ivf often you will take a trigger shot which is hcg
and that would turn a home pregnancy test positive you need to make sure that you have waited long
enough time after that trigger shot to take a home pregnancy test or you could end up with a false
positive from that injection yeah now some people will take a pregnancy test every day after that
trigger shot to follow it down or test out yeah and watching this line get lighter every day and
then hopefully watching the line that second line get darker again after that yeah but again that's
a lot of testing um and a lot of anxiety yeah so now what happens if someone got an embryo transfer
well nowadays most embryo transfers are done on day five and a day five embryo is called
a blastocyst and we know that after they're put back in the uterus at the transfer they usually
implant in the first 24 to 48-ish hours once implantation happens that after that that embryo
starts secreting hcg so you might get a positive home pregnancy test as early as day four or five
so the big takeaway that in a natural cycle right conceiving naturally at home
you might get a positive home pregnancy test on post ovulation day eight or nine but just
because you don't does not mean you're not going to be pregnant that cycle yeah
and then after embryo transfer you might get a home positive home pregnancy test as early
as four to five days post transfer correct but again just because it isn't positive
does not mean that you aren't going to be pregnant um and most clinics actually if
you're doing ivf will tell you do not do your pregnancy tests at home so i am a bit neurotic
whatever when it comes to testing um and when trying to conceive the old-fashioned way
i would usually start secretly testing around post-ovulation day six or 7.
yes and yes i know that's really probably too early to get a positive but i read on
some of these forums that there are people out there that get a big fat positive on day
six or seven and you never know um i got a real with cease with my first pregnancy i got a
faint positive a squinter on um dpo10 so 10 days after ovulation
got a squinter and then that i wasn't told about and then on day 11 definitely had a positive
that we if you watch our video of when we found out with that one i actually knew it first
but anyway so i'm a little bit of go a little while when it comes to testing
and i think over the last year of yeah i think the downside of that is for all of the times we
weren't pregnant with a second go-around it was a lot and a lot of negative tests yeah and we i
mean we recorded many videos of us you know like let's do this pregnancy test reveal for youtube
and they were negative time and time again um so yeah it was a it was a year of an excessive amount
of negative pregnancy tests so with ivf i guess um i did all the things your clinic tells you not to
as you know they generally use the best patient recommend that you don't do home pregnancy tests
you just take your blood test usually 10 to 12 days after your transfer and the reason for that
is just because you get a negative on day four or five or six or whatever doesn't mean it is
going to be negative so they try to save you a little bit of that emotional rollercoaster and
disappointment when it's not necessary um which i learned very well so on transfer day i took a
pregnancy test to test out my trigger make sure it was negative um because i had taken a hcg trigger
it was like 1500 units uh the seven days before so i was like this should be completely negative
that trigger should be out of my system took a pregnancy test negative great and then
like a bozo two days post transfer decided to take a pregnancy test in the morning like just
knowing it would be negative just for kicks and giggles well sure enough put a pic it looked like
there was a squinter a very very faint line i sent it to my doctor who's also like one of my
dearest friends and we analyzed over this together and we're like no that's really there we see this
i took another test that night like the evening of post-transfer day to in the evening and it
also like i don't think we were imagining it you can see um and so that was you know so exciting
and then i wanting to watch these lines darken on three days post transfer i took another test in
the morning and it was negative very negative another test was very negative um and that
i was pretty devastated i like rationally my doctor obgyn fertility doctor
brain said it's way too early way too early calm down it's fine that the positive the day before
was probably from your trigger or something like that probably wasn't real just to keep breathing
um so then on day three i went and got a blood test because i was like we both saw it it was
pause there was a squinter it's gotta be five or something anyway the hcg level was less than
two the blood test so that was very real negative um and again i was still pretty bummed um yeah i
think we were apart for this like we were both traveling for work i left shortly there after
for a conference yeah and like it was actually like tougher to go like having gone through ivf
and then thinking we failed or thinking it was positive and then then it was negative and it
was so i went away to a conference took boxes of pregnancy tests and a variety of different
pregnancy tests and um again on day four it was negative and then on day five we got this
um and i texted kurt a picture first thing in the morning i showed my roommate she's like yes that's
absolutely a positive uh texted it to my doc texted it to my friend who was also there and
had been giving me injection my progesterone injections and we were like this is a positive
it is five days post transfer that is a real line yay we're so excited so um then again like a
anxious silly person who had too much access to care on day six post transfer i got a blood
test done again and my hcg was 36. so we're like okay this is real then like a normal patient i
got my blood work done 10 days after transfer and it was a good normal post transfer hcg and
we were like this is this is happening the theme of the story is if you do what you're supposed to
you avoid lots of anxiety and hopefully get an answer that is true that is true with one test yes
okay so we are having another baby and we are so excited it's been so different just
the whole process obviously um ivf and then also just baby number two yes but while i i tell all
of my patients while you didn't get pregnant the old-fashioned way now you are just pregnant
um and so that's where we're at we're excited to share the journey of what pregnancy number two
looks like how that goes wrangling a toddler who is determined and active yes and so we are looking
forward to sharing that with all of you that is all we're gonna have for you this week hopefully
it gives you some peace of mind and saves you a few bucks on excessive pregnancy tests um
and as you saw from my uh our irl we are pregnant again here we go um so please continue to hang out
with us as we go through pregnancy number two we will see y'all next week bye guys
we're doctors but not your doctors anything we've said in this video
is for education or entertainment purposes only it is not medical advice
any specific medical questions you have should be directed to your provider