Celebrities, including Lindsay Lohan and Kourtney Kardashian, have recently announced their pregnancies. A pregnancy test can tell a person a lot about their health status, depending on how light or dark the line on the test is.

At-home urine pregnancy tests have a 99% accuracy rate when used correctly. That being said, patients with a dark positive result can be relatively confident that they are pregnant, and those without a line can be relatively confident that they are not pregnant. But what confidence level does a faint line imply? And how can you help patients navigate the next steps if they receive one?

Cleveland Clinic. Pregnancy Tests.

 

According to G Thomas Ruiz, MD, a gynecologist at MemorialCare Hospital in Orange County, a faint line on a pregnancy test doesn’t promise much in the immediate term, but can provide hints for the future. First and foremost, it implies that it’s a good idea for the person to take another pregnancy test in two or three days in order to confirm whether they are pregnant.

To best guide a patient in how to proceed after receiving a faint line on their pregnancy test, you may want to help them understand why the line was faint in the first place. A faint line can imply that the person contains low levels of the human chorionic gonadotropin (hCG), a hormone produced by the placenta (usually) during pregnancy—and the hormone that pregnancy tests look for to confirm a positive or negative result. This hormone triggers the body to produce more estrogen and progesterone, tells it to stop menstruating (or producing eggs), and thickens the uterus lining to support pregnancy.

Cleveland Clinic. Human Chorionic Gonadotropin.

 

“Repeat the test in two days: If there's a normal rise in hCG, that line will get darker,” Ruiz says.

He adds that the waiting period is important, as the result is unlikely to change before then.  

“A lot of women who are trying to get pregnant get that first positive pregnancy test and don't believe it and want do it again right away,” he says. “But they're pretty reliable tests.”

 

Here are some things that a faint line—or low hCG levels—can imply:

 

• The patient is in the very early stages of their pregnancy.

According to Cleveland Clinic, hCG can typically be detected in the blood 10 days after conception—or when the sperm fertilizes the egg. If a person takes a pregnancy test at or before the 10-day mark, the line may be faint or nonexistent. 

• The patient has had a miscarriage or is experiencing an early loss of pregnancy.

A person who gets pregnant but experiences loss of pregnancy may maintain some hCG levels. Depending on how far along they were before the loss, they may experience normal to heavy menstrual bleeding, indicating that they are not (or are no longer) pregnant, despite the faint line.

Cleveland Clinic. Causes of a False Positive Pregnancy Test.

 

• The patient is experiencing a blighted ovum.

  Cleveland Clinic. Blighted Ovum.

   

In this case, the patient experienced a fertilized egg being implanted into the uterus but not growing into an embryo. The person is not pregnant. 

• The patient is undergoing menopause. 

Menopause-related hormones can mimic hCG and confuse pregnancy tests.

“Believe it or not, something happens in menopause where a woman's pituitary is excreting increased amounts of these other hormones that look like hCG, and that may cause a faint false positive,” says Ruiz. 

But, he adds, people who are experiencing menopause may be less likely to reach for a pregnancy test in the first place

• The patient is exhibiting other hormones that the test is mistaking for hCG regardless of whether or not they are experiencing menopause

• In rare and repeated cases, experiencing a molar or trophoblastic disease.

Repeated cases can also be a sign that something is not right with the body, in which case seeking medical attention is wise, says Ruiz. Communicating with patients who are experiencing complications with at-home pregnancy tests or frequently receiving a faint line can be a good way to stay alert about their condition and connect them with necessary types of testing.

In cases of uncertainty or concern, taking blood pregnancy tests can be a good next step, Ruiz sways. Blood tests also look for the hCG hormone, but rather than look only for its presence, these tests measure exact hCG levels. These can be more accurate and can be important to use on people with continuous faint results or those who want peace of mind, Ruiz says.

 

Faint lines and planned versus unplanned pregnancies

 

For patients who are trying to get pregnant and who receive a faint positive line on a pregnancy test, the best next step is to retake the test a few days later. For patients who are not trying or ready to get pregnant, the best next step may be  immediately visiting a safe abortion clinic or Planned Parenthood to set up an appointment or procedure or medication abortion, particularly if they are located in a state in which abortion is banned, says Ruiz.

“If you're in a state that has a six-week ban, then as soon as you see that light line [and] confirm it in two days, and you don't want to keep the pregnancy, you better get into Planned Parenthood quick,” Ruiz says. “You don't have a lot of time.”