Baby Gesture

Twins Can Cause a False Negative Pregnancy Test Result—Here’s What to Know

January 23, 2024 | by Carlene Kuntz

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Understanding False Negative Pregnancy Test Results

A false negative pregnancy test result can be a confusing and frustrating experience for women who are trying to conceive. It occurs when a woman is pregnant, but the test fails to detect the pregnancy hormone, hCG (human chorionic gonadotropin), in her urine. While false negatives can happen for various reasons, one lesser-known factor that can contribute to this is the presence of twins.

The Role of hCG in Pregnancy Tests

Pregnancy tests work by detecting the presence of hCG in a woman’s urine. This hormone is produced by the placenta shortly after the fertilized egg implants in the uterus. As the pregnancy progresses, the levels of hCG increase significantly. Most pregnancy tests are designed to detect hCG levels above a certain threshold, typically around 25 mIU/mL.

Why Twins Can Lead to False Negative Results

In the case of a twin pregnancy, the levels of hCG are often higher than in a singleton pregnancy. This is because each embryo produces its own hCG, resulting in a higher overall concentration of the hormone. However, not all pregnancy tests are equally sensitive to higher hCG levels.

Some tests may have a higher threshold for detecting hCG, meaning they require a higher concentration of the hormone to produce a positive result. If a woman is carrying twins and her hCG levels are not yet high enough to meet the threshold of the test she is using, she may receive a false negative result.

When to Take a Pregnancy Test

For women who suspect they may be pregnant with twins, it is advisable to wait until a few days after a missed period to take a pregnancy test. This allows more time for hCG levels to rise, increasing the chances of an accurate result. Taking the test too early may result in a false negative, even if twins are present.

Confirming a Twin Pregnancy

If a woman receives a negative result on a pregnancy test but suspects she may be pregnant with twins due to other symptoms or risk factors, it is recommended to consult with a healthcare professional. They can perform a blood test that measures the exact levels of hCG in the body, providing a more accurate assessment of pregnancy.

In some cases, an ultrasound may also be necessary to confirm a twin pregnancy. This imaging technique can detect multiple gestational sacs or heartbeats, providing definitive proof of twins.

Other Factors Contributing to False Negative Results

While twins can be a factor in false negative pregnancy test results, it is important to note that there are other reasons why a test may fail to detect a pregnancy. These include:

  • Testing too early: Taking a pregnancy test before hCG levels have risen sufficiently can result in a false negative.
  • Improper test usage: Failing to follow the instructions correctly, such as not using the first-morning urine or not waiting the recommended amount of time, can affect the accuracy of the test.
  • Expired or faulty test: Using an expired or defective pregnancy test can lead to inaccurate results.
  • Medical conditions: Certain medical conditions, such as an ectopic pregnancy or ovarian cysts, can interfere with hCG production and lead to false negatives.


While a false negative pregnancy test result can be disheartening, it is essential to remember that it is not uncommon, especially in the case of a twin pregnancy. If there is a suspicion of twins or if the test result is inconclusive, seeking medical advice is the best course of action. A healthcare professional can provide further testing and guidance to ensure an accurate assessment of pregnancy.

Remember, every woman’s body is unique, and the accuracy of pregnancy tests can vary. Patience, proper testing techniques, and professional guidance are key in navigating the journey towards confirming a twin pregnancy.


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