If you're like other hopeful parents-to-be in that you're eager to take a pregnancy test ASAP, you may go from feeling overjoyed about an early positive result to curious whether that could mean you're expecting not just one baby but two (or more!).
First of all, congratulations! Early positive test results — received days before your period is due — might be one clue that you're having twins, but don't count on it.
Here's why: Home pregnancy tests look for the presence of human chorionic gonadotropin (hCG) in your urine, and levels of that hormone are indeed higher in multiple pregnancies — but not right away.[1] It takes a few days for the hCG production of twins to outpace the hCG production of one baby.
In fact, on the first day of your first missed period, there might be no difference at all. If you test yourself even earlier than that, it's just as likely that what you measured is simply a normal variation in hormone production.
Early positives may mean you have two more babies on the way (which research indicates is more common among women over the age of 35), or they may mean that you have just one.[2] The only thing for sure right now is that you're pregnant.
Why such an iffy answer? It's because home pregnancy tests must account for several big variables.
First, hCG starts getting manufactured by the cells of the placenta a few days after the embryo implants itself in your uterine wall. It then doubles every two to three days for about 10 weeks.
Your egg can survive in the fallopian tube for up to 24 hours after ovulation, though you can become pregnant if you have sex up to five days before ovulation in addition to up to a day after. Since hCG doesn't get produced until implantation, you may have no measurable levels of it until just before you miss your period, or you may have a stash of nearly two weeks' worth.
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In addition to this variation (or perhaps because of it), the amount of hCG can differ wildly from person to person and pregnancy to pregnancy.
Finally, pregnancy tests themselves vary in sensitivity, not just from brand to brand but from batch to batch. Very few home tests are sensitive enough to use reliably before the first day your period is due; not until then do most women have hCG levels high enough to produce a plus sign.
Some experts recommend waiting a few extra days, to be sure there's enough hormone to measure. That said, any positive result is most likely accurate no matter what day you use the test on.
But if your levels were on the high side and you used an especially sensitive home pregnancy test, you certainly could have gotten early positives and not be having twins.
By the way, blood tests for hCGare more accurate than home pregnancy tests (especially earlier on). A quantitative hCG test specifically measures the amount of the hormone you're producing.
However, the level of hCG varies widely for different women at the same stage of pregnancy — so a single measurement cannot be used to predict how far along you are or if you are pregnant with twins. The only way to confirm a twin pregnancy is with ultrasound.
Few practitioners order blood tests for pregnancy though, since home pregnancy tests are so accurate once a period is missed. However, if you do get especially early positives or have any concerning symptoms (i.e. spotting), your doctor might want to order one.
Also, you will have an early first trimester ultrasound at some point (usually between 6 and 10 weeks), which will let you see if you've got more than one baby on board.
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