Do Tubal Pregnancies Show on Pregnancy Tests?

A positive pregnancy test is often met with joy, hope, and anticipation. But not all pregnancies follow a typical path. One of the most serious complications early in pregnancy is a tubal pregnancy, also known as a type of ectopic pregnancy. These pregnancies can be life-threatening if not diagnosed early and treated properly.

One common question many women have is: “Can a tubal pregnancy still give a positive result on a pregnancy test?” The answer isn’t always straightforward, and understanding how pregnancy tests work and how hCG behaves in ectopic pregnancies is essential.

This blog explores how tubal pregnancies affect pregnancy test results, their risks, symptoms, and what you should do if you suspect something might be wrong—even after a positive test.

What Is a Tubal Pregnancy?

Definition of Ectopic and Tubal Pregnancies

An ectopic pregnancy occurs when a fertilized egg implants outside the uterus. Tubal pregnancies—the most common type—occur when the egg implants in the fallopian tube instead of the uterine lining.

In a normal pregnancy, the fertilized egg travels down the fallopian tube and implants in the uterus. But in a tubal pregnancy, this process is interrupted, and the embryo begins developing in a space that cannot support its growth.

How It Differs from a Normal Pregnancy

Unlike uterine pregnancies, tubal pregnancies cannot result in a viable baby. As the embryo grows, it can rupture the fallopian tube, causing severe internal bleeding, pain, and even death if not treated.

Symptoms of a Tubal Pregnancy

Early signs of a tubal pregnancy may mimic normal pregnancy symptoms but can escalate to include:

• Sharp abdominal or pelvic pain (often on one side)
  
• Vaginal bleeding or spotting
  
• Shoulder pain (from internal bleeding)
  
• Dizziness or fainting

 

How Pregnancy Tests Work

Detection of hCG Hormone in Urine or Blood

Pregnancy tests—whether done at home or in a clinic—are designed to detect the presence of human chorionic gonadotropin (hCG). This hormone is produced by the placenta shortly after a fertilized egg implants in the uterine lining. hCG starts to appear in blood within 6–8 days of ovulation and is typically detectable in urine by around 10–14 days post-ovulation.

At-home urine tests are the most commonly used. They include a test strip or stick coated with antibodies that react to hCG. When hCG binds to these antibodies, a visible line, symbol, or digital word (e.g., “Pregnant”) appears.

In contrast, blood tests for hCG—conducted in medical settings—can measure even lower levels of the hormone and are useful for tracking hCG trends over time.

Typical hCG Production in Early Pregnancy

In a normal intrauterine pregnancy, hCG levels double approximately every 48–72 hours during the first few weeks. This rapid increase is a good sign of healthy early development. Peak hCG levels are usually reached around the 8th to 11th week of pregnancy, after which they begin to level off or decline slightly.

Understanding this growth pattern is essential when interpreting pregnancy tests, especially when testing early or if there’s concern about the viability or location of the pregnancy.

Relevance of hCG Levels in Ectopic Pregnancies

In the case of a tubal pregnancy (or any ectopic pregnancy), hCG is still produced by the developing embryo. However, the levels may not rise at the typical rate. In fact, a slower-than-expected increase or plateauing hCG levels is one of the red flags doctors use to help identify an abnormal pregnancy, such as one implanted outside the uterus.

This is why, in suspected ectopic cases, your doctor may order serial hCG blood tests 48 hours apart to evaluate the trend rather than relying on a single value.

Can Tubal Pregnancies Show a Positive Pregnancy Test?

Yes, Tubal Pregnancies Can Yield a Positive Result

It might surprise some people, but most tubal pregnancies will produce a positive pregnancy test. That’s because, despite the embryo being in the wrong location, the body still recognizes the pregnancy and begins to produce hCG.

This means that if you take a test at home using a high-sensitivity option like MomMed Pregnancy Test Strips, which detect hCG levels as low as 25 mIU/mL, you're likely to get a positive result—even if the pregnancy is ectopic. These test strips are a practical choice for early testing and cycle tracking, offering lab-grade accuracy from the comfort of home.

Why the Result May Still Be Misleading

While the test may detect hCG and show a positive result, it does not confirm that the pregnancy is healthy or located in the uterus. This is one of the key limitations of home pregnancy tests: they answer the question “Am I pregnant?” but not “Is this pregnancy progressing normally or safely?”

In a tubal pregnancy, hCG is typically:

• Lower than expected for the gestational age
  
• Slower to rise than in a normal pregnancy
  
• Sometimes erratic or even declining, depending on the health of the embryo
  

This variability in hCG levels is a warning sign that further evaluation—typically involving blood tests and a transvaginal ultrasound—is needed.

When You Should Be Concerned

If your pregnancy test is positive but you experience abdominal pain, abnormal spotting, or dizziness, these could be signs of an ectopic pregnancy. Do not rely solely on the result of the test to assume that everything is fine. A positive test with troubling symptoms should always be followed up with a healthcare provider.

It’s also important to note that not all ectopic pregnancies show symptoms right away. Some may appear to progress normally for a short time, which is why early ultrasounds and hCG monitoring are recommended for anyone at risk or unsure.

 

Limitations of Pregnancy Tests for Detecting Tubal Pregnancy

Pregnancy Tests Confirm Pregnancy—Not Location

Home pregnancy tests are designed to answer a binary question: Is hCG present in the body or not? While this hormone indicates pregnancy, it does not reveal where the embryo has implanted. In a healthy intrauterine pregnancy, or a dangerous ectopic pregnancy such as a tubal one, hCG may still be present. This means a test might yield a positive result even if the pregnancy is not viable or safe.

This limitation is critical to understand: a positive pregnancy test is not a guarantee of a healthy pregnancy—only that hCG is circulating in your body.

Ultrasounds Are Required for Accurate Diagnosis

The only definitive way to determine the location of a pregnancy is through a transvaginal ultrasound. An ultrasound can help doctors confirm whether the gestational sac is inside the uterus or elsewhere (e.g., in a fallopian tube). In some cases, serial ultrasounds and hCG level tracking over several days are necessary to pinpoint the pregnancy’s location and development.

If you’ve had a previous ectopic pregnancy or have risk factors (such as tubal surgery or infections like PID), your doctor may recommend an early ultrasound as soon as your pregnancy test is positive.

Subtle Symptoms May Delay Detection

Another limitation is that symptoms of a tubal pregnancy can initially mimic a normal pregnancy, making it easy to miss. This includes mild cramping, light spotting, and early pregnancy discomforts that don’t raise immediate red flags. In these cases, relying solely on at-home tests without medical oversight may delay critical care.

That’s why it's essential to pair at-home testing with early prenatal care—especially if your cycle is irregular, or your pregnancy test line appears unusually faint or doesn’t darken over time.

When to Seek Medical Attention

Know the Red Flags of a Tubal Pregnancy

While some tubal pregnancies remain asymptomatic in the early days, many eventually present with distinct warning signs. These symptoms should never be ignored, especially if a pregnancy has already been confirmed via a test. Common signs include:

• Sharp or stabbing pain on one side of the lower abdomen
  
• Shoulder pain (due to internal bleeding irritating the diaphragm)
  
• Heavy vaginal bleeding or spotting that intensifies
  
• Sudden dizziness, fainting, or lightheadedness
  
• Rectal pressure or urgency to defecate (a sign of pelvic irritation)
  

If you experience any of these symptoms, especially in combination with a positive pregnancy test, seek emergency care immediately. A ruptured ectopic pregnancy is a medical emergency and can be life-threatening without prompt treatment.

Early Intervention Can Save Fertility—and Lives

The earlier a tubal pregnancy is detected, the more treatment options are available. Non-surgical approaches, such as methotrexate (a medication that stops cell growth), may be used if the pregnancy is caught before rupture. In more advanced cases, surgery may be required to remove the pregnancy and repair or remove the affected fallopian tube.

Prompt medical attention not only preserves future fertility but also protects your health and safety. If you’re trying to conceive again, understanding what happened and getting your doctor’s guidance will be key to a healthier future pregnancy.

 

What to Do After a Positive Pregnancy Test If You Suspect a Tubal Pregnancy

Start with Early Prenatal Care

If you suspect pregnancy and experience unusual symptoms or have a history of ectopic pregnancy, schedule a prenatal appointment early. Your provider will monitor your hCG levels and may perform an early ultrasound to check pregnancy location.

If you’ve been tracking ovulation with tools like the MomMed Ovulation Test Strips, you’ll have valuable information to share with your doctor. These strips can help identify your fertile window and provide context for pregnancy dating and potential implantation timelines.

Continue Monitoring and Stay Informed

In some cases, tubal pregnancies are caught before symptoms become severe. Regular monitoring and communication with your provider can help guide safe decision-making.
It’s also important to seek emotional support during this time. A suspected or confirmed ectopic pregnancy can bring shock, grief, and anxiety. Talk to a trusted healthcare provider, counselor, or support group to help navigate this difficult experience.

 

Conclusion

A tubal pregnancy is a serious condition that can still produce positive pregnancy test results, which can be confusing and even misleading if symptoms arise. Understanding how hCG works and recognizing the limits of at-home pregnancy tests is vital.

Tools like MomMed Pregnancy Test Strips offer reliable, early detection of hCG at home, while MomMed Ovulation Test Strips help monitor cycles and conception efforts. But once you get a positive result, especially if accompanied by unusual pain or bleeding, don’t wait—consult a healthcare provider immediately.

Early diagnosis and treatment are crucial to your health and fertility. When it comes to pregnancy—especially one outside the uterus—knowledge, awareness, and timely action can make all the difference.