best early pregnancy test?

The Best Pregnancy Test
By Leigh Krietsch BoernerUpdated April 8, 2019
The Best Pregnancy Test
Photo: Rozette Rago

FYI

We’ve added testing notes for our also-great pick, ClinicalGuard HCG Pregnancy Test Strips.
April 8, 2019

The result displayed on a pregnancy test can be life-changing, so you need a clear, accurate result. After more than 50 hours of research, talking to a pregnancy hormone (hCG) expert and an ob-gyn, drinking too many cups of tea, and peeing on more than 60 sticks and strips, we think the First Response Early Result manual test is the pregnancy test to take.

If you’d prefer to buy in bulk, we have a recommendation for wand-free test strips that cost less than a quarter each at the time of publication—though you may want to verify your results by using one of our other picks (or visiting your doctor).
Our pick
First Response Early Result
Most sensitive, easy to read

The First Response Early Result manual test is the most sensitive over-the-counter pregnancy test you can buy. It gives accurate results as or more quickly than most of the tests we considered and is just as easy to read as a digital test.
$13 $7 from Woot

Free shipping for Prime members
$13 from Amazon
(pack of three)
$13 from Walmart

The First Response Early Result manual test—the most sensitive over-the-counter pregnancy test, according to USA hCG Reference Service—emerged as the clear winner in our research and testing. We found that it gives a clear result quickly, and its ergonomic design makes the handle easier to hold onto compared with the wands on comparable tests.

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Runner-up
Clearblue Rapid Detection
Nice design, less sensitive

This test has a nice, usable design, with a big sponge tip, but it’s harder to hold and less sensitive than the First Response manual test.
$12* from Amazon
(pack of three)
$17 from Walmart
(pack of three)
$10 from Target

*At the time of publishing, the price was $10.

In the incredibly unlikely event that you can’t find a First Response manual test, our runner-up choice is another manual test, the Clearblue Rapid Detection. It’s well designed, with a big absorbent pad and thin gripping end, but it’s not as easy to grip as the First Response. It’s also not as sensitive and can’t pick up on very early pregnancies as well as the First Response manual test.
Also great
ClinicalGuard HCG Pregnancy Test Strips
A cheap supplemental test

Cheap and simple, you can blow through a ton of these strip tests without spending much. But they don’t have the lab-verified accuracy of more expensive tests.
$12* from Amazon
(pack of 50)
$7 from Walmart
(pack of 20)

*At the time of publishing, the price was $7.

If you anticipate frequent testing and want a cheap, pared-down test you can buy in bulk, we suggest the ClinicalGuard HCG Pregnancy Test Strips. These are thin strips that you dip in a cup of pee. We don’t have independent accuracy information on these, but they fared well in our own (limited) testing, and out of the strip-type tests we tried, ClinicalGuard was by far the cheapest. These strips cost about half as much as comparable tests and less than a tenth of the cost of a single manual test.
Everything we recommend
Our pick
First Response Early Result
Most sensitive, easy to read

The First Response Early Result manual test is the most sensitive over-the-counter pregnancy test you can buy. It gives accurate results as or more quickly than most of the tests we considered and is just as easy to read as a digital test.
Buying Options
$13 $7 from Woot

Free shipping for Prime members
$13 from Amazon
(pack of three)
$13 from Walmart
Runner-up
Clearblue Rapid Detection
Nice design, less sensitive

This test has a nice, usable design, with a big sponge tip, but it’s harder to hold and less sensitive than the First Response manual test.
Buying Options
$12* from Amazon
(pack of three)
$17 from Walmart
(pack of three)
$10 from Target

*At the time of publishing, the price was $10.
Also great
ClinicalGuard HCG Pregnancy Test Strips
A cheap supplemental test

Cheap and simple, you can blow through a ton of these strip tests without spending much. But they don’t have the lab-verified accuracy of more expensive tests.
Buying Options
$12* from Amazon
(pack of 50)
$7 from Walmart
(pack of 20)

*At the time of publishing, the price was $7.

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The research

Why you should trust us
How home pregnancy tests work
How we picked
How we tested
Our pick: First Response Early Result
Flaws but not dealbreakers
Runner-up: Clearblue Rapid Detection
Also great: ClinicalGuard HCG Pregnancy Test Strips
Manual vs. digital pregnancy tests
The competition
Footnotes

Why you should trust us

For this guide, we interviewed Laurence Cole, PhD, a researcher who has long studied home pregnancy tests, and Dr. Tania Serna, an obstetrician-gynecologist (ob-gyn) at Cedars-Sinai Medical Center in Los Angeles.

I’m a science writer with a PhD in chemistry and 10-plus years of lab experience, so I can accurately make solutions and test them (although I am not really used to doing it with my own pee). I’ve also been pregnant twice, including while writing the original version of this guide, so I know what it’s like to take a pregnancy test when you really want to know what it says.
How home pregnancy tests work

Home pregnancy tests measure the small amount of hormones that the body produces when a fertilized egg is implanting and beginning to grow. Specifically, they contain antibodies that can pick up the presence of human chorionic gonadotropin (hCG) in pee.

Two types of hCG are important in early pregnancy. The first, hCG, is a hormone responsible for forming the mechanism by which the placenta gives nutrients to the fetus. The second, hyperglycosylated hCG (or hCG-h), is a whole different, unrelated molecule.

The two hCGs differ in when they’re present in pee during early pregnancy. In very early pregnancy (weeks three and four) only hCG-h is present, Cole said.2

Regular hCG is not produced until you’re about four to five weeks pregnant. Amounts of this hormone double roughly every 72 hours in early pregnancy, reaching their peak around eight to 11 weeks, then level off for the remainder of the pregnancy. Levels of hCG in pee can vary a lot as well. If you’re pregnant and it’s been three weeks since the start of your last period, you can have anywhere from 5 to 50 mIU/mL in your pee. (That’s in milli-International Units per milliliter, a standardized unit that doesn’t really tell you much. Regardless, that’s how levels of this stuff are measured.) At six weeks past your last menstrual period, this spread is from 1,080 to 56,500 mIU/mL. According to studies by Cole and other researchers, hCG is present at low levels in the body even when a person is not pregnant, so the tests can’t be too sensitive or they might erroneously register a false positive.

False negatives, where you are pregnant but get a negative reading on a pregnancy test, are much more common than false positives.

Another way you might get a false positive is if you have what’s called a chemical pregnancy. This is a pregnancy that fails to develop beyond the earliest stages, often resulting in a miscarriage around the time menstrual bleeding would be expected.

False negatives, where you are pregnant but get a negative reading on a pregnancy test, are much more common. According to Dr. Serna at Cedars-Sinai, this can happen when you take a test too early and it can’t pick up on the hCG levels in your pee yet. If you think you may be pregnant and take the test prior to a missed period and get a negative result, wait a week and take the test again. To obtain the most accurate results, test after missing an expected period. The longer you wait after a missed period, the more accurate the test becomes. (To be sure a home pregnancy test is functioning properly, look for what’s called a control line: This should appear whether or not a second line—indicating hCG detection—appears.)

For the most accurate pregnancy testing, visit your doctor.
How we picked

Pregnancy tests should be four things: sensitive enough to pick up on pregnancy early on, easy to use, easy to read, and relatively cheap. Is this combo too much to ask for? Nope.

Luckily, there is a wealth of scientific data on the accuracy of home pregnancy tests. That being the case, we did not run our own accuracy tests but instead relied on the experts. And the most expert-y of experts we could find was biochemist Laurence Cole, who when this article was originally published in 2015 ran the USA hCG Reference Service at the University of New Mexico. He’s done extensive research on home pregnancy tests and hCG, including evaluating the most commonly available home pregnancy tests found in drugstores. He’s found that First Response digital and manual tests are the most sensitive because they can detect hCG-h, the kind of hCG that women produce only very early on in pregnancy, sooner than other drugstore tests.

According to Cole’s research (PDF), Clearblue Easy and EPT are both less sensitive than First Response but more sensitive than other tests. These tests also detect hCG-h but not as well as First Response.

In addition to accuracy, we considered test usability, readability, and cost.
Some home pregnancy tests require that you pee in a clean cup then dip a strip into the urine. Others are housed in plastic wands and have absorbent tips that you can pee directly onto, or dip if you choose. We considered both test types, finding the latter easier to use and read.

Most manual tests cost around $4 to $6 each. Digital tests, which display a written “positive” or “negative” result on a small screen, tend to be more expensive than screenless manual versions.

After taking a few digital tests apart, we learned that they actually use the exact same strips you find in manual tests, only the digital test has a sensor to detect the darkened line for you—often about a minute after most people would be able to eyeball it themselves using a manual test.

Until recently, we’d discounted tests for which we didn’t have independent accuracy data. However, readers have been asking us about cheap, strip-type tests you can buy in bulk online, so we compared these to determine the best choice in this category despite the fact that Cole told us that these are generally less sensitive than the more expensive stick tests.
How we tested

While sensitivity is the most important thing in a pregnancy test, it’s not the only thing. Design is important too—how easy it is to use and how easy it is to read. So that’s where we focused our testing.
pregnancy tests neatly arranged on a table
All of the pregnancy tests I took for the first round of testing. That’s a lot of pee. Photo: Leigh Krietsch Boerner

I took six of each of our contenders and put them through the paces. I tested them multiple times using both the midstream and pee-in-a-cup-and-dip methods. Since I was nine months pregnant at the time of testing, I dipped the various strips in water (and, in one case, had my husband pee on one) to confirm known negative results. I also diluted my own urine down by 1,000 times in water to see what a barely positive looked like.2 To simulate potential user error, I held each test upside down while waiting for the results (a big no-no, according to the packaging), just to see what happened. In short: I totally abused these things.

Two female staff members, neither of whom was pregnant at the time of testing, also tried each of these in both the midstream and dip methods and added their feedback.

In our experience, none of these tests gave what are known as evaporation lines, which are lines that can sometimes appear on manual tests and be mistaken for a positive result.
Our pick: First Response Early Result
A boxed pregnancy test on a table
Photo: Rozette Rago
Our pick
First Response Early Result
Most sensitive, easy to read

The First Response Early Result manual test is the most sensitive over-the-counter pregnancy test you can buy. It gives accurate results as or more quickly than most of the tests we considered and is just as easy to read as a digital test.
$13 $7 from Woot

Free shipping for Prime members
$13 from Amazon
(pack of three)
$13 from Walmart

For its high sensitivity, accuracy, and speedy results, we think a First Response Early Result manual pregnancy test is the one you’ll want to get. It’s the most sensitive over-the-counter pregnancy test you can buy. It’s as easy to read as a digital test and much less likely to give you an error message. In addition, in our tests it gave the clearest positive reading to a very dilute solution of pregnancy-positive pee. Results came in quickly, taking only 40 to 45 seconds on average.

Unlike the Clearblue and EPT tests, the First Response test doesn’t have a separate window for a control line, but we found the strong, dark-pink lines easy to decipher for both positive and negative results.
Three pregnancy tests on a table
The three manual tests after dipping in the same sample of diluted pregnancy pee. The bottom test, the First Response manual (this is the old version), is clearly positive. It was more difficult to determine if the EPT and Clearblue tests were giving a negative or a positive result. Photo: Leigh Krietsch Boerner

To mimic the earliest days of pregnancy, I prepared a very dilute solution of hCG-positive urine. As you can see in the photo, the First Response manual test showed a very clear positive response with a strong fuchsia line, while the other pregnancy tests barely registered faint blue marks.
First response pregnancy tests on a table
Side view of First Response pregnancy tests
The old, pre-2016 First Response manual test (top) next to the new, redesigned test (bottom). Photo: Leigh Krietsch Boerner

The current First Response manual test has an ergonomic, user-friendly shape. It has a nice wide tip, so hitting that target while on the toilet is a little bit easier, should you choose to use the midstream method. It also has a curved handle with grippy texture on the back that makes it easy to both hold onto and pick up from a table. Plus the handle is big enough to wrap your whole hand around, not just pinch between thumb and forefinger. That made me feel that I was less likely to drop the whole thing in the toilet bowl.

Since our original testing in 2015, we haven’t found a more sensitive nor easier-to-use-and-read home pregnancy test. Wirecutter staffers who have used the First Response since 2015 have found that it indeed picks up on hCG and displays a “pregnant” result sooner than digital tests from First Response and Clearblue.
Flaws but not dealbreakers

The First Response test is easy to read, although the varying darkness of the two lines can be a little confusing. In one test, with full-strength, positive urine, the pink line on the right was much, much lighter than the positive line. (It does say in the brochure that this can happen.) This changed when I tested the diluted solutions of urine. In this case, the line on the right was much brighter than the positive line. However, there was no mistaking the positive line.

Some people have complained that the curved window in the redesigned test makes it harder to read. Depending on how the light hits that plastic window, there can be a reflection that some people might mistake for a second line. It’s best to examine the results of any pregnancy test in different lighting conditions.
view from above of first response pregnancy tests
Glare in the curved window of the redesigned manual First Response test shown on the bottom has confused some users. There’s an easy solution—just tilt the test. Photo: Leigh Krietsch Boerner
Runner-up: Clearblue Rapid Detection
A boxed Clearblue pregnancy test
Photo: Sarah Kobos
Runner-up
Clearblue Rapid Detection
Nice design, less sensitive

This test has a nice, usable design, with a big sponge tip, but it’s harder to hold and less sensitive than the First Response manual test.
$12* from Amazon
(pack of three)
$17 from Walmart
(pack of three)
$10 from Target

*At the time of publishing, the price was $10.

Though it’s not as sensitive as the First Response manual test, the Clearblue Rapid Detection manual test is a good backup option if the First Response is not available. It has a thin, grip-friendly handle that we found makes it better to hold than the EPT test (though not as easy to hold as the First Response). Like the First Response test, it has a fat tip, making it a generous target for a stream of pee. The absorbent pad on the Clearblue manual test turns pink when it gets wet, so you can see when it starts working. I got a positive from the Clearblue test in as little as 10 seconds on one occasion, but the average was more like 45 to 50 seconds, for either positive or negative. The Clearblue digital tests took anywhere from 1½ to 3 minutes to give results.
A ClearBlue pregnancy test on a table
A ClearBlue pregnancy test on a table
Photo: Sarah Kobos
Also great: ClinicalGuard HCG Pregnancy Test Strips
ClinicalGuard pregnancy test with packaging
Photo: Rozette Rago
Also great
ClinicalGuard HCG Pregnancy Test Strips
A cheap supplemental test

Cheap and simple, you can blow through a ton of these strip tests without spending much. But they don’t have the lab-verified accuracy of more expensive tests.
$12* from Amazon
(pack of 50)
$7 from Walmart
(pack of 20)

*At the time of publishing, the price was $7.

If you want to go really, really basic and save money when buying lots of tests, we suggest the ClinicalGuard HCG Pregnancy Test Strips, with a caveat: We don’t have independent accuracy information on these tests like we do for our other picks. Still, thousands of customer reviewers have found these test strips to be accurate, as did a Wirecutter editor for whom the ClinicalGuard test strips gave faint-but-detectable true-positive results three days before an expected period and clear negative results when she was not pregnant.

Strip tests use the same technology as the manual tests we recommend and display the results similarly; they just lack the plastic housing that make manual and digital tests easier to use and read. You cannot pee directly onto these. Instead, you dip them into a cup of urine. The advantage is that strip tests typically cost less than a tenth of what our other picks cost.
Three pregnancy test strips side-by-side
The strip pregnancy tests that we tried. From left: Wondfo, Easy@Home, and ClinicalGuard. Photo: Leigh Krietsch Boerner

According to Cole, some inexpensive strip tests can pick up hCG only when it’s at about 25 mIU/mL—so, not that early in pregnancy, depending on the person. However, hCG levels can vary a lot from pregnancy to pregnancy—anywhere from 5 to 50 mIU/mL for most people when they are three weeks along (or, one week after a missed period). So the strip tests may accurately report one person’s true-positive result early on, but not another’s.

Of the three strip tests we looked at (ClinicalGuard, Wondfo, and Easy@Home), ClinicalGuard was the cheapest by far. Everything else—the size of the strip, the time to result, the ease of use—was Exactly. The. Same. Really. If prices change, just go for the cheapest test, but keep in mind that you may end up wanting to confirm the results with a test that’s known to be highly sensitive, such as the First Response (or with a visit to your doctor).
Manual vs. digital pregnancy tests

As far as manual vs. digital tests go, there’s really no contest: Manuals are the clear winners on price and are just as easy to read as digital in our experience.

This surprised me. Before working on this guide, when shopping for pregnancy tests I made a beeline for the digital ones. I didn’t want any ambiguity about a positive or a negative result. I wanted the thing to tell me a clear “yes” or “no.”

Digital tests are really just manual tests with a battery and a sensor that reads the lines for you.

But I have since found that the manual tests do give a clear answer. There wasn’t any question of the result while using any of the manual tests evaluated for this guide. Also, the manual tests—which contain no circuitry—are much less likely to fail on you. They are also much faster at giving a result: Around 40 seconds on average versus 3 minutes? Um, yeah. In the grand scheme of things, 3 minutes is not long to wait at all. But when it comes to taking a pregnancy test, most likely you’d prefer to know the result as soon as possible.

The funny thing is that digital tests are really just manual tests with a battery and a sensor that reads the lines for you. I cracked open all three brands of digital tests, and they look just like the manual ones on the inside.
The interior of a Clearblue test is shown
A person pulls at the strip inside a Clearblue test
The inner bits of a Clearblue digital test. Photo: Leigh Krietsch Boerner

See that strip in the picture above? Look familiar? Yep, that’s the same as what the manual tests show you. There’s a little sensor in the row of three squares a bit to the right of where the test strip is above (I peeled it back from there). So basically, it just reads those lines for you and tells you, in writing, whether the strip detected hCG. But it takes longer to do this than you likely would.

The manufacturers themselves note that digital tests tend to be less sensitive than manual ones. According to the boxes of all of these tests, these are the stats obtained from lab testing:

First Response: The manual test picks up on 76 percent of pregnancies five days out from the expected period date, while the digital test says yes to only 60 percent of people who are actually pregnant at that time. By the time it’s the day you expect your period, both give a positive to more than 99 percent of those who are pregnant.

Clearblue: The manual tests give a positive to 56 percent of people who are actually pregnant four days before a missed period, and the digital gives a positive to 51 percent. These numbers are 98 percent and 95 percent, respectively, for the day of a missed period.

EPT: Four days before a missed period, manual tests give a positive result 53 percent of the time, the same as EPT’s digital tests. On the day of a missed period, these numbers jump to 99 percent.

These company-reported results mirror Cole’s results. He found that the First Response manual test was the most sensitive of all those tested.
The competition

First Response Digital gave me a false negative. I also had technical problems with a second test, which eventually gave me a positive but only after waiting for 6½ minutes. The other tests gave results in 3 to 3½ minutes. The instructions say it should take 3 minutes.

The Clearblue Digital is a bit clunkier and heavier than the manual test. Both were really easy to read, but the manual test gave faster results.

The EPT manual test, aka the “Error Proof Test,” was the first over-the-counter pregnancy test. (Its name really comes from “early pregnancy test.”) In our tests it had a control line that went sideways, although it later corrected itself. The manual tests took a speedy 20 to 30 seconds, although it usually took up to 40 seconds for the test line to appear. (EPT suggests not reading the test before 2 minutes.)

The EPT Digital was the speediest of the lot and gave me results in less than 2 minutes. (The digital tests are supposed to be read after 3 minutes, although the brochure says some results show up in as little as 1 minute.) However, its design is clunky, and it’s not as sensitive to hCG as First Response.

Dollar Tree and other discount stores often carry $1 pregnancy tests like this one from Assured. As with the test strips we recommend from ClinicalGuard, you must first pee in a clean cup to use this test. (You can’t use the in-stream method like you can with wand-style manual tests.) Although we don’t have independent accuracy information, customer reviews indicate that this test has picked up true positives after missed periods. But it costs around four times as much per test compared with the ClinicalGuard strips.

The Easy@Home and Wondfo strip tests are pretty much identical. The strips look exactly the same, and the included directions are exactly the same, except that the Easy@Home directions have their logo at the top. At the time of this writing, the Easy@Home tests were very slightly cheaper than the Wondfo tests, but both were more costly than those from ClinicalGuard.

At the CES 2016 trade show, First Response launched its Bluetooth-enabled Pregnancy Pro test, which features the ability to pair with a smartphone. Besides being loaded with a bunch of options that are of dubious usefulness (the test offers a three-minute timer on your phone, where you’re supposed to either select “Educate Me,” “Entertain Me,” or “Calm Me” options while you wait) this new test costs more than three times the price of the First Response manual test. There’s no reason to spend the extra money.
Footnotes

A quick interjection about pregnancy terminology—ever heard someone say that they are x weeks pregnant? Doctors count these weeks starting on the first day of the person’s last period before they get pregnant. Because ovulation happens roughly two weeks after this date, you basically get two weeks’ worth of pregnancy free, as far as the terminology goes. So a person who has a period that starts on February 1 and gets pregnant on their ovulation cycle immediately following that can say that they’re four weeks pregnant on March 1. The day of pregnancy varies from person to person—you don’t get pregnant on the day you ovulate, but later, after the egg is fertilized (which can take a few days) and the fertilized egg implants (which can take up to five days after fertilization). Jump back.

For dilution 1, I took 5 mL of my pee and added 95 mL of water. I then took 5 mL of this solution and added it to 95 mL of water for dilution 2. I dipped the tests in both of these for the “dilute” tests. Unfortunately, I did not know the hCG concentration of my pee at this point. In late pregnancy, which is what I was when I did the tests, a woman can have anywhere from 3,640 to 117,000 mIU/mL of hCG in her urine. It wasn’t practical to get my hCG levels tested to know the exact amount. But that means that dilution 1 had an hCG level from 182 to 5,850 mIU/mL, and dilution 2 had an hCG level from 9.1 to 292.5 mIU/mL. I’m guessing it was toward the lower end, because the tests were showing up as barely positive. Jump back.