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Negative at-home pregnancy test: How accurate are pregnancy tests?

The accuracy of a home pregnancy test depends on:

How you take the test
When you take the test
Test sensitivity

Certain rare types of pregnancies (such as ectopic pregnancies) or medical conditions can also affect home pregnancy test accuracy.
Is it possible to have a negative pregnancy test but still be pregnant?

Yes, it's possible to be pregnant and have a negative pregnancy test result. In fact, some researchers estimate this happens with up to 5 percent of home pregnancy tests. It's called a "false negative" pregnancy test result.
What can cause a false negative pregnancy test result?

You might be pregnant but still get a negative result on a home pregnancy test because:

The test was taken too soon. A home pregnancy test will be positive only if it detects the pregnancy hormone human chorionic gonadotropin (hCG). When an egg is fertilized after you ovulate, it takes about a week to travel through a fallopian tube to the uterus. And your body starts producing hCG only after a fertilized egg implants in the uterus. If it's very early in your pregnancy, your body might not have produced enough hCG yet. Although some tests can detect hCG the first day you miss your period, you'll have a better chance of getting an accurate result if you wait a week.
Your hormone levels were too low or diluted. For the most accurate result, take the test when you first get up in the morning. That's the time when your urine – and any hCG – is the most concentrated.
You conceived later than you think. Don't time the test based on when you think you might have conceived. Sperm can live in the fallopian tubes for up to five days, so it's possible you conceived several days after having sex. It's also possible that you ovulated later than you think, and not enough days have passed since the time of conception to get a positive pregnancy test result.
You didn't follow the test instructions correctly. Read the test instructions carefully. Make sure you didn't check the results too soon. (Consider setting a timer according to the instructions the next time you take a test.)
The test expired or wasn't stored properly. The chemicals that detect hCG in a test will eventually degrade and break down after the expiration date, or they can be damaged from extreme temperatures or exposure to water. Check the outside of the package for the expiration date and storage instructions.

Other, more rare causes of a false negative pregnancy test result include:

Too much hCG: This can happen if you are further along in your pregnancy or if you're carrying twins or triplets. Occasionally, extremely high levels of hCG prevent home pregnancy tests from being able to properly read the result, and the read ends up being negative. This is known as the "hook effect."
Ectopic or molar pregnancies: Sometimes, ectopic pregnancies (when a fertilized egg implants outside the uterus) or molar pregnancies (when a fertilized egg develops into a growth called a mole rather than a normal embryo) can result in a false negative test result.

If you suspect your pregnancy test result is a false negative, ask your doctor for a blood pregnancy test. These tests use different technology to detect hCG levels and are more accurate than urine pregnancy tests.
How do home pregnancy tests work?

Pregnancy tests can bring exciting news. Find out how they work, how to take one, and what factors could lead to seeing a false positive or negative.
My period is two weeks late, but my pregnancy tests are negative. Could I still be pregnant?

If you continue to get a negative result on home pregnancy tests for more than a week after missing your period, it's very unlikely that you're pregnant. However, it is possible, so check with your doctor to be sure.

Your ovaries normally release one egg every month or so, and if it's not fertilized, menstruation starts about 14 days after the egg is released.

If you miss more than three periods in a row and pregnancy tests are all negative, see your doctor for a thorough evaluation. Women can stop having regular periods for many reasons, including diabetes, eating disorders, excessive exercise, stress, obesity, very low body fat, or some medications. Here are other common reasons:

Thyroid problems: Your thyroid gland controls your body's metabolism. If the gland isn't working properly, it could interfere with your periods. Other symptoms of a thyroid problem include extreme fatigue, hair loss, weight gain, and a constant feeling of being cold, even when the temperature is moderate. A simple blood test can determine how well your thyroid is working, and thyroid conditions can usually be corrected with medication.
Too much prolactin: You might miss a period (or more than one) if you're producing an abnormally high level of the hormone prolactin. Your body usually makes prolactin when you're breastfeeding, which is why menstruation generally stops during that time. If this is what's happening to you (and you're not breastfeeding), you may notice a milky discharge from your nipples. This condition can usually be treated with medication.
Polycystic ovary syndrome (PCOS): This condition affects the hormones that release mature eggs. If you have PCOS, eggs remain in the ovaries, where they can't be fertilized. Symptoms often start with irregularities in your menstrual cycle.
Perimenopause: As you approach menopause (a stage known as perimenopause), your periods become more erratic. This typically happens during your 40s, but some women experience perimenopause as early as their 30s.