The Honest Truth About Early Signs
Here's something most fertility websites won't tell you: many "early pregnancy symptoms" are identical to premenstrual symptoms. Progesterone—which rises after ovulation regardless of whether conception occurred—is responsible for most of the symptoms associated with both early pregnancy and PMS.
That said, here's what the research tells us about the most commonly reported early signs.
The Most Reliable Early Sign
A missed period. For women with regular cycles, a missed period is the most reliable indicator of pregnancy. No symptom before a missed period is a reliable predictor on its own.
Commonly Reported Symptoms
Implantation bleeding (6–12 days post-ovulation): Some women notice light spotting around the time of implantation. This occurs in roughly 25% of pregnancies. It's typically lighter and shorter than a period, but not everyone experiences it and it can be mistaken for a light period.
Breast tenderness and changes: Increased breast sensitivity, tingling, or heaviness can begin shortly after conception due to rising hCG and progesterone. However, this is also a common PMS symptom.
Fatigue: Extreme tiredness, often described as overwhelming, can begin in the first few weeks of pregnancy due to rapidly rising progesterone. Again, fatigue is also common in the luteal phase.
Nausea: "Morning sickness" typically doesn't begin until around 6 weeks of pregnancy. Very early nausea (before a missed period) is uncommon and usually has other causes.
Frequent urination: Increased blood flow to the kidneys and hormonal changes can lead to more frequent urination in early pregnancy, though this usually becomes noticeable after week 4–6.
The Two-Week Wait
The period between ovulation and when you can reliably test—often called the "two-week wait" or TWW—is widely considered the most emotionally challenging part of TTC. It's tempting to analyze every twinge and symptom, but the reality is that it's nearly impossible to distinguish early pregnancy symptoms from normal luteal phase symptoms by feel alone.
Read more in our two-week wait survival guide.
Ready to Test?
When you've reached the day of your expected period (or can't wait any longer), a home pregnancy test is the most reliable way to know. Read our complete testing guide for timing tips.
Browse Pregnancy Tests on Amazon →This guide was last reviewed on January 18, 2026.