What Is the Two-Week Wait in IVF?

In Vitro Fertilization (IVF) is a long process containing a range of emotions from excitement to anxiety. Out of all the steps in the IVF process, there is one step that is considered the longest lasting, on average, two weeks. This is known as the two-week wait (2WW).

The two-week wait is widely known to be the most difficult emotional step in the IVF process. This period is exactly what it states, the waiting period from embryo transfer until the blood test to.

This period may be difficult but knowing what occurs during this time, some of the symptoms, and ways to cope with the wait makes the time pass more easily. The information contained in this guide is essentially everything you need to know about the two-week wait in the IVF process.

What Is the Two-Week Wait in IVF?

Through the IVF process, the two-week wait is the period that is confined from the embryo transfer and the test that confirms pregnancy, this is most commonly a blood test to confirm the presence of Human Chorionic Gonadotropin (hCG).

Although it is widely known as the “two-week” wait, the time span is actually a range from 9 to 14 days. This is mainly dependent on the protocol of your fertility specialist, as well as the type of embryo that was transferred.

In this time span of waiting:

– Embryo transfer may result to implantation.

– If the previous step was successful, the hormone of early pregnancy will begin to develop.

– For Hormonal Support, additional hormones will be administered through prescribed medications.

– It is recommended to refrain from conducting any form of at-home pregnancy tests prior to the scheduled blood pregnancy test.

Because it’s hard to tell if implantation has occurred, this stage has a lot of uncertainty.

Why Is the Two-Week Wait So Important?

The embryo is busy trying to implant during the two-week wait.

If implantation is successful:

– The embryo will be embedded in the uterine lining.
– The embryo will be able to start forming the placenta.
– Hormonal production of hCG will begin, and pregnancy will be confirmed through a blood test.
If implantation is unsuccessful, the levels of hormones will remain low and pregnancy will not be confirmed.

The majority of the important biological functions that will take place during this time happen inside the body. Therefore, patients have very little to no control over the subsequent steps of the process after the embryo has been transferred. For this reason, resting or monitoring symptoms excessively will not influence the outcome.

What Happens During the Two-Week Wait?

Though there is some individual variability in the time that each woman may spend in each stage of the process, the duration of the process is relatively consistent for all.

Days 1–3 After Embryo Transfer

For the first three days or so:

– Continued development of the embryo is still in preparation for the process of implantation.
– During this time, the uterine lining is supported by medication of a hormonal nature.
During this stage, the majority of women report no symptoms of any kind.

Days 4–7

This is the time implantation is generally happening.

During this stage, the following may be experienced:

– Mild cramping
– Light spotting which may be a sign of implantation.
– Fatigue
– Not a single symptom

If no symptoms are present, that indicates the process of IVF has not been successful.

Days 8–14

When implantation is successful during this time:

– The level of the hCG hormones will start to increase.
– After a blood test, pregnancy will be confirmed.
– There will be more noticeable hormonal shifts and changes.

Used alone, personal observations are an unreliable method to confirm a pregnancy, as symptoms common to IVF and pregnancy frequently overlap.

Symptoms During the Two-Week Wait

Each IVF experience is distinct and some women report a host of symptoms, while many women report no noticeable symptoms at all.

Common symptoms include the following:

Cramping

Light cramping may be experienced post embryo transfer and during embryo implantation. This symptom should be brief and is usually not bothersome.

Spotting

Some women may experience light spotting, which may be light pink or brown.

This can be caused by:

– Embryo implantation

– Transfer-related irritation of the cervix

– The hormonal medications

Heavy bleeding should be reported to your fertility clinic.

Breast Changes

Tissue swelling and sensitivity of the breasts and nipples will often occur with the supplemental progesterone and may be experienced by some women. This symptom does not indicate a positive pregnancy test.

Fatigue

Fatigue can be commonly experienced for the duration of the wait as levels of progesterone remain elevated.

Bloating

Abdominal discomfort and a sensation of fullness can be common side effects of the hormonal medications and are often experienced after the ovarian stimulation phase of the IVF cycle.

Mood Changes

Anxiety, irritability and fear can be commonly experienced during the wait, along with an altered ability to concentrate. Hormonal changes can contribute to this, but the emotional burden of the unknown is a greater contributor.

Symptoms That Do Not Indicate Pregnancy

IVF recipients often rely on the interpretation of physical sensations during the two-week wait. Many women adopt this practice.

However, the following symptoms can all be attributed to fertility medications.

– Nausea

– Tenderness in breasts

– Fatigue

– Cramping

– Bloating

– Increased urination

Also, no symptoms does not mean implantation has not occurred.

Only the blood pregnancy test, which is done at the clinic, will confirm the result.

Should You Take a Home Pregnancy Test?

The most difficult part of the two-week wait is the temptation to test early.

Most fertility specialists do not recommend this for various reasons:

– Trigger shots (which may contain hCG) can lead to false positive tests.

– Testing early can result in a false negative hCG is below the threshold.

– The stress associated with the constant testing is not good for the body.

Blood beta hCG tests are done in the fertility clinic, and will be the best conclusive test to confirm a pregnancy.

What Should You Avoid During the Two-Week Wait?

Most of your day-to-day activities can continue during the two-week wait.

However, some items should be avoided during this time.

– Heavy lifting

– High impact exercise

– Smoking

– Alcohol and recreational drugs

– Non-approved medications

– Hot tubs or saunas

– Excessive caffeine

Continue taking any medications prescribed by your fertility specialist.

Can You Exercise During the Two Week Wait?

Low impact exercise is safe during the two-week wait.

The following items are all considered safe.

– Walking

– Gentle stretching

– Prenatal Yoga (if approved)

– Breathing exercises

As always, follow any advice given to you by the clinic.

Emotional Coping During the Two-Week Wait

Stress management complements following your doctor’s orders.

The following tips have helped many patients.

Stay Engaged

The best way to distract your mind is to keep yourself busy.

You can

– read

– watch

– cook

– craft

– spend time

Reduce Cyber Self-Diagnosis

• Finding multiple ways to guess if you’re having symptoms can create more stress than it provides peace of mind.
• Keep in mind that no two IVF journeys are the same.

Use Stress Reduction Techniques

The following have been shown to help during the wait

– Meditate

– Do Deep Breaths

– Relax With Guidance

– Journal

– Play Calm Music

Use Your Resources

Talking to your partner; to your more trusted family members; to your friends; to your fertility support groups; to your mental health professionals can help with your feelings of loneliness.

Getting through IVF

Balanced Nutrition

It’s always a good idea to follow a nutritious, wholesome diet during IVF

Try to consume

– enough fruits

– enough vegetables

– enough whole grains

– enough lean proteins

– enough health fats

– and be hydrated

Keep taking your prenatals and the other recommended supplements. There is no “implantation diet” that has been proven by science. Please avoid restrictive diets and searching for miracle fertility foods.

When Should You Contact Your Fertility Clinic?

Most symptoms during the two week wait are harmless.

But see a doctor right away if you have:

– Significant vaginal bleeding

– Intense stomach pain

– Chill

– Difficulty in Breathing

– Severe swelling

– Frequent Vomiting

– Ovarian Hyperstimulation Syndrome (OHSS) symptom

Your fertility team is the best to contact for any concerns regarding your symptoms.

Conclusion

The two-week wait in IVF can be the most challenging part of the whole process.

It’s common to analyze symptoms or to think about whether implantation may have happened, but keep in mind physical signs alone can never confirm a successful or failed cycle. Progesterone and estrogen supplements can often mimic early signs of pregnancy, and many women who report positive pregnancy tests did not report any pregnancy signs.

Following the instructions of your fertility doctor, taking fertility medications, and following a healthy lifestyle while avoiding testing and being good to yourself during the waiting period is very important. Regardless of the outcome, you have taken the next important step on your fertility journey.

Being patient with the two-week wait is very difficult. It is very important to give your bodies time and rely on your medical team for the most accurate and reliable answer, which is the official blood pregnancy test.

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