Sierra Dehmler is Illume Fertility’s Content Marketing Manager - and also a fertility patient herself. Combining empathy gained on her personal journey with her professional experience in marketing and content creation, she aims to empower and support other fertility patients by demystifying the fertility treatment process.
Ah, yes. Everyone's least favorite thing about trying to conceive: the dreaded "two week wait." Obsessively wondering if you're pregnant, documenting your symptoms by the hour, blowing through packages of pregnancy tests even though you know you should wait to test...it's a difficult time to navigate.
As a fertility patient who has recently been through it (a few times!), and had a ton of anxiety during my own two week waits, I decided to ask my fertility nurse Brigitte Alicea some questions and share them with you. My hope is that reading these responses will give you some peace of mind - or at least stop you from driving yourself crazy searching the internet for clear answers!
What is the two week wait?
Also referred to as the "TWW" in the fertility community, the two week wait is the period of time between ovulation and when an embryo implants (if the pregnancy is successful).
After this two week waiting period, your body will be producing enough beta-hCG (also known as the pregnancy hormone) to be detected in your urine or blood when you take a pregnancy test. If you are pregnant, you may even start experiencing some early pregnancy symptoms (more on those below).
The Emotional Struggle
Whether you're experiencing any potential pregnancy symptoms or not, the most difficult part of the two week wait is usually the emotional roller coaster of it all. When you've been focusing so much energy, time (and money) trying to conceive, it feels like everything is riding on the end result of this two week time frame.
Mood swings and hormone changes aside, it's only natural to feel anxious, upset or stressed during the two week wait. Especially if you've been trying to conceive for a long time. Having a baby shouldn't have to be this hard. And it's okay to feel angry or sad that these are the cards you were dealt.
Feeling overwhelmed? We've got you.
Know that your emotions are valid, especially during this time. Acknowledging that this is tough and giving yourself space to process all of the uncertainty and other emotions you may be feeling right now is healthy.
Common Two Week Wait Questions, Answered by a Nurse
While every person's experience is slightly different, there are some very commonly asked questions about the two week wait that we want to address. To provide you with the most accurate, evidence-based answers, I enlisted the help of one of our veteran fertility nurses (who also happens to be my own nurse), Brigitte Alicea, RN. Here's her take on the two week wait:
It's only natural to have a million questions during this uncertain time, and if you're working with a fertility clinic or other healthcare provider, we encourage you to reach out to your Care Team. We've heard it all - so don't be afraid to contact us when you're feeling worried or just need some reassurance.
💡Remember: It's much better to ask your Care Team than Dr. Google (who will often provide you with some very conflicting, confusing answers). We're here to help you!
What are other patients asking during the TWW?
Patients most frequently reach out to me to ask questions about cramping, spotting and whether X symptom is normal (or a possible pregnancy symptom). Patients on hormone supplementation experience even more of those confusing "possible" early pregnancy symptoms, leading to increased frustration.
Other common queries:
Can I have sex during the two week wait? Generally speaking, yes. But check with your doctor or Care Team, who will be able to advise you best after taking your medical history and any other potential concerns into account.
Can I exercise during the two week wait? Again, usually - yes! But do check with your personal provider before beginning an exercise regimen during the two week wait.
What foods should I avoid during this time? To answer this question, let's exploreanother acronym the fertility community uses a lot: PUPO (pregnant until proven otherwise). This is a great way to approach the two week wait - treat your body as if you're officially pregnant! That means following pregnancy food rules. Wondering if you can eat something specific? Just ask your doc!
Why is it important to wait until your official pregnancy test (via bloodwork) instead of testing at home?
A blood test is the most accurate way to check for pregnancy when performed 16 or more days after you've taken an Ovidrel/HCG injection.
Testing too early can cause frustrating and confusing false positives, since the Ovidrel/HCG may still be in your system. Why? Ovidrel/HCG causes your HCG levels to rise and can take about 13 days to leave your system.
If you take a UPT (urine pregnancy test) at home and get a negative result, it may also be that the HCG is not yet detected in your urine. This sometimes causes patients to stop their hormone supplementation too soon, which can (sadly) jeopardize their outcome.
Is it possible to get an early positive on a pregnancy test at home? What does it mean if the line goes away?
Yes, it is possible to get an early positive pregnancy test, but it could be a false positive, due to HCG still hanging around in your system for a bit. So if you see a faint line one day and no line the next, this may be why. It's so hard to see two lines and then none - I've been there.
You can also get a positive test when implantation began but the embryo didn’t continue to develop. If any of these scenarios feels like a loss to you, that's because it is. It doesn't matter how far along you were, what the details of your pregnancy may have been...you're allowed to grieve. Remember that.
Need support after a loss? Read:
How long is the wait after a timed intercourse or IUI cycle?
Despite the "two" in two week wait, it's not always two weeks exactly. After an IUI or timed intercourse cycle, you will need to wait 16 days to see if you're pregnant after taking your HCG/Ovidrel injection.
Keep in mind, we don't check initial pregnancy tests on the weekend, so if your 16-day mark falls on a weekend, we will bring you back to the office for a pregnancy test on Day 15 or 17 instead.
How long is the wait after an IVF embryo transfer?
For embryo transfers, an initial pregnancy blood test is done nine days after the embryo transfer. The difference with transfer cycles is that HCG/Ovidrel are not involved.
Tips for Surviving the Two Week Wait
It's so tough to think about anything besides pregnancy and your results when you're in the two week wait - but trying to distract yourself can really help ease anxiety and pass the time.
Here are some ideas from Brigitte:
Keep busy. Schedule plans with your partner or friends.
Get support. Whether it's from people who know you are trying to conceive, infertility support groups or a therapist/social worker, support is vital during the two week wait.
Ask questions. Your nurse or doctor is there to help you.
Try relaxation techniques such as yoga, exploring new hobbies, acupuncture, breathing exercises or meditation.
Be compassionate with yourself. Give yourself extra attention during this time and focus on taking care of yourself.
Early Pregnancy Symptoms
I can't tell you how many times I've searched Google about specific symptoms I was experiencing, desperately hoping that they were signs of early pregnancy. If you're anything like me, you've probably looked for answers too. While I'd encourage you to (try to) avoid comparing symptoms for your own sanity...I understand how hard it is to resist.
Nature's cruelest joke is that early pregnancy symptoms and PMS symptoms often overlap, making it hard to tell whether you're possibly pregnant or are simply about to get your period. If you're a fertility patient on medications to support a potential pregnancy (like progesterone or estrogen), it can cause even more confusion.
So, keeping all of that in mind, here are some of the most common symptoms you may hear about or experience during early pregnancy:
Fatigue. This is a BIG one. Rapid rises in hormones like progesterone during early pregnancy Fatigue also ranks high among early symptoms of pregnancy. No one knows for certain what causes sleepiness during the first trimester of pregnancy. However, a rapid rise in the levels of the hormone progesterone during early pregnancy might contribute to fatigue.
A missed period. This may feel like an obvious symptom, but if you have PCOS or other fertility issues that cause irregular cycles, it can be difficult to predict when your period will arrive. Keeping that in mind, if a week or more has passed without the start of an expected menstrual cycle, it's possible you could be pregnant.
Moodiness.There's a huge flood of hormones in your body in early pregnancy which can make you extra emotional. Mood swings are very common during this time. (And again, often exacerbated by any hormone medication you may be on!)
Nausea and/or vomiting. Morning sickness is a misnomer - nausea can occur at any time of day! Some people never experience nausea during pregnancy, so it's normal to not have morning sickness too.
Tender or swollen breasts. Hormonal changes might make your breasts sensitive and sore in the early weeks of pregnancy.
Explore your fertility factors:
Constipation.Hormonal changes cause your digestive system to slow down, which can lead to constipation.
Increased urination. Running to the bathroom more often than usual? This is a fairly common early pregnancy symptom - and maybe not for the reason you might think! The culprit for increased urination is actually the amount of blood in your body increases during pregnancy which results in your kidneys needing to process extra fluid (and that all ends up in your bladder).
Bloating. Ah, the bloat is REAL. And hormones are to blame (as usual).
Light spotting.Also referred to as implantation bleeding, this light spotting typically happens when the fertilized egg attaches to the lining of the uterus between 10-14 days post-conception. But keep in mind - not all people experience spotting.
Cramping.Some people experience mild uterine cramping early in their pregnancy. If you have really painful cramping (or simply feel nervous about it), don't hesitate to reach out to your Care Team for reassurance.
Nasal congestion. Such a weird symptom, but it's true! Increasing hormones and changes in blood production in your body can cause nasal congestion, nosebleeds and stuffiness.
❤️A Note About Symptom Spotting: As someone who wrote down every single symptom I was feeling during my own two week wait, I know how hard it is to not want to track everything you're experiencing. But if you can manage to distract yourself for the next couple weeks, it will likely lessen your anxiety a bit.