How to cope with the two-week wait after IVF

An "egg timer" looking annoyed (IVF)

SO FAR, I'VE EXPERIENCED A TOTAL OF SEVEN TWO-WEEK WAITS AFTER FERTILITY TREATMENT. The first six resulted in BFNs that were as big and fat and negative as they come. The seventh began as a small, thin, puny positive – and it gradually beefed up into a line that undeniably, unmistakably meant “pregnant”. Thirty-six pregnancy tests later, I started to believe it. 

But what about the 14 days prior to the pregnancy test? For many women, the two-week wait between “embryo transfer day” and “pregnancy test day” consists of wracked nerves, compulsive googling, fervent avoidance of soft cheese, chewed lips and anxious tears. It’s a bit of a shitty experience, to put it very Britishly, and often more distressing than the preceding months of consultations and treatment. 

But does it have to be this way? NO! Plenty of coping strategies can help you deal with the dreaded Fortnight of Fertility Fear; you just need to know what they are and how to use them.

Feel free to pick and mix from any of the suggestions below. 

Try not to obsess over symptoms 

Your body will feel different after embryo transfer – particularly if you’ve had a fresh (rather than a frozen) transfer, because it hasn’t had a chance to calm down from all the stimulation drugs. 

If you’re unlucky enough to experience even a milld case of ovarian hyperstimulation syndrome (OHSS) after egg retrieval, you'll feel even more “odd”: you'll be bloated from the build-up of fluid in your abdomen, and you'll experience nausea, ovary pain (from “stretched” ovaries) and mild weight gain caused by the build-up of fluid. These symptoms of OHSS typically don't kick in until a few days after egg retrieval, which means you'll experience them around the same time as your fresh embryo transfer. 

Nausea, ovary pain, mild weight gain…? Sounds like a classic case of pregnancy to you and me. In fact, it’s just a classic example of how life is sometimes totally ironic in a totally crappy way. 

If you don’t get OHSS or you’re having a frozen embryo transfer, you may still feel twinges/cramping, bloating, breast tenderness and tiredness during the two-week wait – and you may also be more emotional/moody than normal. Unfortunately, what looks and feels like pregnancy could actually be the side effects of the extra progesterone you’re taking as part of your treatment… 

Your own body will have been producing progesterone during stimulation, but doctors often prescribe extra – just to be sure. Most IVF patients are told to start using progesterone pessaries and/or injections about a week before embryo transfer, and then to continue taking them (in decreasing doses) until around the tenth week of pregnancy. Why is progesterone so important? Because it helps to keep the uterus lining thick and cushy for the embryo. 

The side effects of progesterone supplementation (the aforementioned bloat, cramps, breast tenderness, tiredness and moodiness) are simply another example of crappy IVF irony, and they’re another reason not to trust any symptoms during the two-week wait. 

Try not to obsess over not having symptoms

Plenty of women won’t have a single symptom during the two-week wait – including me (until Week 6, when all hell broke loose on my gag reflex). 

During the two-week wait, there’s no need to worry if you have no symptoms – and the same goes for the rest of your pregnancy (if you get the good news that you’re pregnant). The only time to worry is if – once you know you’re definitely pregnant – your previously strong symptoms have suddenly disappeared.

Remember that many women get pregnant and have no idea for the first few months because they have no symptoms or easy-to-miss symptoms. 

Feel reassured that an embryo really can’t fall out once it’s been transferred

No amount of sneezing, weeing, coughing or jumping will “dislodge” your embryo and cause it to fall out. In an effort to convince you, here are quotes from a couple of authoritative sources: 

“Once the embryo is placed in the womb there is no chance for the embryo to fell down as it is safely tucked between the two walls of the womb..” –Homerton NHS hospital 

“Many patients call their nurse after transfer, worried that their embryo may fall out, possibly while going to the bathroom. We assure you that this is not possible, as the embryo is in a much smaller space than you may realize. As one physician said, ‘It’s like a grain of sand in a peanut butter sandwich.’” –Shady Grove Fertility

An embryo might not implant once it’s in the uterus, of course, but that’s a totally different situation – and again, a failure to implant has nothing to do with sneezing, weeing, coughing or jumping either. 

Cliche alert: try meditating (or other relaxation techniques)

I know, I know: “meditation” is pretty much considered filler content these days – i.e. an easy way to increase the word count. 

I used to think the same… until I tried meditation. Admittedly, I only started meditating after the birth of my son rather than during IVF or the two-week wait, but I’m pretty sure it would have helped massively if I’d been aware of it while undergoing my daily scans and blood tests. 

I’ve fallen off the meditation wagon recently, but writing this article has reminded me how helpful it was during a particularly difficult time in my life – and how I need to start again. I can’t describe how it works; all I know is that ten minutes a day of meditation enabled me to both feel clearheaded and stop having unhelpful imaginary conversations or self-flagellating thoughts. 

If meditation isn’t your thing, there are tons of other tried-and-tested relaxation techniques – from simple in-and-out deep breathing to yoga, tai chi, long walks and self-massage. Google “relaxation techniques” for some inspiration. 

The IVF process from start to finish (PLUS glossary): free download

This downloadable IVF summary provides a condensed, no-nonsense overview of everything up to and including embryo transfer. It'll quickly help you get to grips with what's going to happen, when it's going to happen, and why it's going to happen.

If you're worried about terminology, don't be! You'll also receive a huuuge glossary, which includes definitions AND explanations of almost every word and phrase you’ll encounter while doing IVF. There are about 80 words and phrases in total – everything from “AMH” to “zygote”.

I won't send you spam. Unsubscribe at any time.

Start a “two-week wait” project 

Two weeks will feel like forever if all you’re doing is waiting for it to pass. So how about turning it into a goal instead? What can you learn or achieve in two weeks that you wouldn’t normally? 

Perhaps you can aim to start and finish a particular book? Or you can take an online course in a subject that’s always interested you. Or you could clear out the garage, or aim to watch a different Oscar-winning movie every night for the next fortnight. Maybe you could arrange to have a phone conversation with a variety of people you haven’t spoken to in a while. 

Yes: I’m basically saying, “Keep busy”. But there’s a bit more to it than that. I’m saying, “Keep busy with a purpose or goal” – because otherwise it’s hard to know what to keep busy with or what the point of it is. It may take a bit of advanced planning, but – if you ask me – you’ll do a much better job of keeping busy this way. 

Decide in advance how you want to receive the news – and what you want to do if the news isn’t good

For some reason, there are TONS of stock photos of negative pregnancy test results – and they’re awful. They almost always feature a woman sitting on the toilet with her skirt pulled down, a pee stick in her hand and tears running down her cheeks.

Finding out that you aren’t pregnant will always be upsetting, but it doesn’t have to feel so lonely. Before the two-week wait starts, discuss with your partner how you want to handle Test Day. For example: 

  • Do you want your partner to look at the pee stick first, and then pass the news on to you? 
  • If the news isn’t positive, do you want to have a large glass of wine at the ready? Or perhaps you’ll want to go out for a meal to forget about it for a few hours? 
  • Do you want to discuss next steps immediately, or wait a few days? 

Give your partner the specifics so he can help you cope. And ask him what he’d like too, so you can support each other together. 

Don’t test early: it might be inaccurate

When you become pregnant, your embryo starts to release a hormone called hCG (human chorionic gonadotrophin). hCG is important because it helps to maintain progesterone production, which – as noted above – is important for a successful pregnancy. 

Levels of hCG rise for the first 10 or so weeks of pregnancy before plateauing and then declining, and pregnancy tests work by detecting if there's any hCG in your urine (or blood). If there’s even a small amount of hCG present, you’re determined to be pregnant because men and non-pregnant women have almost zero levels of the hormone in their system. (Admittedly this isn't quite true. Concentrations of hCG in non-pregnant women increase with age, which means some menopausal women can get false-positive pregnancy tests. But let's not go down that particular rabbit hole right now: it isn't relevant.)

(In case you’re interested, bog-standard pregnancy tests simply figure out if there’s any hCG in your system, and then they tell you “pregnant” or “not pregnant”. New-fangled, fancy schmancy pregnancy tests measure how much hCG there is, which means they’re able to estimate how far along you are.) 

When a woman gets pregnant the “normal” way, home pregnancy tests can detect hCG about two weeks after conception – i.e. around the time of a missed period. Before that, she might get a false-negative if she tests. 

When you have IVF treatment, things are a bit more convoluted and confusing. Before your eggs are collected for fertilisation, they need to be “mature” enough for ovulation and subsequent fertilisation. To get them to reach that final stage, you’ll be instructed to give yourself a “trigger injection” about 36 hours before your egg retrieval appointment. This trigger injection almost always contains the hormone hCG. (Read about the entire process of IVF here.)

Wait what? Why? Well… hCG is very similar to LH – which is what stimulates ovulation in “normal”, “non-IVF” cycles. hCG can have a similar stimulatory effect in women undergoing IVF (whereas LH isn’t as effective because it’s often been artificially suppressed at the start of treatment. Again, for more on all this, read about the entire process of IVF here). 

If you test early – i.e. less than 14 days after embryo transfer – the hCG from the trigger injection will still be swirling around your body, and could easily give you a false positive. I’m sure you’ll agree that a false positive is far, far worse than a false negative if you want to be pregnant. (Note: this only applies to fresh embryo transfers.)

Schedule time to worry

I’m hopeful that some of the tips in this article will help you be less anxious than if you hadn’t read them, but I know they won’t completely stop you from worrying during the two-week wait. 

Unfortunately, even this low-grade anxiety can be detrimental. It makes it harder to focus on anything and ends up taking over every thought anyway. You might not be having an all-out panic attack, but what you’re going through isn’t much better. 

Rather than accept it, you could schedule in some time for when you’re allowed to go all-out on worrying. Make it the same time every day, for 15 or so minutes. I recommend writing everything you’re worried about in a list, because it’ll help you realise what’s truly worth worrying about and what’s just taking up headspace. 

Next, pinpoint the worries that you can do something about (i.e. the ones you have control over), and make a time and date to conquer them. For example, if you’re worried about the amount of caffeine you drank yesterday, you can call your clinic for reassurance and/or advice later today. 

When it comes to the worries that are outside your control, ask yourself if they’re worth worrying about at all. And if they are, try to figure out how you can feel better about the situation – even if you can’t do anything about it. 

Scheduling your worries will give you the opportunity to be productive about the ones you can do something about while helping you see which ones aren’t worth concerning yourself with (either because they’re not that bad after all, or because there’s nothing you can do about them anyway). It’s not easy at first, but you should soon notice a new ability to control when you worry.

The IVF process from start to finish (PLUS glossary): free download

This downloadable IVF summary provides a condensed, no-nonsense overview of everything up to and including embryo transfer. It'll quickly help you get to grips with what's going to happen, when it's going to happen, and why it's going to happen.

If you're worried about terminology, don't be! You'll also receive a huuuge glossary, which includes definitions AND explanations of almost every word and phrase you’ll encounter while doing IVF. There are about 80 words and phrases in total – everything from “AMH” to “zygote”.

I won't send you spam. Unsubscribe at any time.