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The Two-Week Wait

The "two-week wait" is the gaping space between the time you complete your fertility treatment and the time you come to the clinic to take your pregnancy test. When you're in the midst of it, those two weeks can feel like an eternity.

It’s easy to imagine the ‘symptoms’ of the wait. Overwhelmingly, your mind is fixated on one question – “Am I pregnant?”

You become hyper-aware of every physical sensation and wonder if each one is your body's way of telling you whether or not you’re pregnant. The two-week wait may feel like a form of purgatory, but you will get through it.

Here are some suggestions for not just surviving, but thriving during this trying time:

NEST AND NURTURE YOURSELF

Because fertility treatments are stressful for both body and mind, your two-week wait is a perfect time to get plenty of rest and relaxation. You deserve it! Instead of associating each new physical sensation with whether or not you might be pregnant, try relating them with either tension or relaxation. If you feel tense, wherein your body are you holding that tension?

Are you clenching your jaw? Carrying your shoulders close to your ears? If so, your body is carrying stress. Nurturing yourself with rest and relaxation is not just a healthy method of lowering your stress level, but also a way to create a healthy environment for your baby. Keeping this in mind, give yourself permission to take a nap or go to sleep early. Try gentle yoga or brisk walks in place of high-impact exercise. Enjoy a calming massage!

Nurture yourself by ‘nesting’ internally and externally. Make sure your diet is nutritious and delicious. Eat as though you were already pregnant! Nest externally by making certain you feel comfortable and safe in your home environment. Then, cozy up!

TUNE INTO YOUR BODY

The nature of the two-week wait is one of mystery. While conception remains a giant question mark, the inner workings of your body don't have to! Understand what your body is experiencing and let go of anxiety.

At the completion of your fertility treatment(s), your body has undergone something substantial. The goal of post-treatment medications is to promote an optimal environment for pregnancy, but they can cause side effects. You may experience many of the physical sensations you would normally experience during PMS or pregnancy: cramping, breast tenderness, fatigue, bloating, spotting, or light bleeding. These are entirely normal, a natural part of the process of undergoing fertility treatment and taking post-treatment medicine.

If you feel anxious about these symptoms, practice slow, deep breathing. This simple technique can immediately return you to your baseline physiological level, and often brings a wave of mental calm. Symptoms such as shortness of breath, chest pain, excessive bloating, or lower abdominal pain may indicate ovarian hyper-stimulation. In this case, contact your clinical team.

HONOR YOUR FEELINGS

The two-week wait can produce a flood of emotions to process, sometimes all at once. Your partner, a trusted friend, or a family member can be a wonderful resource to help you balance and work through your feelings. Set aside times to share what you’re feeling with your loved one. Think about what support you’ll need if the news is not positive, and ask for that support. Sometimes, just letting thoughts flow freely is enough to release nervousness and negative thoughts.

Honor your feelings by protecting yourself and thinking proactively. Limiting the number of people you tell about your cycle can be helpful if the news you're hoping for doesn’t come. Decide how you'll handle questions and share the outcome of your pregnancy test. One option that can eliminate the need to call with bad news is to let your friends and family know that ‘no news is bad news.’

RESIST TEMPTATION

Although it may be one of the most difficult tips for thriving during your two-week wait, resist the temptation to perform a home pregnancy test. Your fertility specialist will explain that home pregnancy tests, while tempting, can render either a false negative or a false positive. These tests often rely on human chorionic gonadotropin (hCG) levels, and traces of the hCG used in many fertility treatments to trigger ovulation may be detectable by a home pregnancy test, regardless of whether implantation has actually occurred.

The pregnancy test you receive in our office at the end of your two-week wait is performed by drawing blood and measuring the hCG levels produced by the developing embryo. This is the single most reliable pregnancy test. Avoid false results. Protect your emotions.

REFRAME YOUR THOUGHTS

If you find yourself stuck on any one thought or cycle of thoughts, it can be useful to experiment with reframing. Notice the idea that you're stuck on. How can you frame it in a more positive light? For example, if you're thinking ‘this test will be negative,’ reframe the thought to something more positive – ‘I am open to the possibility of being pregnant’ or ‘it might have worked.’ Another method is to step completely outside your thoughts.

Remember that you are still an interesting person with many other things going on in your life. Take a well-deserved break from your fertility status by diving into a newspaper or a book or immersing yourself in new thoughts and ideas.

BE GENTLE WITH YOURSELF

Care for yourself in your day-to-day schedule. If any of your usual activities cause you to stress, limit those activities if possible, especially during the first five days after treatment. Your fertility specialist will inform you of any specific activities that you should avoid or limit, and for how long, but in general it's a good idea to favor lower-impact activities. It's also a good idea to check in with your nurse about possible travel plans.

TRUST YOUR BODY

Your body is a brilliant operating system. Return to this thought if you find yourself struggling to cultivate patience. Affirmations, mind/body support groups, meditation, counseling, and journaling are some options for letting go of negative beliefs about your body or your future. Hold positive thoughts about your body and inner landscape.

The more you trust in yourself, the easier it is to remain patient through your two-week wait!

Once your IUI or embryo transfer has taken place, there is nothing that you can or cannot do to influence the outcome. It is out of your control.  Feelings of pessimism don’t change the outcome, getting angry at someone won’t change the outcome, and bouncing off the walls won’t change the outcome.  You get the idea; don’t worry about your potential mood swings, feelings of irritability, jealousy, anxiety, etc., because, although they may not be pleasant to experience, they have no impact on any potential pregnancy.  You are officially off the hook.


One of the biggest myths in IVF or other fertility treatments is that embryos can “fall out”.  If the uterus was like a balloon, this would make sense.  However, the uterus is not hollow like the balloon and in fact, embryos, once in the uterus, don’t fall out.  So if you drive over a pothole, go to the bathroom, jump over a puddle, etc., this will have no impact on the success of the cycle.


 If you are taking progesterone it may cause all sorts of confusing symptoms. You may feel tired, bloated, and nauseous and you may note soreness in your breasts, all of which can be signs of an early pregnancy.  During the waiting period, try your best to not focus on these symptoms.  Many women have no symptoms at all and end up with a healthy pregnancy, and some report many symptoms that are related to side effects of the progesterone or some other hormone.  You may even experience vaginal bleeding – this does not exclude pregnancy.  For this reason, everyone needs to come for a pregnancy test.  And remember that if you constantly squeeze and poke your breasts to assess their soreness, they will get sore!


Waiting for the pregnancy test can feel like a long time, especially when you consider all the effort you have already put in for this cycle.  Don’t wake up tomorrow morning and think “how am I going to get through the next eight or ten days?”  Wake up tomorrow morning and say to yourself “what can I do today to distract myself, pamper myself, and make the time go faster?”  If you do this on a daily basis, the time will go by more quickly.


Be picky with the people you spend time with. Feel free to avoid the unsympathetic friends, the overly fertile friends, and the “takers” instead of the “givers”.  Plan to see those who entertain you, nurture you, and distract you.  If you need an official excuse, you can consider yourself under doctor’s orders to avoid baby showers.


Screen your phone calls. If you have told a number of people that you are undergoing fertility treatments, then you may be inundated with frequent phone calls.  If this starts to get to you, appoint a spokesperson for yourself (sister, best friend, etc.).  Tell the people in your lives to call your spokesperson and if/when there is good news to share, you will be sure to be in touch.


Make a date with your partner for the night of your pregnancy test. If it is positive, you can drink lots of nonalcoholic champagne.  If it is negative, it gives you the time to be together, mourn away from family and friends, and plan together the next step.


Although it can be hard, try to balance the fine line between your state of mind and reality. There is no right way to feel.  For some, it is much easier to cope with the days of waiting by feeling hopeful and optimistic; for others it feels more comfortable to protect themselves by feeling pessimistic.  One way to make it easier for all coping styles is to have a “plan B” – the “what if the treatment cycle fails” plan.  Whatever you’re feeling and thinking after a treatment, make sure that you have an appointment for a consultation with your doctor.


Remember that your physician and nursing team are available to you during this waiting time. If you have questions or concerns, don’t sit at home and stew – Call!  We are not only concerned about the medical aspects of your fertility treatment; we care about how you are feeling and want to help you cope in the best way possible.


If you feel as though you are having a really tough time during this waiting period, there are many things which you can do to make the wait easier.

Some suggestions include:

  • make an appointment with your doctor (or even speak with him/her over the phone) to discuss how this cycle went and even start to plan for the next one in case this one didn’t work
  • get a copy of our new relaxation CD, which can give you 20 minutes of peace of mind each time you listen (you can stop by the Domar Center, go online at www.domarcenter.com, or call 781-434-6578 to get a copy)
  • call and making an appointment with one of the Boston IVF social workers or mind/body psychologists to give you a chance to vent any frustration and focus on using your coping strategies or learning new ones
  • consider making an appointment for a session of acupuncture. Although the research thus far has only focused on acupuncture pre and post embryo transfer (and all the published research does show a positive impact on pregnancy rates), there can also be a benefit to experiencing acupuncture during the waiting time, especially in terms of treating anxiety.

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We look forward to speaking with you, and will be in touch as soon as possible!