Woman checking the calendar

THE TWO-WEEK WAIT – that is, the time from intercourse or insemination or embryo transfer until your blood pregnancy test – is one of the most difficult times of all during treatment. Because we’re here to help throughout your journey, we sat down with three of TRIO’s experts and asked them for medical advice, coping strategies, and lifestyle tips designed to make the two-week wait a little bit easier. We hope you find this both useful and comforting. As always, please contact us info@triofertility.com, or your doctor’s office if you have questions, concerns, or feel that you need extra support during this — or any other phase of your treatment.

Kaajal Abrol MD, FRCSC, REI provides a medical perspective by answering questions from patients about the Two-Week Wait

Are there activities I should do or avoid?
The two-week wait is most often a two-week period, but can sometimes be a little shorter (e.g. 10-12 days from Day 5 embryo transfer to pregnancy test). Medically there are no activities that one must do, other than take the medications prescribed for a treatment cycle, as instructed. It is a challenging time for many patients, as anxiety levels and hope for a positive pregnancy test are at their highest. It’s important to find ways to occupy yourself, including keeping busy with work, enjoying fun activities in the evenings or on the weekends to distract yourself, and finding ways to manage stress and anxiety that work for you. Seeing a counsellor at this time can also be helpful.
In terms of activities to avoid, exercise is the most common activity patients worry about. You may continue with most exercise regimens you enjoyed before. One exception would be to avoid activities that increase your core body temperature quite a bit (e.g. hot yoga, saunas, steam rooms). The other caution would be with high-impact exercise (e.g. running or aerobics). If your ovaries were stimulated with medication as part of fertility treatment, this may put you at risk of ovarian torsion (twisting of an ovary). So, it may be best to stick with lighter exercise (e.g. swimming, walking, yoga) until the ovaries decrease in size (usually a few weeks after stimulation).
Intercourse is another activity that is commonly asked about. After an insemination cycle, further intercourse may be recommended. However, after an embryo transfer, it is often discouraged until your pregnancy test.

What about Medications?
As mentioned, you must remember to take any medications your physician prescribed for your treatment cycle, as instructed. If you are not sure if a medication should be continued or stopped, you should always speak to your physician’s office or nurse to clarify. It’s always best to be sure. Prenatal vitamins or folic acid, which should have been started trying to conceive, should be continued during the two-week wait and throughout pregnancy. Coenzyme Q10 or Ubiquinol is a common supplement that is taken by women while trying to conceive, to help with egg quality. If this is something you were on, it is stopped with a positive pregnancy test; unless you underwent IVF and an egg retrieval, in which case it is stopped once the eggs are retrieved.

If you were on medications for other medical issues prior to the two-week wait, you can generally stay on these medications until your pregnancy test. If your test is positive, you would then follow the previous instructions from your physician, about whether to stay on the medication(s) or not. With respect to any new medications being recommended to you (either over-the-counter or prescription), it is best to speak with the physician prescribing the medication or your pharmacist, to ensure it is safe in pregnancy. During this time, when you are waiting to know if you are pregnant or not, it is best to stick with medications considered safe in pregnancy.

How and When will I find out the results?
In general, at TRIO, you will complete your blood pregnancy test in the morning, and a TRIO staff member will call you with the results by that afternoon. It may be a medical secretary or a nurse connected with your physician’s office who calls you with your results.

What are the next steps after I get the result?
The next steps will depend on the result. If an initial pregnancy test is positive, a repeat test is usually done 2 days later (or 4 days later if it falls over a weekend). We want to ensure the pregnancy hormone (BHCG) is rising appropriately (approximately double over 48 hours). Once a second test is done and rising well, an early obstetrical ultrasound is organized through your physician’s office, and a referral to an Obstetrician is initiated through your family doctor or your physician’s office. If the second test is done and not rising as expected, your physician will monitor you accordingly (e.g. further pregnancy tests to see if it rises or falls, possible early ultrasound). If an initial pregnant test is negative, you will be instructed to stop all medications that were given for the cycle (if any), and your physician’s office will let you know how to proceed (e.g. wait for your follow up or try another cycle).

What if I have bleeding or spotting during the two week wait?
Bleeding during the two-week wait can be quite worrisome. It is best to stay on any medications given for your treatment cycle, to put on a sanitary pad, and to monitor the bleeding to see if it continues or subsides. If it continues, you may call your physician’s office. They will likely ask specific questions based on your situation (e.g. amount of bleeding, associated symptoms like cramping or abdominal pain). Accordingly, they may ask you to monitor and see what happens over a few hours, or come for an ultrasound, or go to the Emergency Department for further
assessment.

In addition to the medical perspective about the Two Week Wait offered here, please also read our article offering coping strategies from a fertility counsellor, and our article offering practical tips from a naturopath.