By: Kaajal Abrol, MD, FRCSC, REI
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 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.
Reach out to the TRIO Care Navigator for support at care@triofertility.com or your doctor’s office if you have questions or need extra support during any 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 often 14 days, but it can sometimes be a little shorter (e.g. 10 to 12 days from Day 5 embryo transfer to a 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 hopes 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, interval training or HIIT). If your ovaries were stimulated with medication as part of your 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).
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.
- If you were on medications for other medical issues before 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.
- For 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.
Can I have intercourse?
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 discouraged until your pregnancy test.
What happens if bleeding or spotting begins?
During the two-week wait, spotting or light bleeding can occur. Here’s what to consider:
- Implantation Bleeding: Light spotting or a small amount of pink or brown discharge may occur when the embryo attaches to the uterine lining. This is usually a sign of early pregnancy but can vary from person to person.
- Menstrual-like Bleeding: This could indicate that your period is about to start, which means the treatment may not have been successful this cycle.
- Other Causes: Spotting can also result from hormone medications or other factors unrelated to pregnancy. If you experience significant bleeding or persistent spotting, contact your Doctor’s office to rule out any issues. 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.
Why avoid taking a home pregnancy test?
If you’re undergoing fertility treatment, it’s crucial to understand why testing early might not be advisable:
- Hormone Medications: Fertility treatments often involve hormone medications that can affect the accuracy of home pregnancy tests. These tests might detect the hormones from the medication rather than a pregnancy, leading to false positives or negatives.
- Timing: The accuracy of pregnancy tests improves as you get closer to your missed period. Waiting until the recommended time ensures that the test can provide a more reliable result.
You will be scheduled for a pregnancy test at TRIO. Once you take the test a nurse will contact you later the same day 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 pregnancy 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 are some additional things to keep in mind?
Understanding what to expect, what to avoid, and when to seek medical advice can help you navigate this period more effectively.
Dos:
- Follow Your Doctor’s Instructions: Adhere to the specific instructions given by your Doctor regarding medication, lifestyle changes, and follow-up appointments.
- Maintain a Healthy Lifestyle: Focus on eating a balanced diet, staying hydrated, and getting moderate exercise. Avoid excessive caffeine and alcohol, which can impact your overall well-being.
- Stay Calm and Relaxed: Stress can impact your hormonal balance and overall health. Engage in activities that help you relax, such as meditation, light yoga, or reading.
- Keep Track of Symptoms: While it’s natural to be on high alert for symptoms, it can be helpful to note any changes you experience. Share these observations with your doctor if necessary.
- Seek Support: Talking to friends, family, or a fertility counsellor can help you manage the emotional ups and downs of this waiting period.
Don’ts:
- Avoid Home Pregnancy Tests Too Early: Taking a pregnancy test before the recommended time can lead to false results. This is especially true if you’ve been on hormone medication, which can affect the accuracy of the test.
- Don’t Engage in Excessive Physical Activity: High-intensity workouts or strenuous activities are best avoided, 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). Stick to light to moderate exercise.
- Refrain from Making Major Decisions: Emotional and physical stress can cloud your judgment. Avoid making significant life decisions during this period if possible.
- Don’t Compare Your Experience: Every person’s fertility journey is unique. Avoid comparing your experience to others as it may add unnecessary stress.
The two-week wait can be a particularly emotional and stressful period. By following these guidelines and staying informed, you can manage this time with greater confidence and clarity. Always communicate openly with your team about any concerns or symptoms you experience, and remember that support is available to help you through this journey.
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.
