By: Jennifer Fitzgerald, ND
The Two-Week Wait …. 2 weeks—that’s 14 days. Or 336 hours. Or 20163 minutes. Or 1,209,600 seconds. No matter which way you count it, the time from intercourse or insemination or embryo transfer until your pregnancy test is one of the most difficult times of all during treatment.
This can be further amplified if you are doing fertility treatments since you are likely used to frequent monitoring, and knowing exactly what is happening in your ovaries and blood. Suddenly, there are no appointments or tests for 2 whole weeks. Until now you had a protocol to follow, and without that to-do list, it can feel overwhelming. There are many things that you can not control, but you can take charge of the things under your control: your mind, body, and spirit. Give yourself a sense of hope, positivity, and empowerment, regardless of the outcome.
We’re here to help and we sat down with our expert team for advice, coping strategies, and lifestyle tips to make the two-week wait a little easier. We hope you find this both useful and comforting. As always, please contact us if you have questions or feel that you need extra support during treatment.
Lifestyle Tips for the Two-Week Wait
Dr. Jennifer Fitzgerald, ND, a fertility naturopath specializing in reproductive medicine and adjunctive IVF treatment, is the Co-founder of Conceive Health (located on-site at TRIO). Below she shares practical lifestyle and nutrition tips to support individuals during the Two-Week Wait.
What food should I eat?
You may have read things online such as eating pineapple to improve implantation rates — so is there any truth to that? Unfortunately, there is no science to support that claim, however, pineapple is delicious and can be enjoyed in reasonable amounts.
If we stick to the evidence, dietary choices should focus on getting enough high-quality proteins, including lean meats, eggs, and legumes. Healthy fats, primarily sourced from plant or fish-based oils, are essential components. Most carbohydrates should ideally come from fruits and vegetables, with less reliance on processed foods that offer limited nutritional value.
The key here is blood sugar control to support implantation and early embryo development, as well as providing the building blocks for rapid cellular growth. Consuming adequate healthy fats (Omega-3, olive oil, and avocados) has anti-inflammatory effects throughout the body, which is supportive of implantation. Daily fruits and veggies provide antioxidants to protect the embryo from any potentially harmful effects of oxidative stress.
Foods to support a healthy microbiome
Research suggests a healthy microbiome contributes to more than just gut health. It appears of particular importance for the proper function of the endometrium, successful implantation, and reduction of miscarriage rates. You can consider adding small amounts of fermented and probiotic-containing foods (yogurt, kefir, kombucha, sauerkraut, pickles, miso, tempeh, kimchi, sourdough) to support a healthy microbiome.
Foods that improve blood flow
Nitric oxide, a compound found in certain foods, serves as a vasodilator. It relaxes and widens blood vessels — which can help improve blood flow to important areas. This dilation supports circulation, ensuring that vital organs and tissues receive an optimal supply of oxygen and nutrients. For example, beets are rich in nitrates, which the body converts into nitric oxide. They can help enhance endothelial function, supporting the inner lining of blood vessels. Don’t forget your greens too! Spinach and arugula are excellent sources of nitrates, contributing to their positive impact on blood vessel dilation. And for that sweet tooth, dark chocolate (particularly with high cocoa content) contains flavonoids. This stimulates nitric oxide production, promoting healthy blood flow.
Don’t forget the H2O as well! Proper fluid intake is essential for reproductive health. Dehydration can contribute to uterine contractions and affect implantation. Sipping on that (glass) water bottle throughout the day also helps blood flow to the endometrium so nutrients reach the embryo.
During pregnancy, maintaining proper hydration is vital for expanding blood volume to meet increased demand. It’s also associated with the production of amniotic fluid, crucial for fetal development. Studies emphasize the importance of hydration in supporting a healthy environment for implantation and sustaining mama and baby’s well-being during pregnancy.
What foods should I avoid?
PUPO is a common term used on fertility forums, meaning, “Pregnant Until Proven Otherwise”. Once the possibility of pregnancy is imminent, it’s a good idea to abide by those guidelines — this means skipping specific foods that might be detrimental in pregnancy. These include undercooked meat, deli meats, unpasteurized dairy, undercooked eggs, and raw fish. If you are a tea drinker, herbal teas are ok, but avoid ones with red raspberry leaf for now. Instead, stick to mint, lemon balm, ginger, rooibos, or other teas with recognizable ingredients.
Can I have a coffee?
Most sources suggest that 300 mg or less of caffeine daily is safe during pre-conception. While high caffeine consumption can disrupt implantation and increase miscarriage risk, there is less consensus on what the limits are. There is some evidence that moderate caffeine use (200-350 mg) is not detrimental, while other research suggests that 200 mg or more daily doubled miscarriage rates.
The challenge is that the caffeine in each cup of coffee or brand can vary. If you need to drink a cup of java, we highly recommend you ensure you are below your limit. Use the “one and done” rule: have one cup in the morning and that’s it for the day. That said, caffeine metabolism slows during pregnancy to about half of your non-pregnant normal. So, the same cup of coffee you were having before may be too strong during pregnancy. Caffeine passes through the placenta in pregnancy, and while adult bodies can metabolize caffeine, fetuses can be more vulnerable to the effects. We recommend cutting out the caffeine if you can, either during the implantation period or on a positive pregnancy test. Excessive amounts of caffeine (4 or more servings per day) are associated with miscarriage.
Can I have a glass of wine?
We all know someone who had a few too many drinks one night before realizing they were pregnant, but that doesn’t mean it’s a good idea. For a long time, it was common for medical professionals to advise that one drink won’t hurt. Many of the references used were looking at the risks of fetal alcohol syndrome, where the most significant effects on embryos appeared to occur between 3 and 6 weeks gestation (many would not yet know they were pregnant at that time). When looking through the lens of implantation, most experts now agree that alcohol is correlated with lowered rates of implantation and increased rates of miscarriage. A recent study showed that 4 or more drinks per week (in both partners) negatively affected IVF outcomes, including implantation failure. As few as 2 drinks per week have been associated with increased miscarriage. Of course, there are a few studies out there showing no effects from alcohol as well. Bottom line? Better safe than sorry. Avoid alcohol during conception, implantation, and pregnancy.
Are there supplements I should take?
During pregnancy, the most important supplement is folate — ideally as part of a good quality prenatal vitamin. On top of a prenatal vitamin, we also recommend Omega 3 and vitamin D to support blood flow and immune balance. This can be supportive of implantation and early placental development. Individuals who are pregnant (or are pending pregnancy) should consume at least 300 mg of Omega-3 in the form of DHA daily and 2000 IU of Vitamin D.
While a well-balanced preconception diet typically provides the essential nutrients the body needs, those with restricted diets face a higher risk of having either nutrient deficiencies or excesses. If you have an underlying condition such as thyroid disease, PCOS, or lining issues, or you are following a restricted diet (i.e. vegan, vegetarian, keto, intermittent fasting, etc) speak to an ND to determine if nutrient testing is indicated or if there are other supplements that may be beneficial to you based on your individual needs.
Are there any supplements I should avoid?
Generally speaking, you should not take any supplements in the 2-week wait that are not recommended during pregnancy. You should not take any vitamin or mineral in a higher-than-normal amount unless otherwise recommended by your doctor or fertility naturopath. You should also not take any herbs or supplements that have not been recommended to you by a health care provider. While usually safe outside of pregnancy, they may not be safe for implantation or early pregnancy or may interfere with a medication you are taking. Also, be mindful of herbal teas which are not all recommended at this stage. For example, red raspberry leaf tea should be avoided during pregnancy. Some safer options include ginger, peppermint, or rooibos tea.
Is Acupuncture helpful for implantation?
Acupuncture is beneficial for fertility including implantation — and consistent sessions are more effective than sporadic ones. To support implantation, we recommend acupuncture regularly for a few weeks or months before and during the implantation period, depending on your situation. Acupuncture improves blood flow to the uterus and reduces stress and anxiety — both of which are helpful for implantation!
Should I exercise or take it easy?
Several years ago it was common to recommend bedrest, or taking it extra easy, for the days following embryo transfer. Newer research suggests there is no merit to bed rest. In fact, most research points to movement being beneficial. It seems extremes are the issue in this category. Being too sedentary, as well as too active, may be associated with reduced implantation rates. The current guidelines for the two-week wait suggest taking part in up to 150 minutes per week of low-impact or moderate-intensity activities. This includes walking, swimming, yoga, Tai Chi, and low-impact whole-body aerobics. At this stage, limit exercise to 30-45 mins per day.
Although we recommend being physically active during the 2-week wait, there are a few specific exercises that you should avoid. These include exercising for over 60 minutes per day, regardless of the activity, high-intensity interval training (HIIT) workouts, exercises only targeting the upper body or legs, and movements involving twisting across the pelvis (such as yoga poses that involve wrapping the legs around each other) and inversions.
If you have questions about preconception nutrition, nutraceuticals, acupuncture, and more, simply book a complimentary 15-minute discovery call with a Conceive Health fertility naturopath today. Book online here.
In addition to practical tips about The Two Week Wait from a naturopath, please also read our article offering answers from a fertility specialist, and our article offering coping strategies from a fertility counsellor.