Trying to conceive and undergoing fertility treatments can be downright stressful at times, especially when it comes to the two-week wait. Today we’re going to cover some tips to help you not only survive, but to thrive during this time.
Here’s a quick overview of what you’ll discover:
The two-week wait refers to the time between ovulation and when an embryo implants.
More specifically, it’s the time until your body produces enough beta-hCG (i.e., the pregnancy hormone) to be detected in the urine or blood when you take a pregnancy test. Beta-hCG is commonly referred to as your “beta” because this is specific to the hormone of pregnancy.
And although it’s just two weeks… it can feel like an eternity when you’re in it.
Whether it’s the process of natural ovulation, superovulation, fertilization and implantation, or embryo transfer, your body undergoes A LOT of hormonal changes.
Progesterone, the primary hormone that supports pregnancy, starts to increase either from ovarian production (in the case of an ovulatory menstrual cycle) or from supplemental progesterone if you undergo an embryo transfer.
It’s common to become hyper aware of all physical sensations and symptoms during this time, making you wonder even more…
“Is this pregnancy? Or just ALL the hormones?”
And even though that question can’t be answered during the wait (no matter how many tests you use), it’s important to understand what’s going on physiologically and why you’re feeling the way you’re feeling.
If you’ve undergoing fertility treatments likely IVF your hormones are likely at an all time high, which can definitely accentuate baseline PMS-type symptoms. The goal of supplementing with all those extra hormones (usually a combination of estrogen and progesterone in the case of an embryo transfer) is to create an optimal uterine environment for a new pregnancy and to support an ongoing pregnancy. Unfortunately, these medications can often contribute to increased nausea, bloating, breast tenderness, fatigue, cramping and even light spotting — all of which can also be experienced in early pregnancy.
These symptoms may also be experienced after using a medication like Clomid or Femara for ovulation induction or may be experienced each month around the time of ovulation for many women too (even without medications!).
So how do you manage all of these symptoms while your mind is racing over these two weeks?
Well… let’s dive into what to do and what not to do while you wait…
Now that you know all the symptoms you can have from the medications designed to support your pregnancy efforts, it’s important to remember that they don’t necessarily indicate if you’re pregnant or not.
We know it’s easier said than done, but try not to fixate on early pregnancy symptoms too much or worry about what it does or doesn’t mean.
If you find yourself obsessing over the little stuff (and who wouldn’t when trying to have a baby), try some simple breathing exercises to calm your nerves. We love the 4-7-8 method which is a great way to bring you a sense of inner calm.
If you’ve undergone fertility treatments with an egg retrieval and you experience severe abdominal pain, nausea, vomiting, rapid weight gain, decreased urine output or difficulty breathing you should call your doctor or seek care immediately as these symptoms are more concerning and not considered a normal part of pregnancy or the post-operative state.
Although we are all tempted to do it, taking a pregnancy test too early can yield false positive and false negative results both of which are equally devastating.
False positive urine pregnancy tests can result if you are undergoing fertility treatments and take a “trigger shot” to cause egg maturation or ovulation which include a variety of human chorionic gonadotropin (hCG) products like Pregnyl, Ovidrel, and Novarel. These can ultimately be detected in a urine pregnancy test for up to 10 days after use.
And while urine pregnancy tests have become more and more sensitive over time, false negative results happen WAY too frequently to ever rely on them 100% for the initial beta following IVF.
Remember, UPT’s are qualitative (meaning pregnant: yes or no) whereas a serum pregnancy test is qualitative (gives you an actual beta-hCG value). A serum beta-hCG level (blood level) will always be most accurate. Testing too early could simply mean the pregnancy hormone isn’t high enough to be detected in the urine yet.
If you find yourself wanting to test early, try to redirect that nervous energy to something that will benefit you both mentally and physically… more on that below.
Although we fully encourage staying active as a part of your overall physical and mental wellness plan, try not completely overdue it. If your body isn’t accustomed to running a marathon, now is probably not the best time to decide you’re going to start training.
Or maybe you’re already accustomed to intense exercise. If that’s the case, consider active recovery for the next week or two with lower impact, steady state exercise to get your blood flowing. Your body is going through a lot physically and hormonally, so it’s important not to overexert it during these two weeks.
At the same time, don’t feel like you have to stay sedentary and lay flat and not move all day. That may ultimately have the opposite effect…. We recommend speaking with your physician about specific recommendations for exercise immediately following fertility treatment as everyone’s circumstances are unique.
It is tempting to avoid people and simply stay home all week. However, don’t underestimate the power of leaving home and sharing quality time with family and friends.
I’ll be the first to admit that I’m a complete homebody. But, it’s important to recognize when that’s a restorative thing or restrictive and detrimental to mental health.
Be mindful of how alone time is affecting you. Sometimes getting out can make all the difference, even if you don’t necessarily want to interact with anyone outside of your home.
While there are so many things to be stressed about during this time, emotional coping strategies are critical for both men and women to thrive during this time as well.
Beyond simple things like nourishing your body with a fertility diet, getting 8 hours of sleep a night, avoiding alcohol and taking your prenatal multivitamin, there are so many other resources you can tap into to help on the mental and physical side of things that are just as important.
First and foremost don’t forget to take care of YOU. If any of your usual day to day causes you a significant amount of stress, look at what you can give up for a week. Don’t be hard on yourself for stressing or wondering what the outcome will be… but if you find yourself stressing over it more than not tap into that 4-7-8 breathing, go on a walk, get outside and get some fresh air, try and cook a new meal or lean into your support system.
Behavioral interventions such as meditation and yoga (i.e., ones that focus on increasing mindfulness) have been shown to improve psychological distress and coping strategies in couples undergoing fertility treatment (1-2).
Every individual’s fertility journey is unique and different and filled with periods of waiting and unknown. Developing a mindfulness practice that facilitates finding peace within the chaos — a way to center yourself within the periods of waiting and unknown — is critical to maintaining overall quality of life throughout the process.
In looking at data on yoga and fertility specifically, one study of women undergoing IVF treatment demonstrated that as little as one 55-minute yoga practice once a week for six weeks leading up to IVF treatment resulted in significantly improved overall quality of life, emotional and mind-body scores in addition to a significant reduction in anxiety and depression (3). In addition to the physical benefits such as increased strength and flexibility, the mental benefits from an increasing inner calm, stress reduction, and overall relaxation can positively impact many areas of life (4)
Another study used a combined approach emphasizing mindfulness of thoughts and feelings through breath, guided body scans and hatha yoga which resulted in improved self-compassion, coping strategies and improved scores in all domains of a quality of life assessment (2).
There are numerous guided meditations available online for free. Apps like Circle and Bloom, Headspace and Calm are becoming more common and are easily accessible from the privacy and comfort of your own home.
Acupuncture is a Traditional Chinese Medicine (TCM) technique that has been used for thousands of years. Acupuncture techniques can vary widely, but have been increasingly studied for their potential benefit on fertility and fertility treatment outcomes.
At this point there are no consistent findings in terms of acupuncture’s impact on pregnancy rates, but data has shown benefit in terms of decreasing anxiety and depression scores particularly in women with PCOS (5). Some women find it to be an incredibly calming and grounding experience.
If you’ve been curious and have been wanting to test the waters, ask your doctor for some recommendations that can be continued into pregnancy as well!
Community can be invaluable when going through stressful times especially if others understand exactly what you’re going through…
Resolve has some great resources and options for local community support groups. If in person isn’t your thing, there are plenty of online support groups to tap into. It also has tons of other great information and patient resources for support!
On the other hand if group gatherings or hearing other’s stories leaves you feeling more stressed and in a state of comparing yourself to others, maybe purposely taking a step back would serve you better. Consider leaning into family or close friends or try journaling as a source of support and a healthful outlet.
There are so many ways to center yourself.
Find what works for you!
Periods of waiting are the PERFECT time to try something new.
It doesn’t have to be dramatic or fancy… just something new to focus your energies on and change your environment a little bit.
Start a new tradition of going on a walk after dinner with your partner.
Play a new game.
Try a new recipe.
Work mindfulness practice into your everyday routine.
Go on a hike.
Take a weekend trip.
Watch a movie.
Meet up with a friend.
Sometimes just changing things up a little can give you a whole new perspective.
Your body is nothing short of a miracle and capable of so much. If you find yourself stressing about being pregnant or not during the two-week wait or are focusing on all the tests and test results… remember just how amazing your body truly is and all that it’s done for you to this point and will continue to do.
If the end of that two week wait comes and only a single line appears… or you get your period again… know that you are going to be ok.
Lean into your partner.
Reach out to your closest friend.
Make a standing appointment with a therapist or counselor.
Follow up with your physician to discuss next steps.
Focus on your mindfulness based practices.
Prioritize yourself. Take care of yourself. Practice self love.
Find a fertility affirmation and tape it to your mirror so it’s the first and last thing you see each and every day. Let it be your sign.
Whatever you do, don’t lose hope.
The two-week wait is an incredibly stressful part of the fertility journey… when it feels like all you can do is count the days. But during those times remember to be compassionate with yourself and to take care of yourself. Take one day at a time and lean on others for support.
Incorporate some of the strategies discussed above to not only survive those two weeks but to thrive in them. You are not alone in this.
Galhardo A, Cunha M, Pinto-Gouveia J. Mindfulness-Based Program for Infertility: efficacy study. Fertil Steril 2013;100:1059-67.
Li J, Long L, Liu Y, He W, Li M. Effects of a mindfulness-based intervention on fertility quality of life and pregnancy rates among women subjected to first in vitro fertilization treatment. Behav Res Ther 2016;77:96-104.
Oron G, Allnutt E, Lackman T, Sokal-Arnon T, Holzer H, Takefman J. A prospective study using Hatha Yoga for stress reduction among women waiting for IVF treatment. Reprod Biomed Online 2015;30:542-8.
Valoriani V, Lotti F, Vanni C, Noci MC, Fontanarosa N, Ferrari G, et al. Hatha-yoga as a psychological adjuvant for women undergoing IVF: a pilot study. Eur J Obstet Gynecol Reprod Biol 2014;176:158-62.
Stener-Victorin E, Holm G, Janson PO, Gustafson D, Waern M. Acupuncture and physical exercise for affective symptoms and health-related quality of life in polycystic ovary syndrome: secondary analysis from a randomized controlled trial. BMC Complement Altern Med 2013;13:131.
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