The Two Week Wait: Do’s and Don’ts

I find the TWW after an embryo transfer to be more difficult than the “normal” TWW following ovulation or IUI. With ovulation/IUI, there’s a chance that an embryo is floating around my reproductive system; with an embryo transfer there ABSOLUTELY is an embryo floating around inside my uterus!

My clinic is very conservative with two week wait limitations. I’m not allowed to exercise (including anything that will engage abdominal muscles), take a bath, eat soft cheeses, have sexual intercourse… the list goes on. Not only that, my clinic recommends testing for pregnancy after an entire 14 days after transfer! This would mean testing when a pregnancy is 5 weeks and 5 days which is far longer than most people wait to test. Trust me, the wait is agonizing! (Though of course I usually test a few days early, leading up to the official test date).

Lest you think this is easy for me, I'm in a TWW as I type this and truly, this list is as much for me as it is for you. There’s a reason people talk about TWW so much - it’s one of the hardest waits during IVF, rivaling the 5 day embryo blastocyst wait.

Here are some things that have helped me get through the agonizing wait:

Do keep detailed records - I use the Fertility Friend app. It’s a little clunky to start (and makes you feel like you’re using a website from the 1990s) but once figuring out how things work it’s a great tool to track meds and symptoms. I like how easily I can compare past and current cycles. A few of my TCC friends use the app as well so we can watch each other’s cycles and encourage each other.

Along with the digital record I use my weekly planner to track my meds since I have to take or inject things about 8x a day. My system helps me remember which pills or shots I’ve already done so I don’t duplicate or forget!

Don’t symptom spot (with exception!) - I 100% guarantee every person on a conception journey has convinced themselves they must be pregnant due to a solid list of symptoms. In reality, the pills/patches/injections/hormones are the real cause of any TWW symptom.

Here’s the exception I allow myself: I look for symptoms in the 5 days of progesterone before the transfer. This helps me remember that it’s possible to feel “pregnancy symptoms” before there’s even an embryo there! Usually my pre-transfer symptoms have been tender nipples, cramping, fatigue, and mood swings.

Do pamper yourself - my go-to is booking a haircut or appointment for some face framing highlights (check with your doctor if you’re concerned about hair dye!). Sitting in the salon chair is a guaranteed 2 hours when I can’t google “Is X safe in early pregnancy?” without the guilt of the stylist reading over my shoulder. Bonus: that lovely scalp massage! So relaxing.

Don’t make faith purchases - Obviously this is up to you, but something I don’t usually allow myself to do during two week waits is make “faith purchases” such as baby onesies and toys. There will always be cute baby things available (somehow there are always babies being born, as mind boggling as that is to us) and I promise when you’re ready, you’ll find lots of adorable things to buy for your bub.

This prevents the newly purchased item from becoming a token of sadness instead of hope. And if you do purchase something or are gifted something, hide it away until you have need for it!

Do buy flowers or a new house plant - You don’t have to receive flowers to feel the mood boosting benefits; buying yourself flowers will lift your mood just as much. Put your flowers somewhere you’ll admire them most: your desk, kitchen table, or entry way. Bonus: spend time creating a flower arrangement, or do some repotting of house plants, or dig in to a gardening project.

Do start a show binge or movie marathon - Now is the time to subscribe to a new streaming service and add some options to your watch list. Our first FET TWW we marathoned all the Harry Potter movies together- it took us about 12 days to get through all the movies and I promised I wouldn’t test until we had finished the canon; we even watched the Fantastic Beasts because I was nervous to test early.

I recommend a comedy series to keep things light- nothing is worse than a pregnancy story line to trigger you while already feeling emotional. Plus, a study done in Israel points to evidence that laughter may improve implantation rates for IVF patients.

Don’t say yes to anything physically strenuous - This is not the time for moving furniture or any sort of manual labor. Instead, focus on things that you can do from a relaxed posture. Research your next vacation or watch how-to videos for remodeling your bathroom in the FUTURE.

Do treat yourself with food - I’ve been very health conscious this transfer, trying to avoid foods that might give me gut inflammation and bloating. But its important that I also find pleasure from food; food is one of life’s true pleasures! I’ve been indulging with a few squares of organic chocolate and pairing the chocolate with other foods so my blood sugars stay stable.

Example afternoon snack: 1 oz of cheddar cheese (for protein), handful of kalamata olives (for healthy fats and a little salt kick), 5 gluten free seed crackers (for that nice snacky crunch!), an organic carrot cut into sticks (for A vitamins, fiber, and crunch; also helps with estrogen metabolizing), a few slices of apple (energy/carbs, fiber) and a square of organic chocolate. Yum!

A choice of treat will be unique to each of us and I’m here to reassure you that a little indulgence will not affect your pregnancy outcome. But do stick with things that are known to be pregnancy friendly!

Don’t eat without research - some of your habitual foods might not be recommended during pregnancy. If in doubt, do a google. Foods with risk of bacteria or infection are the biggest culprit (like soft cheeses, packaged meats, anything raw) but other things like mercury-heavy fish or even herbal teas can be on the list to avoid.

Do keep your kitchen stocked - Focus on shopping and eating the right foods, and keep your kitchen full of these foods! Don’t wait until you run out; keep basics in stock so you won’t risk getting hangry or double down on that chocolate bar.

My go-to shopping list for a TWW is mostly organic: eggs, cheese (usually cheddar or similar hard cheese), whole milk, spinach, carrots, potatoes, gluten free pasta, oats, yogurt, decaf/herbal teas, dino kale, fruit, peanut and almond butters, salmon, cod, chicken, beans, and of course, high quality chocolate.

Don’t make any big decisions - while this is a great opportunity to do some deep soul searching, take the time to write down your thoughts and think through different scenarios and decisions.

Try to avoid making decisions now that may/may not be impacted by the results of your test day. This is not the time to be purchasing big ticket items or quitting your job. Due to the high risk of a transfer, all elevated situations in our life will feel elevated. Observe your feelings and thoughts and write them down. Maybe speak to your partner, a therapist, or a friend about how you are feeling. In a few weeks’ time you’ll be able to accept the situation or make a choice to change the situation, without the pressure of the TWW.

Do use timers - I mean this in two different ways. First, make a schedule for meds/injections if you’ll think you’ll forget and set alarms on your phone.

Secondly, if you’re allowing yourself a “dr google rabbit hole” search, I recommend setting a limit or timer for yourself. Spending 3 hours on a Sunday googling “implantation bleeding 2 days past transfer” will NOT HELP your sanity! (I can confirm from experience).

Don’t test too early - Specifically, if you’ve used any HCG in your cycle, don’t test early or you are likely to see a false positive. This is most common on fresh cycles (or timed intercourse/IUI cycles) but HCG is also used occasionally on FET cycles. It will take 9-12 days for HCG to leave your system (depending on several factors). I know many women like to “test out the trigger” but I certainly don’t have the strength to see a positive test and know it was false! For me, the wait was always worth it.

Even if HCG wasn’t part of your protocol, there’s a reason clinics give a test date. Testing early and seeing a negative test is so discouraging and might not be accurate to the final result. It might even cause you to want to stop with your injections or suppositories. Similarly, even if you’re lucky enough to test positive early on, you could then spend the rest of the TWW worrying that lines are too light or panicking over any spotting.

Do get out out of the house - take time to walk the dog or browse a local shop. I like to pack a reusable coffee cup in a canvas bag and browse my neighborhood. The light exercise could only be good for circulation, a coffee bought" “out” is a total treat, and the change of scenery serves as a mental pickup when anxiety is constantly at the ready.

Don’t allow your body temperature to drop - Based on Chinese medicine, you should keep your body warm during a two week wait, particularly your feet! I’m not sure how much science there is to this but if your body is struggling to keep up a comfortable temperature it makes sense that other bodily functions might not be prioritized.

Similarly, be sure not to overheat with saunas, hot tubs, or heating pads; fever level temperatures can be harmful during pregnancy.

Do confide in a few people - I understand we all have different comfort levels with sharing about our infertility. Now that I’ve started sharing a little more I’ve found the comfort of having a few trusted friends who will check in on me and let me speak my mind (and complaints) when needed.

The downside of course is having to share when a cycle has failed but I guarantee the right kind of support will make such a difference in how you deal with those feelings. A true friend will sit with you in those scary, sad, anxious feelings and support you no matter what.

Don’t panic at the sight of blood - As scary as it is, bleeding during the TWW and early pregnancy is VERY COMMON. Even more so with IVF cycles. I’m saying this just as much to myself as to you, bleeding doesn’t mean a failed cycle. Observe the volume of bleeding and when it occurred and reach out to your clinic for support.

What bad habits are you guilty of during the TWW? I’ve certainly done a few of these ‘don’ts’ but also plenty of the ‘do’s’! Balance and moderation are key to keeping away the crazy. If you’re in a two week wait, I wish you patience and good luck!