The Two Week Wait

If you are trying to conceive you will be familiar with the ‘two week wait.’ This is the stretch of time at which you must wait to find out if you are pregnant. Everyone goes through it on the journey to pregnancy, and for many people, it is filled with hope, uncertainty – and looking for any early signs of possible pregnancy.

We understand it can be an emotional time. In this blog, we explain what happens during the two week wait, what pregnancy symptoms you might experience, and give you tips to help you through it.

The two week wait – often called the ‘2ww’ or ‘tww’ by many trying to conceive – is the time between embryo transfer and performing a pregnancy test, which is usually done around the time your next period is due. We advise against taking a pregnancy test until approximately 16 days after your egg collection, as any earlier may lead to an inaccurate result.

Although the name implies a 14-day wait, for many women, the time frame is longer or shorter, as everyone’s cycle is different. What is common, however, are the feelings of anxiety that go with it. The 2ww is a hot topic in online fertility forums and TTC (trying to conceive) threads for this reason, with women all over the world sharing their tips and thoughts on possible pregnancy symptoms.

While you are busy wondering if you are pregnant or not during the two week wait, a lot is happening to your body.

If you have been trying to conceive naturally:

• An egg has travelled down your fallopian tube.
• Your body has increased the amount of progesterone to prepare the uterus for pregnancy, increasing the thickness of the lining of the uterus ready for embryo implantation.
• If the egg has been fertilised, and the embryo successfully implants into your uterus, pregnancy occurs. The embryo produces a hormone called Human Chorionic Gonadotropin (hCG), which rises as pregnancy progresses. Levels of hCG are usually high enough to be picked up by an over-the-counter pregnancy test around the day your period is due or if testing is performed using a blood test a few days earlier. This is why it is not a good idea to test too early during the 2ww – even though it is tempting – as it may give a false result if your hCG levels are not high enough yet.
• If the egg has not been fertilised this time or has not implanted, hormone levels drop, and the uterine lining is shed with the commencement of your next period.

If you have had IVF, what happens during your 2ww is a little different:

• A good quality embryo has been placed into your uterus.
• You are usually given progesterone supplements to support the uterus for pregnancy, just as it would happen naturally.
• If the embryo successfully implants, pregnancy occurs, and hCG levels start to rise. As with natural conception, levels of hCG are usually high enough to be detected by a blood test a few days before your period is due. Your specialist will request a pregnancy blood test around 11 days after transfer.
• If the embryo does not implant successfully, the pregnancy test will be negative, and the uterine lining will shed through your period a few days later.

Now you know what is happening during the 2ww, are there any pregnancy symptoms you can look out for? Although some women say they knew they were pregnant before a positive test, lots of women do not have any early symptoms at all – and the only sign is a missed period.

Many of the common early signs of pregnancy are also similar to the signs of an upcoming period, which can make it even more difficult to try and guess if you are pregnant or not.

If you have had IVF, you may also have symptoms during the 2ww that are due to the embryo transfer procedure and hormone supplements, not necessarily caused by pregnancy.

So it is wise to treat any symptom or feeling you get during the 2ww with caution. The only sure way to know if you are pregnant or not is through a pregnancy test around the time your period is due.

However, if you do want to symptom spot during the 2ww, the most common early signs of pregnancy that women report include:

• Spotting and cramps: Light spotting – not like your usual period bleeding – during the 2ww may be an indication that the embryo has implanted, resulting in very light bleeding and mild cramps as the embryo attaches to the uterine wall.
• Breast tenderness: Some women report increased breast sensitivity and soreness that is unusual for them.
• Fatigue: You may feel much more tired than usual. Women say this is ‘exhaustion-level’ tiredness rather than just needing to catch up on sleep.
• Food changes: Some women say they went ‘off’ particular food and drinks, such as coffee.
• Bloating: If you experience bloating, which again is not normal for you in your menstrual cycle, this may also be a sign of early pregnancy caused by hormonal changes. However, bloating can also be a side effect of the progesterone medication, so while it’s understandable to feel hopeful, it’s best to keep in mind that it may not always indicate pregnancy.

No matter how many times you have been through the two week wait, the time until you can take a pregnancy test can feel endless. To help you through, our team share some do’s and don’ts: 

Do:

• Make plans: Many women say distraction is the best way to manage the two week wait. So plan a get-together or enjoy a change of scene to take your mind off pregnancy symptom spotting.
• De-stress: If there is a way you like to de-stress, now is the time – such as gentle yoga and exercise, outdoor walks, breathing and meditation. Any way you can reduce your stress is beneficial when trying to conceive, whether you are pregnant this time or not.
• Try something new: Take up a new hobby or do things you have been putting off. Keeping yourself busy is a great way to distract yourself from thinking about the pregnancy test countdown.
• Lean on your support people: Chat with your partner, friends, or family about how you feel and what is happening. You can also use online forums to connect with other women who are going through the same experience.

Don’t:

• Overthink: It is hard not to overthink when you are watching for any possible pregnancy sign, googling symptoms, or are deep into 2ww advice forums. However, it is important to remember that during the 2ww, whether you are pregnant or not is actually out of your hands. So try to relax and carry on as normal – however hard this may be.
• Use alcohol to cope: It might be tempting to have a quick drink to cope with the stress of the 2ww, but alcohol is not advised when you are trying to conceive, especially if you are pregnant.
• Test early: We know it is tough not to test early, but as we have already mentioned, testing too early using a home pregnancy test can give a negative result even though you are pregnant. hCG levels may not be high enough until your period is due and, in some women, may still not be high enough until after this time.
• Struggle alone: If you are finding the 2ww hard to manage, particularly if you have been trying to conceive for some time or you have symptoms you are not sure about, please talk to our nursing team. We also have in-house counsellors who are well-experienced in guiding people through the emotional rollercoaster that is the 2ww.