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The Two Week Wait (2WW)

The two week wait. Those 16 long, long days between when your embryo is implanted, and you find out if you are pregnant. 

The abbreviation TWW or 2WW is known to every fertility patient who has travelled this road before.

It’s a uniquely agonising and hopeful time, when many women find themselves focussing in hyper-detail on every feeling in their bodies, wondering if each tiny twinge or cramp signifies that their lives are about to change forever. That their dreams are about to come true. 

Unfortunately, when it comes to the 2WW on an IVF cycle, the early signs that you might be pregnant…are often the same symptoms often caused by the IVF cycle itself. 

As fertility specialists, we always advise you to try to get on with your lives during this time and not fixate too much until we can give you a definitive pregnancy test here at the clinic. 


(But we also know that telling you to do this is probably as pointless as yelling into the wind.)


We know you’re going to be thinking about this. So to help you understand what you may experience physically and mentally during this time, we’ve created a short guide to some of the symptoms you might have during the 2WW, and what they might mean. 

Cramps

It’s very normal to have period-like cramps during the two weeks after transfer, with the majority happening in the few days after transfer. 

Where things get confounding, however, is that cramps felt around 7-10 days after transfer can also signify that the embryo has implanted. This can feel like a cramp, a twinge, an ache, or a little pinch. 

Unfortunately, there’s just no way of knowing. Not yet. 

It’s too early for a pregnancy test, as the pregnancy hormone won’t have had time to establish itself yet. (So please don’t torture yourself, or waste money buying the local chemist out of pee sticks.) 

And if you get zero cramps during the whole process, you can absolutely still be pregnant. Just like with period cramps, women experience cramps differently. Many pregnant women have no unusual sensations at all. 

Spotting or Light Bleeding

We know that the sight of blood can strike terror into the heart of anyone who has struggled to conceive. 

We want to reassure you that spotting or light bleeding is common after an embryo transfer. This can also be a positive sign, in that spotting around that 7-10 day window after the transfer may indicate implantation has occurred. 

This happens because the uterus is filled with blood vessels, and implantation can irritate blood vessels and cause them to bleed. The colour of this blood is often brownish, light pink, or a small amount of fresh blood. The overwhelming majority of women (75%) will get no implantation bleeding at all. 

Heavy bleeding with bright red blood admittedly does not bode well for your chances of a pregnancy from this cycle. However, there are occasions where a pregnancy does continue despite heavy bleeding, depending on where the blood is coming from and why. 

We are here for you. If you experience bleeding that you are concerned about, please give us a call and we can advise and support you. 

Swollen or Sore Breasts

Sore or swollen breasts are a very common early sign of pregnancy. However, this is another unfortunate example of the hormones used in an IVF cycle mimicking the hormones of pregnancy. Hormones can take weeks to settle down, so symptoms can come and go in confusing ways. 

Some women won’t have sore breasts at all, either during IVF or pregnancy. Some women will have terribly sore breasts, but not be pregnant. Some women, most vexedly, will have sore breasts in one IVF cycle, and not in the next, but not be pregnant either time. 

It is easy to go a little mad trying to interpret the soreness of one’s boobs. The answers aren’t to be found there. Definitive answers are only to be found in a pregnancy test—and we thoroughly suggest waiting until you come to see us in the practice!

Bloating

Bloating is extremely common during an IVF cycle because your ovaries have been artificially stimulated and can become quite swollen. 

If the embryo implants, the swollen feeling could conceivably increase, as the pregnancy hormones then act on top of your already swollen ovaries. 

Other women will find they still have a perfectly flat stomach through the whole procedure, but discover that they are pregnant at the end of the two week wait. 

Please, don’t agonise over the size of your stomach. No good ever came of that anyway. 

Avoid the Home Pregnancy Test, and Don’t Test Early.

We don’t tell you this to torture you. We want you to have every moment of joy possible, as soon as possible. 

This is another example of the IVF hormones messing with things. The hormones from your trigger injection can linger in your body for up to 16 days, and as the hormone falsely raises your HCG level (the thing we test for pregnancy), you run the real risk of getting a false positive by testing at home early. 

Which is why the extremely accurate blood test we do in-clinic at the end of the two-week-wait is the only sure way of knowing whether you are truly pregnant, so we strongly suggest you wait for that. A false positive at this point will break your heart. 

Look After Yourself.

With all of these symptoms it’s important to keep as much perspective as possible. It’s tempting to let yourself celebrate at the smallest sign and go around grinning all day and telling your loved ones, but it’s not healthy nor helpful to allow yourself to reach such emotional heights when it’s not (yet) based on reality. The same goes for losing hope if you’re spotting a little, or not seeing the symptoms that everyone else is talking about on your fertility forum. 

Step away where you can. Take a nice walk. Have a picnic in the park with your bestie. Eat nutritiously and get your rest. Get a massage. 

Let Us Look After You.

This is a hard time to manage, as all your hopes and dreams are focussed on a tiny speck inside you. At this point, there’s nothing you can do to affect the outcome of your IVF cycle, and in all truth, there’s nothing tangible that we, as fertility specialists can do either. We can’t change the result of the process that is in motion.

But that doesn’t mean we’re not here to support you. 

It’s important that you look after your emotional and physical wellbeing during the 2WW, and our fertility specialists, as well as Genea’s nurses and counsellors, are here to help. We can talk you through any questions or concerns you may have, or just provide that listening ear while you have a good cry. 

Fertility treatment isn’t called an emotional rollercoaster for nothing. But rollercoasters, last we checked, are meant to be fun, and there can be days in the 2WW that can certainly challenge that. 

However, we’re on board this rollercoaster with you. So please, lean on us for support.