Understanding the two-week wait in IVF

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By Dr Marcin Stankiewicz, Medical Director of City Fertility Centre Adelaide.

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During an IVF cycle, the two-week wait between embryo transfer and the pregnancy result can often be stressful. The truth is, on an emotional level, for many people it could be the most difficult time to endure.

While it is an exciting and optimistic time of the treatment cycle, it is also often emotionally charged with expectation and anxiety. You may have felt some similar feelings before seeking fertility help, when you were waiting each month to see whether or not you were pregnant.

I therefore like to explain to my patients the reasons why there is a two-week wait and give them some advice on how best to handle it on a physical and emotional level. Here are some facts and tips I hope will help you.

 

Why wait two weeks?

These two weeks are considered the final phase of IVF. Called the luteal phase, it is the time between embryo transfer and the pregnancy test. These two weeks would be equivalent to the part of a non-stimulated (normal) 28-day cycle that happens between days 15 and 28.

Progesterone and/or estrogen medication is working in your body to help produce the same levels of hormones that would occur naturally in the early stages of pregnancy. These also help prepare the lining of the uterus for implantation. Once transferred, the embryo needs to implant itself into the uterine lining, about day 20 of the cycle, and then continue to grow into a fetus, for pregnancy to occur.

 

When will you know if you are pregnant?

It takes about 10 days for all traces of the hormone you used as the trigger to be cleared from your body, and in turn for less than 10 per cent of it to show up in a blood test. This is why we wait 14 days to make sure the new pregnancy is producing enough of the hormone hCG (human chorionic gonadotropin) to be detected in a blood test. This is the most accurate indication of pregnancy.

I do not recommend home pregnancy tests before the two-week mark as they can deliver false results, both positive and negative. One reason for this is that the hCG injection given to mature and release the eggs, and as a booster, can give a false positive urine test, which only adds to the emotional roller coaster.

 

What is happening to you during the two weeks?

The hormone medication given to you to optimise your body for pregnancy may be having an impact on you emotionally and physically. You may feel emotional and be more prone to tears, anxiety and irritability. You may also experience some cramping, spotting or light bleeding, abdominal bloating, fatigue and breast tenderness. While changes can be alarming, they are normally fine and do not indicate whether you are pregnant or not. However, any extreme symptoms should be reported to your doctor immediately.

 

Some lifestyle tips during this phase:

  • Limit activity for the first 24 hours after transfer.
  • Gradually increase activity over the next few days, ensuring it is non-strenuous and non-aerobic, and return to work when ready – your treating specialist will guide you if you are unsure.
  • Eat nutritiously and stay hydrated.
  • Keep busy by planning meaningful or fun distractions.
  • Practise your favourite relaxation activity to keep stress levels down.
  • Set aside a timeslot each day (between 15 and 30 minutes) to think about your journey and write down your thoughts or discuss them with someone. This may help you stay aware of and process the range of feelings (such as fear and excitement) that often arise during this time.
  • If you are feeling overwhelmed by the emotions, finding it exceptionally hard to deal with the stress of waiting or not coping, you are not on your own. Call your treating specialist, IVF nurse or counsellor for help. You can also contact support groups such as AccessAustralia (www.access.org.au).

 

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Image courtesy of Shutterstock.com

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