The Two-Week Wait Strategies for coping until you can test

The two-week wait, also referred to as “2WW” on fertility discussion boards, can be agonizing for all couples, but especially so for ones with fertility issues.

What is the Two-Week Wait?

For those unfamiliar with the term, the two-week wait is the time between ovulation and the beginning of a woman’s next period. For women who are not trying to get pregnant, the two-week wait is as little noted as any other time of the month. For women who are trying to conceive, especially those who have been on the fertility journey for a while, the two-week wait can seem like forever.

Susan Leonard, a licensed professional counselor and marriage and family therapist who works with infertile couples, runs workshops based upon Dr. Alice Domar’s mind/body techniques. A client once told her, “When you’re thinking and obsessing and hoping during that two-week wait, what you’re hoping is that you’ll soon join a different population, the population of the pregnant, while worrying that you just might not.”

Looking for Symptoms?

A common thread on fertility discussion boards is women asking other women what this twinge or that bloat or this headache means. Even physical signs that seem like they couldn’t possibly be related to pregnancy are often discussed in great depth. This is typical, Leonard says, noting that during the wait women do tend to obsess over every twinge, ache, and cramp. She says some of this is a natural outgrowth of the strong, instinctive desire for motherhood, but for women undergoing fertility treatment, it’s also a time when the distractions and actions of trying to conceive come to a full stop.

“In IVF [in vitro fertilization], for the first two weeks there is something going on virtually every day leading up to the big moment of the transfer,” Leonard says. “As part of that activity, most women see a doctor or nurse every day. Then everything stops. They go from all of that activity to just waiting and there’s nothing concrete they can do to guarantee success. It’s not unusual for patients to describe a sense of powerlessness.”

Ways to Pass the Time

Leonard suggests activities that focus on the quest to become pregnant, but in a positive, nurturing manner that are specific to conception. For example:

Testing Too Early

One of the biggest issues women obsess over during the two-week wait is when to take a home pregnancy test. Dr. George D. Kofinas, the founder and medical director of the Fertility Institute in Brooklyn, New York, says they give their patients a time when they can start testing, and he recommends against testing any earlier.

“If you test earlier, it’s possible to have a false positive,” he says. “It takes two weeks to get the hCG (used in some fertility treatments) out of the system. If you test too early, you always have the risk of measuring the pregnancy hormone. The only exception is frozen embryo transfer, but even then there are pitfalls because some patients do not become positive early enough. A few days later they may be positive. For that reason, again, stick with the two weeks in order to avoid those false results.”

In general, the fertility provider will retest regardless of the outcome of the home pregnancy test.

A Plan of Action

Leonard says what’s really important during the two-week wait is to create a plan of action for whatever result presents itself at the end of that wait. This plan will help you and your partner through the two-week wait and through these possible scenarios:

A negative test

  • How will you both face the news?
  • Who will you talk to, your RE, a counselor, or perhaps a compassionate nurse at your clinic?
  • Do you go forward immediately, or wait for a time and try again?
  • Is it time to consider alternative family building methods such as adoption?

A positive test

  • Normal protocol with a positive result is for a fertility clinic to retest at specific intervals to be sure the pregnancy hormone is rising normally.
  • Do you tell everyone immediately, or share the news judiciously until the pregnancy is fairly well-established?

“Cautiously optimistic is the healthiest way to approach the two-week wait,” Leonard says. “Have that plan and put it on the back burner. Think positively, but also keep in mind that at least we know what we’re going to do either way, without dwelling on it.”

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