What Really Happens During The Two-Week Wait?

Ask Monica is a Q&A video series hosted by Nurse Practitioner Monica Moore.

In this article:

• How Embryo Implantation Works
• Planning for a Healthy Pregnancy
• Should I be on bed rest after embryo transfer?
• How will I receive my pregnancy test results?
• Can I do anything to disrupt implantation?

While it’s undoubtedly an anxiety-filled time for most, the biological processes that occur during these critical days post-embryo transfer or IUI procedure are pretty incredible. In this episode, learn what happens in the body during the two-week wait, plus how to manage the roller coaster of emotions you may be feeling.

Monica Moore:

Hi everyone. Monica Moore, nurse practitioner at Illume Fertility here.

In this edition of Ask Monica, we are going to be talking about what happens during the two-week wait, that notorious time between either embryo transfer, if you're doing IVF, or insemination or intercourse, if you're not doing IVF.

I can tell you in one word what happens is anxiety, usually.

What is going on in my body? What can I do? What can I not do?

How Embryo Implantation Works

Here's a brief explanation of implantation: It's a communication between the embryo, which is now called a blastocyst, and the uterine lining.

They sort of have a conversation where the uterine lining says, "I'm going to let you in." And the embryo says, "I am good enough for what we call competent enough to be let in." Because the uterus' whole job is to keep out foreign bodies like viruses and bacteria. So it's very particular about who it lets in.

With that in mind, the embryo spends about 72 hours in the uterine cavity (once it's a blastocyst) before implanting. Its main nourishment in the uterine cavity is, at that point in time, the maternal bloodstream and what's going on at the level of the uterus.

Planning for a Healthy Pregnancy

That's why we are very particular about checking your uterus (within a certain period of time) prior to starting a fertility treatment cycle. Often, that time period is about six months (or less), just to make sure that there's nothing that we see that could prevent or hinder future implantation, like a polyp, fibroid, scar tissue, or bacteria.

Assuming that all of that fertility testing was negative [meaning your uterus was in great shape to receive an embryo], a lot of people will still ask, "Well, can I move around?" or "I have a cold/fever, is that dangerous?" And I promise - there is nothing that you can do that is really going to disrupt this potential implantation from taking place.

The bottom line? Normal life activities are completely fine.

Waiting isn't easy.

Get our complete guide to the two-week wait, including which symptoms are typical, how to manage your anxiety, and whether or not you should take at-home pregnancy tests.

Should I be on bed rest after embryo transfer?

Recent studies have looked at the question of bed rest. Many patients wonder,"Do I need to lay down and have complete bed rest?" immediately afterwards.

If you had an embryo transfer, the time between transfer until the pregnancy test is referred to as the two-week wait. This time period of 11 days (9 to 11 days) after embryo transfer can be very difficult, because not only are you thinking, "What can I do?" but also, "What am I feeling? And is this feeling representative of implantation?"

The truth is that it's very difficult to tell. Many people are on hormones such as estrogen and progesterone [during fertility treatment] that can create a feeling in the body similar to early pregnancy. It's very difficult to discern or differentiate if you feel like you're pregnant or if you feel like you're getting your period, because the medications can confuse things.

I often tell people to go about their life as normally as possible, to do whatever they can do to kind of distract themselves and keep themselves busy until the pregnancy test.

How will I receive my pregnancy test results?

I also tell patients to have a conversation with their nurse or patient navigator prior to a pregnancy test to confirm when and how you would like to be notified of your pregnancy test results.

I think many people going through treatment often feel pretty helpless during this time, just sitting around waiting, when they were previously coming in so frequently for ultrasounds and/or blood work.

The waiting part can be really hard.

The part that you can have control over is how you want to receive this news - this very important news. I have many patients who are teachers and they say, "I have a free period between 2:10 and 3:00pm" or "I'm out of school at 2:30pm." And if your nurse is in the office until 4:00 or 5:00pm, you can make a plan for that phone call to occur during your free time.

You can make a plan for that phone call to be left on a voicemail. You can make a plan for that to be emailed to you in our secure server. There are various options.

Can I do anything to disrupt implantation? 

I do want to reassure you that although this two-week time is difficult - and we know it's so hard it is counting down the days until that "official" pregnancy test - try not to worry about your own actions somehow causing your cycle to be successful or not successful.

If you do anything during that two-week period, such as running after something, falling, getting sick, sneezed or coughing a lot...those things are truly not going to do anything to disrupt implantation.

So, please continue sending us your questions! I hope this was helpful, and see you next time. Thanks so much.

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