As National Infertility Awareness Week draws to a close, we thought this incredible week should end by discussing the dreaded two week wait (TWW). We want to shed some light on why you have to go through it and how to survive it.
Time is a funny thing. For a start it is relative, and not just in the Einstein sense. We all know how circumstances affect our perception of time, from the last day of the holidays that flew by in a moment, to the office clock that never seems to move.
When we experience stress, time can seem inordinately stretched out especially when the stress is combined with nervous anticipation.
For couples undergoing the process of IVF, with all its associated stresses and concerns, the height of stress and anticipation takes place during the infamous TWW. This is the period between embryo transfer and taking a pregnancy test 14 days later.
If implantation is successful, the placenta produces human chorionic gonadotropin (HCG). Pregnancy testing kits detect this to give a positive result.
The TWW can be a very stressful and anxious time, coming on top of all the challenging treatment that has led up to it. Couples count down the minutes to the time when they will know whether all the effort has been worth it or whether they are back at square one.
Obviously, the temptation of doing a pregnancy test early can be extremely strong! This temptation, however, is best avoided. The main reason is that testing too early may well give a false result. There are two scenarios to consider here:
- Non-frozen embryo transfer: in this process HCG is injected about 36 hours prior to egg retrieval to help with the maturation of the follicles. However it can remain detectable for at least a week and sometimes up to 12 days later i.e. well within the window for embryo transfer. It is therefore entirely possible for this HCG to generate a false positive on a pregnancy test for a few days after embryo transfer
- Frozen embryo transfer: since HCG is not injected, false positives are unlikely. However, false negatives are possible with early pregnancy testing because the placenta won’t have started generating enough HCG to be detected yet.
Pregnancy tests can be accurate but need to be undertaken a full 14 days or so after embryo transfer. Furthermore, whatever the result from a home testing kit, positive or negative, it is absolutely vital to verify it with an HCG blood test. Because of the differences in accuracy between testing systems it is possible to follow a negative home pregnancy test result with a positive HCG blood test within 24 hours! So blood HCG levels are always more accurate and sensitive than a home pregnancy test.
So how can you get through the TWW without going stir crazy? Here are some ideas:
- Take it easy: no lifting or vigorous exercise. If you have a partner use them for any donkeywork that’s needed about the house!
- Medications: be religious about adhering to these. Set up alarms on your phone for when you need to take them, and create a table that you can check off each time you take them.
- Home vacation: if you can, take the two weeks off work. You really doesn’t need the challenges of work to add to the stress of the TWW. Plan your time off in advance and plan some serious Netflix binge watching, are there any good books that you wanted to read but never got around to? Use the time to indulge in your hobbies, or try new pastimes that encourage serenity and balance. Have you ever tried meditation, calming music, poetry, flower arranging, cookery, or light gardening?
- Don’t panic if you have spotting or bleeding: this can happen in the TWW because the uterus is under pressure from the meds and your embryo so implantation bleeding can occur. Twinges and cramps are also common and to be expected as your womb adjusts to the new situation. If you are worried, speak to your clinic for reassurance.
- Eat well: go for a balanced mix of vegetables, fruit, pulses, carbs and proteins but avoid stimulants like caffeine. It’s worth remembering that chocolate also contains caffeine-like stimulants so, unfortunately, this is off the menu for the TWW!
There is no avoiding the fact that the TWW is a stressful time and for many, time seems to drag ever more slowly towards that ‘make-or-break’ appointment with destiny. The temptation to reach for the pregnancy test is overwhelming, but as you know on this journey that is infertility, good things come to those who wait and wait and wait, so do try to resist. If you do succumb to temptation before the TWW is up beware that the results might be fickle. Remember if you have any concerns your clinic is always there to advise and reassure you.
Good luck and even though the national conversation about uncovering infertility is over for another year, we along with your healthcare provider are here all year round to talk about the right treatment plan for you.
