Two-week wait

The two-week wait is the gap between an embryo transfer or an insemination and the pregnancy test that means anything. It is usually nine to fourteen days rather than a full fortnight, and most people find it the hardest stretch to sit through, so it is worth planning for.

Where you'll meet it

At the end of every attempt. After an IVF transfer, after a frozen transfer, after an insemination with donor sperm. The active part of treatment stops, there is nothing left to do, and that is exactly why a plan helps.

Why it takes that long

An embryo takes a few days to implant, and only then does the placenta begin producing hCG, the hormone a pregnancy test detects. The level has to climb far enough to be measurable, and it roughly doubles every couple of days early on. Testing before that point does not give you an early answer. It gives you an unreliable one.

Clinics test with a blood test rather than a urine one because blood picks up lower levels and gives a number rather than a line. From a day-five blastocyst transfer the test usually falls around nine to eleven days later. From a day-three transfer or an insemination it is a little longer.

There is a specific trap after IVF. The trigger injection contains hCG, and it can still be in your system for up to about two weeks. A home test taken too early can pick up the trigger rather than a pregnancy, which produces a positive that fades. That is the main reason clinics ask you to wait for the blood test.

What is actually happening to you

Progesterone support carries on through the wait, and progesterone produces sore breasts, tiredness, cramping and nausea. So do early pregnancy and an imminent period. So symptoms cannot tell you either way, and it is completely natural to notice them anyway. Being kind to yourself about that is part of getting through the fortnight.

Light spotting is common and does not predict the outcome either way. Heavy bleeding is worth a call, as is severe pain or anything that feels wrong.

What helps

You do not need bed rest. The embryo cannot fall out, and studies of resting after transfer have not shown any benefit. Normal activity, normal work, normal walking are all fine. Avoid the things you would avoid in early pregnancy, keep taking the medication exactly as prescribed, and otherwise go about your life.

What people tell me actually helps is having something booked. A week back at work, a trip, a project, anything that occupies the days. Decide in advance whether you are going to test at home, because the couples who agreed a rule beforehand seem to have a much easier fortnight than the ones negotiating it at six in the morning on day seven.

Agree in advance, too, who takes the call and where you will be. A result arriving at your desk is a different experience from one arriving at home.

Questions to ask

Ask exactly which day your blood test is booked for and why that day. Ask how long the trigger is likely to stay detectable if you are considering testing at home. Ask what the plan is for both outcomes, including who you speak to if it is negative, because that conversation is much easier to have while you are still calm.

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