It’s nothing new, that the time after the embryo transfer until the result of the pregnancy test also known as the two week wait or beta hCG, is the most difficult stage during fertility treatment. Because of this, we here at IVF-Spain Madrid would like to explain the symptoms that women feel during this stage and give you some tips on how to cope with the beta hCG.
For this purpose, we have talked to our specialist Raquel Pascual, nurse and psychologist at the IVF-Spain clinic in Madrid.
Only patients who have gone through the seemingly never-ending two week wait know how difficult it is to cope with it. That is why, with the support of our expert, in this article, we want to help you identify the symptoms that you may experience during beta hCG and give you some tips on how to better get through it.
What is the two week wait?
The time between the embryo transfer and the pregnancy test is known as two week wait or beta hCG. In this pregnancy test, the levels of the hormone hCG, which can be found in the urine or blood of pregnant women, are determined.
As its common denomination already says, the two week wait or beta hCG lasts approximately 14 days, although it may vary depending on the stage of embryonic development in which the embryos were transferred. As fertility specialists, we know that the two week wait is a very stressful time, where patients are alert to every little change that they notice in their body.
Beta-hCG hormone levels
The Human chorionic gonadotropin (hCG) is a hormone released by the embryo upon implantation in the mother’s uterus.
This hormone promotes the secretion of progesterone by the corpus luteum, which allows the development of the endometrium and thus the growth of the foetus.
As foetal development progresses, beta-hCG levels gradually increase until the second or third month of pregnancy, when they start to decrease again.
For this reason, it is recommended to wait at least 10-14 days to perform the pregnancy test after the embryo transfer, as hormone levels may be insufficient to be detected beforehand. In this way, the pregnancy test result will be more reliable and false positives or negatives can be avoided.
How to interpret the test results: False positives and negatives
To summarise, in order to confirm the viability of the pregnancy, hCG (human chorionic gonadotropin) levels must increase exponentially until the end of the first trimester. After that, the values will decrease and remain stable for the rest of the pregnancy.
False-negative: This occurs when the pregnancy test result is negative even though the patient is pregnant. A false negative may happen when the pregnancy test is taken too early as the beta-hCG hormone value may be below the level at which the test can detect it.
False-positive: In this case the pregnancy test is positive, but no embryo implantation has taken place. The main cause of false positives is the medication given to trigger ovulation. When the pregnancy test is performed too close to the insemination or transfer, there may still be traces of said medication which can falsify the result of the test.
False positives should not be confused with biochemical pregnancies. In a biochemical pregnancy, the test result is real, since implantation has taken place. However, very soon after implantation, the embryo stops developing and, therefore, the pregnancy cannot progress. The beta-hCG hormone is present after implantation, but it is too low due to the embryo not developing.
How long should I wait to take a pregnancy test after IVF?
In assisted reproduction, embryo implantation occurs around the 5th to 7th day after fertilisation. In a natural pregnancy with a menstrual cycle of 28 days, implantation would occur between the 19th and 23rd day, which is the optimal time for the endometrium to receive the embryo.
According to Dr Rut Gómez de Segura (gynaecologist and fertility specialist at the IVF-Spain Madrid clinic), it is necessary to wait until the luteal phase to perform the pregnancy test.
An in vitro fertilisationhas several phases. The first phase is the egg retrieval phase, lasting from menstruation until the follicular puncture (when the eggs are retrieved from the ovary). This phase usually lasts between 12-14 days.
After the oocyte retrieval, the second phase called the “laboratory phase” begins. In this stage, the eggs are fertilised and the embryos develop in the laboratory. It is possible to transfer embryos between the 2nd and 5th day of embryonic development. Based on experience, however, embryos at day 5-6 of development have a better potential for implantation.
When the embryo transfer is performed on day 5 of development (also known as the blastocyst stage), the pregnancy test (blood test for b-hCG levels) is scheduled 10-12 days after the transfer. The period from the transfer until the pregnancy test is called the luteal phase.
Two week wait: When do symptoms start?
We must clarify that each patient experiences the process of embryo implantation differently and that, in the first few days, the embryo has not even implanted in the uterus yet.
Following assisted reproduction treatment, symptoms are usually associated with the side effects of ovarian stimulation , as well as the progesterone that patients continue to take during this time.
Some women do not experience any symptoms at all, while others will notice changes in their bodies. Most women will even experience what our colleague and specialist Raquel Pascual calls a state of hypervigilance.
Hypervigilance is a state during which many patients are very sensitive to any signs or symptoms that they may feel. It is entirely understandable that this phenomenon occurs during the two week wait as we try to seek information to help identify whether the test result will be positive or negative.
The most common symptoms during the two week wait are the following:
- Abdominal bloating
- Breast pain
- Frequent urination
- Lower back pain
- Headache and nausea
- Light bleeding, commonly known as “implantation bleeding” – you can read more about implantation bleeding here.
As we have already mentioned, it is normal for a woman not to feel any of these symptoms. Not having symptoms does not indicate anything neither positive nor negative. After all, it is not possible to know whether a woman is pregnant until she has taken a pregnancy test.
Tips for coping with the symptoms of the two week wait
First of all, we at IVF-Spain want to make you aware that this is going to be a difficult stage in which we must be prepared to accept every emotion: be it positive or negative ones. We know that beta waiting is a process during the treatment that we cannot avoid, and it is something that everyone who is trying to get pregnant will experience.
Most of the time we tend to fall into the habit of overthinking things. We must be realistic about our chances and the likelihood of success after fertility treatment. It is important to have a positive attitude but we must be aware that we may not be able to receive a positive result.
As we mentioned earlier, hypervigilance is very common at this stage. During beta hCG or the two week wait, we will pay attention to all the signs and symptoms that appear in us: headaches, swollen breasts, pain in the ovaries, among other symptoms, and it is normal because in this situation we try to look for anything that will help us to identify whether we are pregnant or not.
However, we have to be careful with this, because any hormone medication we take can cause physical symptoms similar to the symptoms during beta hCG, and noticing them does not mean that the result will be positive or negative.
On the other hand, it is a period in which we should take time for ourselves. It is very important to take advantage of this time to take care of ourselves, to dedicate time to our personal projects and, above all, to do things we enjoy.
“Having free time and continuing to do things that we enjoy is very important. On top of all the stress and tension that the Beta hCG waiting period brings, we should not also stop ourselves from doing things that make us happy. Otherwise, it may negatively affect us.” Pascual emphasises.
Once the embryo transfer has been performed, the only thing left to do is to wait approximately two weeks for the result. We are aware that during the two week wait many women face a rollercoaster of emotional ups and downs: fear, joy, excitement, happiness, anguish, a set of emotions that we need to control. If you need emotional support during this stage or if you have doubts about any of your symptoms, do not hesitate to contact us.
How did you experience this time?