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The 2-Week Wait: What to Expect After Your Embryo Implantation

The two weeks after an embryo transfer can be one of the most nerve-wracking parts of IVF treatment. Whether you’ve had fresh or frozen embryos transferred, or are undergoing intrauterine insemination (IUI), there is no getting around the dreaded 2-Week Wait (or 2WW, as it is commonly abbreviated) before going back to the clinic for pregnancy testing. These two weeks are not the same for everyone, with some women experiencing a range of symptoms commonly associated with pregnancy and some experiencing no symptoms at all. Below, we’ll go over what to expect after your embryo transfer and explore what any potential symptoms mean.  

When does embryo implantation take place?

Embryo implantation typically occurs between days 20 and 24 of a 28-day menstrual cycle. While the embryo transfer process is sometimes referred to as embryo implantation, your embryo won’t actually implant in your endometrium on the day of your transfer procedure. Instead, embryo implantation occurs 6-10 days after your egg retrieval, and 1-5 days after your embryo transfer.  If you are doing a frozen embryo transfer (FET), implantation occurs 1-5 days after your embryo transfer procedure. Prior to the embryo implantation process, doctors may also choose to conduct a mock cycle and an endometrial receptivity test in order to determine your receptivity status. They may also want to conduct generalized endometrial testing to check your reproductive health. The IUI and IVF success rate is largely affected by your body’s natural receptivity levels.  

What is the 2-Week Wait?

Once the embryo transfer has been performed, it takes about 15 days for the pregnancy hormones to reach high enough levels and stabilize in your bloodstream for accurate testing. If you take a pregnancy test before then, you’re likely to get a false positive/negative. This is why the two-week wait is unavoidable, no matter how you’re trying to get pregnant.  

False pregnancy test results could be due to the amount of the pregnancy hormone hCG in your body. Hormone levels can fluctuate during these precarious weeks, which is why pregnancy tests performed during this period are unreliable.  

It’s important to note that any symptoms you experience are most likely the result of the hormonal medications that you’ve taken during your infertility treatment.  

Common symptoms after embryo transfer and what they mean

Most women experience a mixture of symptoms during their two-week wait. Some women, however, may have no symptoms at all. It all depends on how the ovarian stimulation medications are processed in your body. It is not unusual for women to report being hyperaware of all the changes in their body during infertility treatment, but it’s important to remember that many of the early symptoms of pregnancy are the same as side effects caused by your drug regimen. The following are some of the most common symptoms after the embryo transfer process has been completed: 

Light bleeding or spotting

Many women report light bleeding within the first 2-3 days after their embryo transfer, but it typically stops after this point. Most of the time, this is caused by the cannula inserted into the cervix during the embryo transfer process. However, it should be a lot less blood than menstrual bleeding. If you experience bleeding comparable to a menstrual cycle, it’s important to contact your doctor immediately.  

Cramping

Many women report cramping in the days following their embryo transfer. This is very common due to the nature of the procedure, and it should feel similar to the cramps you would experience during a typical menstrual cycle.  

Increase in vaginal discharge

In the days following their embryo transfer, many women have reported a significant increase in vaginal discharge. This is a result of the changes in hormone levels that occur during the process as well as the vaginally administered progesterone, which serves to support the endometrium throughout the embryo implantation process.  

Breast change

Your breasts may change in shape, appearance, and texture following the embryo transfer. Many women have reported that their breasts felt harder or swollen, with tingling and darkening of the nipples. These are all common symptoms during the period of embryo implantation. 

Nausea

Due to the regimen of hormone-boosting medications necessary to support the IVF process, women frequently report feeling nauseous both before and after their embryo transfer. While it’s a common symptom, some women do not experience it.  

Fatigue  

This is common in natural pregnancies and those from IUI or IVF because of higher levels of progesterone in the body. Progesterone levels increasing in the uterus can cause fatigue. However, experiencing fatigue after your embryo transfer does not necessarily mean that you’re pregnant. 

Frequent urination 

Those undergoing infertility treatments are often injected with the pregnancy hormone hCG. One of its side effects is the increased urge to urinate, which is why this is a common symptom for many women after the embryo is transferred. Since this is another symptom common in unassisted pregnancies, it’s important to remember that it isn’t a concrete sign that you are pregnant. 

Absence of menstruation 

Depending on your menstrual cycle and the timing of your window of implantation, this can often be a misleading symptom of pregnancy. It’s essential to wait the full 15 days to ensure your pregnancy test results are accurate.  

What if I don’t experience symptoms?  

Don’t worry if you don’t experience any of the symptoms described above. The large majority of them are caused by the presence of the pregnancy hormone hCG, and after its levels taper off (typically the first few days after the embryo transfer process), these symptoms also tend to dissipate. While it’s common to receive hCG injections prior to embryo transfer, you may have not needed them, in which case you won’t incur any of the side effects. Neither the absence nor the presence of symptoms can tell you definitively whether the embryo implantation process (and IVF round generally) was successful until after the 2WW.  

Dos and don’ts after embryo transfer  

Rest is the most important thing after you undergo the embryo transfer process, but you don’t need to spend the next two weeks in bed. After the procedure takes place, it’s common to remain at the clinic for approximately 30 minutes in order to rest. You can resume your daily activities in the days following the procedure, although you should avoid any strenuous activities. Due to the possibility of increased urination, you should also make sure you drink lots of water and restrict your level of salt consumption.  

As for the don’ts, it’s critical not to have sex during the two-week wait to let the pelvis rest. You should also steer clear of bodies of water such as hot tubs, pools, or the ocean to avoid the possibility of infection. Lastly, it’s crucial not to smoke while attempting to get pregnant because smoking can reduce your fertility. It’s very important to adhere to these rules in order to increase your chances of a successful implantation.  

When to consult a doctor  

In certain circumstances, you will need to contact your doctor. If you’re experiencing heavy bleeding similar to a regular period during the 15 days after the embryo transfer, it’s essential to see your doctor as soon as possible. You should also consult your doctor if you experience acute and persistent pain in the abdomen, headaches, fevers, or other symptoms that are more severe than the ones listed above, since they could be a sign that something’s wrong.  

How can we detect when will be the best time to perform the transfer?

Endometrial receptivity testing is very important in order to assess your optimal window of implantation (WOI). As many as 30% of women experiencing infertility have a displaced WOI, which can only be detected with specific testing.  Undergoing an endometrial receptivity test will help determine the best possible time for embryo implantation based on your fertility and can increase your chances of getting pregnant through IVF.  

MIRA™: miRNA-based Receptivity Analysis

MIRA™ is a miRNA-based endometrial receptivity test that uses a range of miRNA biomarkers to assess a woman’s fertility. The optimal time for embryo transfer is different for everyone. If your window of implantation is displaced, using MIRA™ will ensure that your embryo is transferred when it’s most likely to implant successfully.