How to deal with the two-week wait
LAST UPDATED: Nov 09, 2021
7 MIN READ
HERE'S WHAT WE'LL COVER
First things first, we’re going to ask you to take a deep breath with us if you're currently in a two-week wait because we know how stressful that can be.
"During two-week waits," says Modern Fertility staff therapist Meghan Cassidy, LCSW-C, "we can find ourselves obsessing over symptoms, researching on the internet, feeling numb." So, we're here to help you feel as knowledgeable, calm, and relaxed as possible throughout the process.
Below, we're talking about waiting to take your first pregnancy test, what happens in your body in the two weeks following ovulation if you’re pregnant, and how you can manage the waiting game. Here are your biggest takeaways:
Early pregnancy tests allow you to start testing as early as six days before your missed period (around eight days post-ovulation), but results will become more accurate the closer you are to the first day of your missed period.
During the two-week wait, if you did conceive, there might be early signs of pregnancy. But because these symptoms overlap with the ones associated with the start of another period, your best bet for understanding whether or not you're pregnant is a pregnancy test.
Remember to be gentle with yourself during these two weeks. Check in with how you're feeling, give yourself what you need, and connect with a solid support system.
OB-GYN and Modern Fertility medical advisor Dr. Eva Luo, MD, MBA adds this advice: "Be kind to yourself and distract yourself instead of googling yourself down a rabbit hole. There is no harm in waiting even though some pregnancy tests can now detect a pregnancy before your missed period. The closer you are to your expected period date, the more accurate the pregnancy results will be. You want a slam dunk rather than a maybe that can cause more worry."
Now, let’s jump into what you need to know and how you can take care of yourself during your own two-week wait.
What is the two-week wait?
The two-week wait is the time period between ovulation and the point at which an at-home pregnancy test can detect pregnancy with the highest accuracy. You might see the two-week wait simply referred to as "TWW" in fertility forums or online communities. For some people, the end of this two-week period lands right around the time they would expect to have (or miss) their next period — but since we don't all have a "textbook" 28-day cycle, it won't be exactly two weeks for everyone.
Why do you have to wait two weeks post-ovulation for the most accurate pregnancy test results? That two-week period allows for the following to happen:
During ovulation, an egg is released by the ovaries and begins its journey through the fallopian tubes. If sperm is present in the reproductive tract around the time of ovulation, it can fertilize the released egg to form an embryo.
The embryo then travels from the fallopian tubes into the uterus, where it attaches to the uterine wall (aka the endometrium) about 1-2 weeks after fertilization. That attachment is called implantation.
Within one day of implantation, a structure called the chorion (that forms around the embryo) begins producing human chorionic gonadotropin (hCG) to support the growing pregnancy. At-home pregnancy tests detect hCG in your urine to confirm pregnancy.
Early on in pregnancy, hCG levels increase about 50% every day — meaning the closer you are to your missed period, the more likely an at-home pregnancy test is to detect hCG in your urine.
Early pregnancy tests with high sensitivity to hCG let you start testing as early as six days before a missed period, or as early as eight days post-ovulation. That said, accuracy rises up to 99% when you test on the day of your missed period — in other words, after that two-week wait.
The waiting game after fertility treatment
If you've tried to conceive using a fertility treatment like in vitro fertilization (IVF), your fertility doctor will likely confirm the pregnancy via blood work (and possibly conduct ultrasounds) much earlier in your pregnancy. So, while the wait before the pregnancy test will still happen, the timing isn't something you'll need to keep track of.
How do you know how many weeks you are past ovulation?
Great question! If you've been tracking luteinizing hormone (LH) in your urine with an ovulation test so you could time sex or insemination, you'll have a better sense of how many days have passed since your LH surge (which comes about 24-48 hours before ovulation). If you timed sex or insemination around your two most fertile days (the day of your LH surge and the day after), you can use that starting point to count off two weeks.
If you haven't been tracking LH, Dr. Luo says to wait until the day you expect your next period to come. For example: If you generally have 35-day cycles, wait until day 35 of 36.
What are some possible signs or symptoms of pregnancy before that two-week wait is up?
Here’s where it gets tricky. While there are some symptoms of pregnancy that can pop up before you miss your period, many of them overlap with premenstrual syndrome (PMS) symptoms — and for some people, looking out for these symptoms (sometimes called "symptom-spotting") can add to the stress of the two-week wait. Always feel free to check in with your body and how it's feeling, but remember that a positive pregnancy test followed by doctor confirmation is the only sign that confirms a pregnancy.
Here are some of the early signs of pregnancy:
Frequent bathroom trips: During pregnancy, your body’s blood supply increases. This means more blood for your kidney to filter through, which means you pee more frequently.
Fatigue: The first trimester results in fatigue for many pregnant people due to high levels of the hormone progesterone.
Sore and enlarged breasts/chest: This symptom tends to go away as the body becomes accustomed to the hormonal changes that happen during pregnancy, but it's a common early pregnancy symptom. You may also notice that your nipples become darker and enlarged.
Implantation bleeding: "Implantation bleeding is defined as a small amount of spotting that occurs 10-14 days after fertilization and just happens to correspond to the first day of the missed menstrual period," says Dr. Luo. But implantation bleeding is a diagnosis of exclusion rather than a necessary sign of early pregnancy. This bleeding is evaluated to rule out complications like ectopic pregnancy or miscarriage.
Friendly reminder here that experiencing these symptoms does not necessarily indicate a pregnancy. A positive pregnancy test followed by doctor confirmation is the only thing that does with certainty.
What can you do to take care of yourself during the two-week wait?
For many people, the two-week wait brings about a lot of anxiety — so it's especially important to keep tabs on your mental health during this time. We asked the Modern Fertility staff therapist, Meghan Cassidy, LCSW-C, how she recommends doing that while waiting to take that pregnancy test.
Practice awareness of what you're feeling and try being still with yourself.
"You can literally ask yourself, 'why am I symptom-checking?’ and see what answer comes up." Meghan says. "It might be a variety of answers, but very often it can help discover what you are actually feeling: scared, angry, fearful."
After identifying what you're feeling, it's time to try for stillness. "Take a few slow deep breaths if that helps you center, and pay attention to the behavior that is keeping you from feeling relaxed or calm," Meghan says.
"You can literally ask yourself, 'why am I symptom-checking?’ and see what answer comes up."
Move your body through your emotions.
The stillness Meghan recommends can help you understand what you're feeling a bit better and take steps to address any negative emotions. But it's about dealing with those emotions rather than avoiding them.
"Feeling fear or emotional pain is vulnerable and our brains try to avoid these emotions at all cost, which can lead to trying to feel better by distracting, suppressing emotions, or trying to control them," Meghan explains. "Unfortunately, none of these tactics actually work — instead we need to allow difficult emotions to literally move through our bodies."
Meghan recommends some of the following ways to move through these emotions:
Physical closeness with a loved one
Crying or screaming
What works best is unique for each person, so try experimenting with different ways to move through your emotions so you can land on the right one for you.
"We need to allow difficult emotions to literally move through our bodies."
Ask yourself what you need right now and try giving that to yourself.
"Let yourself know that it is okay to feel this way. Let yourself know that you are here and want to help this part of you to feel comforted during this difficult time," Meghan says. "Ask the part of you who is holding pain, 'what do you need right now to feel better?' Try to give yourself the comfort this part of you asks for." Basically, treat yourself just like you would a friend who's dealing with the two-week wait.
What can you do to prepare in case you are pregnant?
"Many adopt pregnancy diet recommendations (no alcohol, no sushi, etc) while trying to conceive and I generally say that only seems necessary to do so if that provides you with comfort and a sense of control," explains Dr. Luo. "That being said, I'm a huge proponent of preconception counseling with your OB-GYN to discuss your medical history and medications to determine if there are any changes that should be made before TTC." Some recommended changes may be treating existing conditions or switching medications that aren't safe for pregnancy.
You’ve gotten a positive pregnancy test, now what?
So, you’ve waited patiently (or maybe not so patiently, we won’t judge) through your two weeks and you’ve gotten a positive pregnancy test. The first thing you’ll want to do is call your healthcare provider and book an appointment.
Your first prenatal appointment will be set for about eight weeks out from your last menstrual period (LMP) so your doctor can confirm your pregnancy with a urine or blood test and do an ultrasound to confirm safe implantation within the uterus. (In about 2% of pregnancies, implantation can happen within the fallopian tube — a dangerous complication known as an ectopic pregnancy.) This appointment is also a good time to bring up any questions you have about your pregnancy — and it's often a longer appointment given how much information there is to cover.
Why call your healthcare provider right away if you're not going in until eight weeks? "Since COVID-19, many practices have adopted a change where that first appointment can be done as early as 5-8 weeks to review your medical history, current symptoms, make sure you are taking a prenatal vitamin, etc. Then this is followed by an in-person visit at 8-11 weeks. An ultrasound may be ordered asynchronously," explains Dr. Luo. "The reason why I advocate establishing care earlier rather than later is so you have a place to go if symptoms such as bleeding, cramping, sudden abdominal pain, or life-disrupting nausea occur. When established with a practice early, they can help you through these symptoms rather than sending you to the emergency department."
If you have any concerning symptoms, like bleeding, cramping, or sudden abdominal pain, get in touch with your provider as soon as possible.
The bottom line
When you're waiting to start testing for pregnancy after trying to conceive, it can be a really challenging time. Try to show yourself some compassion and let yourself feel what you need to to get through it.
The two-week wait can be a tough time, but know that Modern Fertility and your healthcare provider are always here for you.
This article was medically reviewed by Dr. Eva Marie Luo, MD, MBA, OB-GYN at Beth Israel Deaconess Medical Center and Clinical Lead for Value at the Center for Healthcare Delivery Science at Beth Israel Deaconess Medical Center.
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.