Commonly Asked Questions
For most patients who undergo fertility treatment, the two-week wait before you have
your beta (pregnancy) test can seem like an eternity. Each day seems longer than the
last, and the question “Am I pregnant?” goes through your mind hundreds of times a
day. One becomes hyperaware of your body’s every sensation. We all sympathize and
wish there were some medical way to make the time shorter or easier for you. In an
effort to ease some of the anxienty, we gathered some questions from our community,
ran them by our nurse educators, and came up with some answers to your pressing
two-week wait questions.
Q: What is the two-week wait?
A: The two-week wait is the period of time between the end of your fertility treatment
cycle and beta hCG blood test—the test that determines whether or not you’re
pregnant. It takes about two weeks from the time a fertilized egg implants in the uterine
wall to start emitting enough of the hormone hCG (human chorionic gonadotropin) to be
detected by a blood test. We sometimes call the test a “beta” because the test actually
measures a beta chain portion of the hCG hormone molecule and is officially named a
“beta HCG test.”
Q: Can I take a home pregnancy test to see if I’m pregnant?
A: We recommend that you refrain from performing a home pregnancy test as they can
render false results, either a false negative or false positive. A false positive result may
be due to the fact that in many of our treatments, hCG, the same hormone that
measures pregnancy, is given to “trigger” ovulation in many of our patients. Traces of
the administered hCG can still be in your bloodstream and detectable by a test, even if
implantation has not occurred. A false negative might occur as a low level of hCG may
be undetectable in a urine test, despite a pregnancy starting, as urine tests are less
sensitive than the blood hormone tests we use.
On average, two weeks after your IUI or embryo transfer you will come back to our
center for your pregnancy test. This test is done by blood draw and measures the hCG
levels produced by the developing embryo. The most reliable pregnancy test is the
blood test we perform in our offices.
Q: What is happening to my body during the two-week wait?
A: During this time, you may feel as if you are about to start your period. Your body has
been through a lot and the medications you’re taking are designed to promote the
optimal environment for pregnancy. You may experience some cramping, spotting, or
light bleeding, abdominal bloating, fatigue, and breast tenderness. While you may be

slightly alarmed to experience some of these symptoms, they are normal and do not
signify that you are or are not pregnant.
Please note, if after your treatment you feel excessive bloating, shortness of breath,
chest pain, or lower abdominal pain, you may have ovarian hyperstimulation and should
call your clinical team immediately.
Q: Will I be taking medications during this time?
A: Yes. Most patients need to continue to take progesterone supplements in order to
produce the same levels of hormones that would occur in early stages of pregnancy.
While most patients will supplement their progesterone via pill or vaginal insert, patients
who are using donor egg or frozen embryos will use the injectable form of progesterone
for their cycles.
Additionally, patients who undergo IVF, donor egg, or frozen embryo transfers may also
be prescribed estrogen supplements to help thicken and maintain the uterine lining.
Please do not stop taking these medications until you have been advised by the medical
staff to do so.
Q: Can I continue my normal day-to-day activities during the two-week wait?
A: We tell all of our patients to be cautious during their first five days after their
treatment. We recommend that you refrain from strenuous physical activities as well as
sexual activities during that time as they may cause uterine contractions that might
impair the implantation process. There is also a greater risk during that time of ovarian
issues arising since, for many patients, the ovaries are still slightly enlarged at that
point.
After those first few days, you can start to do light aerobic activities such as yoga,
swimming, moderate walking and swimming, and lightweight training on a step machine
or elliptical trainers—activities that can get your heart rate up, but are not demanding or
heavily impact the body like jogging, impact aerobics, or treadmills.
Q: Do I need to adjust my diet during this time?
A: No special diet is required, but we recommend that you start making nutritional
choices as if you’re already pregnant. This means eating well-balanced meals, no sushi
or other raw or undercooked meats, avoiding high-mercury fish and soft cheeses, no
alcohol, and continuing to take prenatal vitamins.
Q: Can I travel during the two-week wait (or thereafter if pregnant)?
A: We prefer that patients avoid traveling for the first few days post-treatment, primarily
so that you are close to our center for examination should any problems develop. This
also is true during and following the time of your pregnancy testing and ultrasound.

Early pregnancy complications such as hyperstimulation, bleeding, or pain can occur
and we would want you near your team here for care. In addition, the rigors of travel,
time zone changes, luggage, etc. leave you vulnerable to complications. Before you
schedule travel during this period of time, check with your nurse and team to see if this
is at all advisable.
Q: What levels of hCG will determine if I’m pregnant?
A: Any positive level of beta hCG above 5 mIu/ml indicates a pregnancy has started
(unless the test is done too early following an HCG trigger injection). A blood hCG
number over 100 is a good first beta result, but many, many ongoing pregnancies start
out with a beta hCG level below that number. Higher numbers cannot predict a multiple
pregnancy; only the ultrasound can determine that.
Additional beta tests will be performed every 48 hours after the first positive test to
confirm the hCG level continue to rise. We look for the level of hCG to rise about 60
percent or more in each of the additional tests. If the number continues to increase,
we’re more confident that it’s likely a viable pregnancy.
We will then have you come in for ultrasounds usually between six to seven weeks to
determine if the embryo continues to develop into a fetus. At about eight plus weeks,
our center will refer you back to your OB-GYN to continue your prenatal care.
Q: If I am pregnant, how do you “count” how far along we are?
A: As soon as it is determined that you are pregnant, we revert to the obstetrical
counting / dating system. This is done to avoid using one set of dates from the time of
an IUI or IVF versus another set of dates used by obstetricians. The OB doctors
determine pregnancy dating to be from the last menstrual period, at least two weeks
prior to ovulation. Obviously, we often know more about when ovulation may have
occurred than usually they do, but for convention, we add two weeks to our dates to
conform with the OB. As an example, if we know when ovulation was triggered and an
IUI or IVF was performed, your beta might be two weeks thereafter. If it is positive, the
OB would say you are FOUR weeks pregnant, not two, and therefore so do we.
Your first early pregnancy ultrasound is usually scheduled between six to seven weeks
gestational age. That is actually only four to five weeks from your IUI or embryo transfer.
You just saved two weeks off the length of a 40-week pregnancy!!
Q: What are my next steps if I’m not pregnant?
A: If you aren’t successful, your nurse will advise you to stop your medications. You will
have the opportunity to talk with your physician to review the past cycle and make a
decision together about your next steps.
Q: How long after a failed cycle can I do another cycle?

A: While your physician will determine the timing of a new cycle, it’s not always
necessary to take time off between cycles unless otherwise directed. Many of our
patients are able to begin their next treatment cycle immediately, and for many, a cycle
of rest is recommended.
We know that these two weeks can be a very stressful time. If you’re looking for ways to
help pass the time, you can reach out and get support from patients who understand
what you are going through. If you have any questions, please don’t hesitate to call us.