Getting Through the 9 to 12 Day Wait after yourEmbryo Transfer
Commonly Asked Questions
For most patients who undergo an egg donor embryo transfer, the 9 to 12 day wait before you have your beta 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, and came up with some answers to your pressing questions.
Q: What is the 9 to 12 day wait?
A: This wait is the period of time between the end of your embryo transfer and beta hCG blood test—the test that determines whether or not you’re pregnant. It takes about 9 days from the time a blastocyst embryo 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, 9 days after your embryo transfer you will visit your OBGYN 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 performed in the clinic.
Q: What is happening to my body during the first two-week?
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 emvryo transfer 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 your OBGYN 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 embryo transfer. 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 the 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 OBGYN for examination should any symptoms 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 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.
You will require several ultrasounds usually between six to seven weeks to determine if the embryo continues to develop into a fetus. At about eight plus weeks, you will continue your prenatal care with your fertility specialist.
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. Determining gestational age after fresh and frozen embryo transfers can be done by calculating the number of days since the embryo transfer. For fresh embryo transfers, the gestational age is calculated from the date of the embryo transfer. For frozen embryo transfers, the gestational age is calculated from the date of the embryo’s original creation, which is typically the date of egg retrieval.
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 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 the embryo did not implant and you arent pregnant dont panic please, we will advise you to stop your medications. You will have the opportunity to talk with us to review the previous transfer and make a decision together about your second embryo transfer.
Q: How long after a failed embryo transfer can I do ?
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.
