• The IVF Two Week Wait (2WW): If and When to Do a Home Pregnancy Test

      The IVF two week wait is one of the most frustrating parts of the process for many women. There's not much to do during those two weeks but to ...wait. One frustrating way to pass the time is to perform as many home pregnancy tests as possible. If that's your plan for your cycle, this article will tell you more about the 2WW and when to test.


      To Test or Not to Test

      Different women have different ideas on whether or not to do a home pregnancy test (hpt) before their official beta hCG blood test date. Some women believe that the anxiety of a possible false negative is not worth the heartache, while others feel like testing gives them back a sense of control over the process. Unless you get your period before the date of your blood test, you will ultimately have a quantitative beta-hCG test through your doctor's office. Whether or not you test early - once or thirty times - is up to you.

      But if you do decide that you're going to pee on a stick (POAS) during the 2WW, you'll want to know when you can test - and this article will walk you through it.

      What Your Test Results Show

      A pregnancy test - whether done at home or done at a physician's office - reveals whether there are detectable amounts of hCG in your urine (home pregnancy tests) or bloodstream (doctors' office). hCG is the "pregnancy hormone", and everything you've ever wanted to know about it can be found on our Beta hCG Values and Facts page. For the information in this article, however, you only need to know:
      What is hCG?
      hCG is human chorionic gonadotropin, better known as "the pregnancy hormone." The body begins to produce hCG when an embryo begins to implant in a uterus, which is typically 5 to 7 days after conception.

      What is a beta test?
      A beta test, also known as beta hCG (human chorionic gonadotropin), is a blood test that confirms pregnancy. A qualitative hCG simply reports whether or not there is hCG present in the bloodstream (or urine), while a quantitative hCG reports the level of hormone that is present.
      So a home pregnancy test is a qualitative hCG test - it indicates whether or not there is any detectable hCG in your urine.

      When Can I Test?

      As much as you'd might be tempted to test on the ride home from your transfer, unfortunately you're going to have to wait. The ovulation "trigger" shot that you took prior to egg retrieval (or insemination, if you did an IUI) contains hCG; so if you test too soon, you'll pick up traces of the hCG trigger shot and not the hCG produced by a pregnancy. The dosage of the trigger shot usually varies between 5,000 to 20,000 I.U. of the drug; it comes in several brand names including Novarel, Ovidrel, Pregnyl, and Profasi. The hCG usually stays in your system 8 - 10 days after the trigger shot; this can vary depending on the dose given by your doctor and your body mass.

      So you absolutely don't want test until at least 9 days after your trigger shot and realistically, it's nearly impossible to get a positive test until 11 days after your trigger. I beg of you - please don't make yourself crazy or sick with worry by testing too soon. Save your money on those extra HPTs and wait until at least 11 days after your trigger shot to do a HPT.


      When to Start HPTs During the Two Week Wait (2WW)

      For a 3-day transfer, don't POAS (pee on a stick) until 6 days after transfer.
      For a 5-day transfer, don't POAS until 4 days after transfer.

      And Now for More Details About the 2WW

      The IVF 2WW can be a little confusing depending on whether you are dealing with a 3-day transfer (3dt) or a 5-day transfer (5dt). In our discussion forums hundreds of women talk about where they are in their cycle in ever-increasing combinations of letters and numbers, such as 3dp3dt or 4dp5dt (the first meaning three days after (post) a 3-day transfer, the second meaning four days after a 5-day transfer). For a frozen embryo transfer (FET), you can sync yourself up with the fresh transfer lingo by referring to your embryos; when they were frozen, were they frozen at 3 days or 5 days? If you have 3-day frozen embryos, you'll be a "3dt" person, and if you have 5-day embryos you'll be a "5dt" person.

      Still confused about the acronyms? Just take a peek (or bookmark) our acronym glossary.

      Here's another thing to know: most of the time, your nurses know this shorthand, too. And the wonderful IVF nurses who work with us every day know exactly how anxiety-producing this whole process can be, so if you have questions about any of your dates (When did I trigger? Were my embryos 3-day embryos?), you can call your nurse(s). Not only is all of that information clearly laid out in your chart, your nurses know how important these dates are for you.

      If you're a details person (like almost all other women going through IVF), you will love this next chart. It gives a day by day view of the IVF 2WW. Your IVF cycle started on day 1 - that's the first day of your period or the day your clinic marks as cycle day 1 (CD1). For the purposes of the 2WW this chart focuses on the second half of your cycle: from trigger (CD12) & ovulation (CD14) to the final outcome of either a period or a conclusive hCG test.


      A Day-by-Day Look at an IVF Two Week Wait

      Cycle Day Event Additional Information
      12 hCG trigger injection for ovulation induction
      13 (waiting) the time between trigger and retrieval is approximately 36 hours
      14 Retrieval Ovulation;
      start of luteal phase
      15 24-hour fertilization report
      16 (waiting)
      17 3-day transfer
      18 (waiting) 1dp3dt
      19 5-day transfer 2dp3dt
      20 (waiting) 3dp3dt;
      1dp5dt;
      Normal human embryos hatch and implant 5 - 7 days after fertilization.
      21 (waiting) 4dp3dt;
      2dp5dt
      22 10 days past trigger (the last day any hCG from the trigger shot should be in your system). 5dp3dt;
      3dp5dt
      23 Start HPTs today, using your first morning pee (hCG is present in urine in the highest concentration first thing in the morning). 6dp3dt;
      4dp5dt
      24 POAS (pee on a stick!) 7dp3dt;
      5dp5dt
      25 POAS 8dp3dt;
      6dp5dt
      26 POAS 9dp3dt;
      7dp5dt
      27 POAS 10dp3dt;
      8dp5dt
      28 Official Quantitative hCG Blood Test
      (This is done at your doctor's office or a lab.)
      11dp3dt;
      9dp5dt;
      Missed period (+) or beginning of period (-).

      It's Not Black and White (Or Plus and Minus, or BFP and BFN)

      These last two paragraphs are probably the most important ones of this article.

      All of the information in this article reflects a scientific "textbook" cycle, which assumes that everyone's body behaves exactly the way our doctors think they will behave. What actually happens during your cycle is very likely to be different from a "textbook" cycle. But IVF is still a relatively new medical procedure (the first IVF baby was conceived only 33 years ago) and there are still a lot of variables within our bodies that doctors don't understand.

      By definition, infertile women are statistical outliers. If our bodies were doing what they should, "textbook"-style, we wouldn't be dealing with IVF. Our bodies are unpredictable, which is why we are going through what we go through to try and conceive. No matter how closely your cycle mirrors the information here, if an over-the-counter "guaranteed" test turns up negative before your official quantitative beta-hCG blood test, that does not mean it's over. It just means your cycle is not textbook. The IVF world is full of women who had a negative HPT on the day before their beta and got pregnant with twins, or started to bleed a few days before their beta was due - only to find out it wasn't a period and they were pregnant. If you find yourself getting anxious or worried about your cycle, join our forums and come talk with others who have already gone through whatever it is you're dealing with. Our community members have learned the hard way that there is a lot more to IVF than the "textbook" facts. They'll share it all with you.

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