The two-week wait, AKA the “TWW,” refers to the period following ovulation and a pregnancy attempt, during which you wait to see if you’re pregnant. The two-week wait can be full of excitement, anxiety, and anticipation while you wait to take a pregnancy test, or for your or your partner’s period to begin. If you tried to conceive with a fertility treatment like in vitro fertilization (IVF), you may experience extra anxiety during the two-week wait.
This article will help you understand the timing of ovulation and pregnancy, symptoms to look for during the two week wait, and ways to manage stress and anxiety during this time.
- The two-week wait is the time period between a pregnancy attempt and being able to find out whether you’re pregnant. Taking a pregnancy test too early during this period may yield false results.
- Physical symptoms you experience during this time may be early signs of pregnancy, or they could be premenstrual symptoms.
- It’s important to take care of yourself and find ways to reduce your stress during this interval.
Overview of the ovulation cycle
To understand the two-week wait, it’s first important to know what goes on during your or your partner’s ovulation and menstrual cycle.
The menstrual cycle starts on the first day of each period and generally lasts about 24 to 38 days (with an average of 28 days). The time varies between people and may also be different each month.
A typical cycle looks like this:
Days 1–5: Menstruation, commonly known as your period. The uterus sheds its previous lining through vaginal bleeding.
Days 5–14: Follicular phase. Increased estrogen hormone levels prompt follicles (immature eggs) in the ovaries to mature.
Day 14: Ovulation. Luteinizing hormone (LH) increases during this time to trigger ovulation. The follicle releases an egg. The egg only survives for around 12 to 24 hours following ovulation if it’s not fertilized by sperm.
Day 15–28: Luteal phase. During this period, progesterone drives the uterine lining to thicken in preparation for a potential pregnancy. If fertilization occurs, the fertilized egg may implant in the uterine lining. If no fertilization occurs, estrogen and progesterone hormone levels will decrease and menstruation will occur, and the cycle restarts.
For a person with ovaries, this process repeats throughout their life, except during pregnancy and sometimes when breastfeeding. The cycle will continue until they reach menopause around age 52.
In order to create a pregnancy naturally, you’ll need to have sex just prior to ovulation. Sperm can survive in the female reproductive system for about 3–5 days, so the 5 days prior to ovulation are the best days to have sex to get pregnant. This is known as the “fertile window.”
The hormonal changes of the luteal phase can also cause symptoms associated with premenstrual syndrome (PMS), such as:
- swollen breasts
- back pain
- sleep issues
- mood swings
When to take an at-home pregnancy test
A pregnancy test works by detecting the human chorionic gonadotropin (hCG) hormone in a person’s urine. The body starts releasing this hormone when a fertilized egg implants in the uterus lining. It can take two to three weeks after having sex for hCG to reach detectable levels in a person’s urine. That’s typically about the point when a person would expect their next menstrual period to begin.
With natural conception, it’s best to wait until at least the first day of your expected period to take an at-home pregnancy test. The average home pregnancy test can detect hCG if the concentration is at least 25mIU per mL of urine. Studies show that most pregnancies don't exceed this level until about 13 days past ovulation. The majority of tests will be most accurate starting from this point.
|Days since ovulation||Days before period (in 28-day cycle)||Median hCG concentration|
Some more sensitive tests may be able to detect hCG sooner, but the accuracy and reliability of those tests may be questionable.
What if you aren’t sure when you ovulated, when your next period should start, or your cycles are irregular? Wait at least 14–21 days after having unprotected sex to take a home pregnancy test.
It’s possible for at-home pregnancy tests to give a false negative result if you take the test too soon, don’t precisely follow the instructions, are taking certain medications that could affect the results, or if the test has expired.
If you take a pregnancy test less than two weeks after ovulation or unprotected sex and it’s negative, that doesn’t mean you’re not pregnant. Wait a few days and try taking a test again.
The “two-week wait” is this period — after ovulation and unprotected sex — when a person or couple is waiting until a home pregnancy test can accurately tell them whether or not they’re expecting.
The two-week wait after fertility treatment
The two-week wait happens after planned sexual intercourse, but it also occurs after a fertility treatment like intrauterine insemination (IUI) or IVF.
Two-week wait after IUI
IUI is a type of artificial insemination. With this procedure, sperm is injected directly inside the uterus, helping it get closer to the egg to fertilize. Intrauterine insemination is done during ovulation to increase the chances of achieving pregnancy.
After the IUI procedure, the process of fertilization and implantation is exactly the same as during natural conception. A blood pregnancy test about two weeks later should be able to identify whether an IUI was successful.
Some IUI procedures involve medication, such as a “trigger shot” that spurs ovulation. This trigger shot sometimes contains hCG — the very same hormone that home pregnancy tests are measuring. Therefore, taking a pregnancy test too soon after an IUI may result in a false positive result, as the hCG from the trigger shot hasn’t cleared the system yet.
It may be difficult to wait two weeks after your IUI to take a pregnancy test, but for the most accurate results, it’s best to hold off until your doctor can see your blood work.
Two-week wait after IVF
IVF is a method of assisted reproduction in which an egg is combined with sperm outside the body to create embryo(s), which is then implanted into the uterus. The embryo transfer procedure is typically done about 5 days after ovulation.
Having an embryo transfer doesn’t automatically mean a person is pregnant. The process only results in a pregnancy if the embryo successfully attaches to the lining of the uterus. As a result, the embryo transfer begins the two-week wait to know if the procedure led to a pregnancy. Typically about two weeks after the embryo transfer, a blood pregnancy test will confirm a pregnancy.
Just as with IUI, taking an hCG trigger as part of your IVF protocol can interfere with the results of a home pregnancy test, and can give a false positive result if you take the test too early. It’s recommended to wait for the blood test at your IVF clinic for the most reliable results.
What to expect during the two-week wait
You’ll likely feel a variety of emotional and physical symptoms during your two-week wait. It’s normal to feel anxious during the two-week wait. You may feel a mixture of hope, worry, excitement, stress, and frustration.
Symptoms of early pregnancy — or menstruation?
During the two-week wait, you may feel physical symptoms, including:
- breast tenderness
You or your partner may be tempted to analyze every symptom as a sign of early pregnancy. It can be frustrating, but important, to remember that early pregnancy signs mimic PMS symptoms, making it hard for a person to tell if they’re pregnant during the two-week wait.
The most reliable symptom of early pregnancy is a missed or late menstrual period. If your or your partner’s period seems to be late by a day or more, that’s a good sign you may be pregnant and that it’s time to take a pregnancy test. (Tracking cycles will give you a better idea of when that period is expected.)
If you or your partner have chest pain, a fever, shortness of breath, or lower stomach pain, it’s important to call your doctor.
Managing stress and anxiety during the two-week wait
If you’re feeling anxious about trying to conceive or infertility, that anxiety may be amplified during the two-week wait. This is a period in which all you can really do is wait — that lack of control can be especially difficult for some people!
It may help to:
- Share your feelings with your partner, or lean on your friends and family for support.
- Connect with people who are going through the same thing, such as through online groups or social media.
- Plan ahead to do things you enjoy. It may help to schedule something exciting during the two-week wait as a way to distract yourself from worrying.
- Meditate, do yoga, or try some exercise (check with your doctor to find out what’s appropriate).
- Talk with a therapist, especially one who specializes in infertility issues.
If you've been trying to get pregnant without success, we recommend doing a semen analysis. This simple mail-in test can assess the fertility of your or your partner's sperm, and highlight issues that might be impeding your ability to conceive.