"Dear Infertility" Episode 3: The Two-Week Wait

The dreaded two-week wait: those 9-14 days after ovulation, an IUI procedure, or an embryo transfer during which time feels like it has stopped entirely while you wait to find out if you're pregnant. In this episode of "Dear Infertility," we take real questions from real fertility patients about navigating the two-week wait and share research-backed tips and strategies for how to cope. To learn more about Rescripted and to join our free fertility support community, head to our website at Rescripted.com.

Published on February 7, 2022

Rescripted _Ep3_The Two-Week Wait: Audio automatically transcribed by Sonix

Rescripted _Ep3_The Two-Week Wait: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Kristyn Hodgdon:
Hi, I'm Kristyn Hodgdon, an IVF mom, current IVF patient, and co-founder of Rescripted.

Ali Domar:
And I'm Dr. Ali Domar, a thirty-four-year fertility industry veteran, psychologist, and expert in the mind-body relationship between stress and infertility.

Kristyn Hodgdon:
Welcome to Dear Infertility, the first-ever podcast that doubles as an advice column for those dealing with the daily stressors related to infertility and pregnancy loss.

Ali Domar:
We're here to answer your real-life questions related to the mental and emotional toll of infertility, while providing research-backed tactics and strategies for overcoming these dilemmas.

Kristyn Hodgdon:
Now, let's dive in and help you find calm on this stressful journey.

Kristyn Hodgdon:
Hi, everyone, and welcome back to the Dear Infertility podcast, I'm Kristyn, your host, and I'm joined with Dr. Ali Domar. Hi, Ali, how are you?

Ali Domar:
Hey! I'm good, Kristyn, how are you?

Kristyn Hodgdon:
I'm doing well. Today, we're going to be talking about the two-week wait or as I like to call it, the dreaded two-week wait, you know, that period of time after you have, well, not usually sex in this community, but.

Ali Domar:
Oh no, you might have had sex, don't let's us say people are completely abstaining from sex.

Kristyn Hodgdon:
Yeah, yeah. So you know, that dreaded waiting period after a cycle before you find out whether you're pregnant or not. So we got a ton of questions about this topic, and the top one was how do I stop obsessing over every possible symptom during the two-week wait?

Ali Domar:
So it's a good question, I get asked this all the time, and I think a part of it is also whether or not you're on progesterone because, you know, although progesterone is a great drug, because it, you know, increases the chances of getting pregnant, it's also an evil drug because it imitates the symptoms of early pregnancy. And so we have this thing at Boston IVF that after someone has an embryo transfer or handed this worksheet that I wrote and basically how to stay sane during the two-week wait. And a lot of what I talk about is as much as you would like to monitor your physical symptoms, you can't, because progesterone can make your breasts sore, and they can make you feel bloated and it can make you have to pee all the time, which are all symptoms of early pregnancy. And in fact, most women who are pregnant don't show symptoms that early. And so anything you're feeling during that two-week wait means nothing. So you can have spotting and that might mean you're pregnant or might mean you're not pregnant. You can have cramping, and that might mean you're pregnant, or it might mean you're not pregnant. If you keep on squeezing your breasts, they're going to get sore. So you kind of, you know, here, I am someone who's been preaching my whole career in the mind-body connection, and I'm telling you for that two weeks, you got kind of sort of cut yourself off at the neck because pretty much nothing your body is telling you means anything for sure.

Kristyn Hodgdon:
Yeah, I love the term pregnant until proven otherwise, because I think it kind of creates a sense of like, treat yourself well during that time, physically, emotionally, you know, treat yourself like your cycle worked and then, you know, be pleasantly surprised if it does.

Ali Domar:
Well, I would say that works in terms of physical stuff like I would say, you know, don't drink a ton of coffee, don't drink any alcohol, don't do drugs, don't run a marathon, you know. So I think physically you do need to treat yourself as though you're pregnant. I think psychologically, it really depends on the individual because I think for some people, it really helps them to think of themselves as pregnant because they believe that being hopeful might increase their chances of getting pregnant. I think there are other people, and I think I have a lot of patients who fall into this category who try not to think about it, because if they allow themselves to be hopeful that crash just feels a whole lot more intense. And so I do tell my patients, you know, distract yourself in any way possible, you know, get some really juicy books to read, get, you know, start watching some, something on streaming TV that's all-encompassing, you know, take long walks with people, try to distract yourself because, you know, it's a very individual thing. If it's going to help you to be optimistic, be optimistic. If it's going to help you not to be optimistic, then just put it out of your mind. But the problem is you really can't read your body. And so if you, you know, you know, this is, you know, Liz Gayle and I wrote the app Ferticalm and one of the most popular parts of it is the two-week wait. And how can you cope with a two-week wait? And, you know, do relaxation techniques, do mini-relaxation techniques, you know, challenge automatic negative thought patterns, come up with snappy comeback lines for people who are saying stupid things to you, et cetera, et cetera. I mean, you might want to map it out ahead of time. You know, you got plenty of time during the first two weeks of your cycle to plan how you're going to cope with a second two weeks of your cycle and you know yourself way better than, you know, I know you, obviously. So think about what you might need during those two weeks to make it easier for you.

Kristyn Hodgdon:
Absolutely.

Ali Domar:
I will, I will say that I do tell all my patients to always have a Plan B. Like, if this cycle doesn't work, I'm going to ask my physician for a different protocol, I'm going to get a second opinion, I'm going to take a break of two months, I'm going to stop drinking caffeine, I have one patient right now who decided because she's overweight, that she's going to spend a few months losing weight to increase her chances, have a plan in case this doesn't work, don't you stick to it but have something, so if you have a negative, that big fat negative, you're not like, oh my god, what do I do now?

Kristyn Hodgdon:
That's so true. I, I always felt so much better having a plan because this process, is so, like it's just so much out of your control. And, you know, I've heard it said a lot that like I've worked hard my whole life and I've always been taught that if I work hard, I will get what what I want. But that's not true with infertility and.

Ali Domar:
But it's true to a certain point. I mean, there are things you can do to increase your chances. And you know, I think we think that, you know, in modern medicine can compensate for everything, but it doesn't. I mean, if you are morbidly obese or if you are seriously underweight, that's going to decrease your chances of getting pregnant. If you smoke cigarettes, that's going to decrease your chances of getting pregnant. If you drink a ton of caffeine or a lot of alcohol, that's likely to decrease your chances of getting pregnant. If you're depressed or very anxious, that might decrease your chances of getting pregnant. So focus on the things you can control and maybe let go of the things you can't.

Kristyn Hodgdon:
Absolutely. Ok, so we got another question from our community, and it is, it's so hard to stay hopeful after so much disappointment, do you have any tips for getting out of a negative headspace after multiple losses and failed transfers?

Ali Domar:
Yeah, I hear this one every day because it is devastating. You know, when you do any kind of treatment, you put your heart and soul into this and you're hopeful and you're excited and et cetera, et cetera, and then if it not doesn't work, you feel completely defeated. So I think one thing that I talked to my patients about and we actually this is a big part of the Mind-Body Fertility Program at Rescripted is challenging these automatic negative thought patterns. And you know, most people going through infertility have thoughts like, I'm never going to get pregnant, the infertility is all my fault. I mean, there are all these things that go through our heads over and over again, and I think one thing that is important is to actually become cognizant of some of the thoughts going through your head and challenging them. Because what it really comes down to, if you knew this wasn't going to work, you wouldn't be trying. And so you have to.

Kristyn Hodgdon:
Good point.

Ali Domar:
There has to be a little bit of hope inside, and what you need to do is figure out how can I nurture that kernel of hope rather than letting pessimism take over?

Kristyn Hodgdon:
Absolutely. So someone also asked, what would you suggest to help with sleep? I have TTC-related anxiety that hits hard at night.

Ali Domar:
Interesting because a study just came out. Well, so .... come out a while ago, I read about it yesterday, looking at the relationships between sleep and fertility, and it's, you know, most people going through infertility report issues with sleep because you might be able to stay busy and distracted all day and then you get into bed and you either can't fall asleep because you're thinking about it or you wake up in the middle of the night and think about it, or you wake up early in the morning and you think about it. So, you know, there are a number of things. One is to try to, you know, jot down your thoughts and fears before you go to bed. And so that way you don't, you know, you've gotten them written down, you don't have to worry. You know, there's this concept called sleep hygiene, where you can Google sleep hygiene, it's like 10 different things that you need to do to really have a good night's sleep. One of the hardest of which is to only use your bed for sex and sleep. And I have a patient now who's had insomnia for months and months and months, and she literally eats dinner, goes upstairs, gets into her bed and either watches TV in her bed or reads on her tablet, every night. And I said, well, but that means your body is conditioned to be in bed and be awake.

Kristyn Hodgdon:
Right.

Ali Domar:
You need your body to be conditioned, other than sex that when it's in bed, it's sleeping. And so you need to literally use your bed only for sex and sleep. You cannot sit in bed and read, you cannot sit in bed and watch TV. You also really don't want to use a phone or a tablet before you go to bed, because the light makes your brain think, oh, we're wide awake, because we're reading or we're watching TV on our tablets. So you really, sleep hygiene is very effective, it's actually pretty easy to cure sleep issues. You just have to follow a pretty strict guidelines. I also think this is a, you know, infertility is a very good time to incorporate relaxation into your day-to-day life. You know, we have all of our patients, either in the Mind-Body program that we have physically or Mind-Body Fertility patients are taught a new relaxation technique every week, and we basically force them to practice it every day so that their baseline level of anxiety comes down and it actually makes sleep a lot easier. We also teach what are called mini-relaxation exercises that you can do during the night when you can't sleep, which calms you down and allows you to fall asleep.

Kristyn Hodgdon:
That's awesome. I need some relaxation techniques in my life.

Ali Domar:
Don't we all?

Kristyn Hodgdon:
So something I was curious about, you know, when you're going through IVF, especially a lot of the things that you usually do to relax or unwind like exercise, are kind of limited, so how can you kind of combat that, especially during the two-week wait, like, do you just tone it down, do you? What are some of the relaxation techniques that you teach in the course that you recommend doing like if normally high intensity exercises like your stress reliever.

Ali Domar:
Right. You know, it's a tough one because, you know, I feel like I can split my brain and my patients who are not currently trying to get pregnant, I'm trying to get them to exercise more vigorously and my infertility patients, I'm trying to get them to dial back a little bit on the intensity of their exercise. I mean, there's a huge amount of controversy in terms of what is the relationship between exercise and fertility, and, you know, people fight about it all the time. I personally believe that very vigorous exercise is contraindicated, that if you're running every day or vigorously using an exercise bike or whatever, that might decrease your chances of fertility. There is some data to show that some women are reproductively sensitive to exercise, and we just don't know who those women are. And so I have had dozens and dozens and dozens and dozens of patients where all they did was dial back on the intensity of exercise and they got pregnant. And so I do recommend to all my patients that, you know, just try it for a couple of months, dial back. On the other hand, because exercise is such a good stress reliever, I don't want people to stop exercising or cut back on exercise because then they're going to get stressed out. So, you know, walking, swimming, slow bicycling, those are all fine, you know, moderate exercise is a really, really good thing. And on the day that we talk to patients about decreasing the intensity of their exercise, we also talk to them about adding like a yoga practice. I mean, Hatha yoga, I'm not talking about hot, sweaty, whatever those are called yoga, I'm talking about Hatha Yoga, which are postures and relaxations which put you into a deep sense of calm relaxation. And you know, that will keep you fit and toned. But it would not interfere with the reproductive system. And there actually have been a couple of studies showing that women who did Hatha yoga actually had higher pregnancy rates.

Kristyn Hodgdon:
Wow.

Ali Domar:
So it's a good thing to do.

Kristyn Hodgdon:
That's awesome. I wonder if there are some YouTube videos for Hatha Yoga, I'm sure there are.

Ali Domar:
I can guarantee you there are tons of fertility yoga things out there. I would just say, make sure it's gentle Hatha yoga and not the hot, sweaty, whatever it's called yoga.

Kristyn Hodgdon:
Right. So my favorite question, what would you read script about how people think about the two week wait?

Ali Domar:
Good question. I would say, how can I distract myself on a day-to-day basis? So, you know, as opposed to saying, Oh my God, I have 13 more days, how am I to get through 13 more days? I say, okay, what can I do today? How can I take care of myself today? How can I distract myself today? What do I need today? And when today is over, tomorrow, you wake up and say the same things to yourself and do that every day for the two weeks.

Kristyn Hodgdon:
Infertility is a really good lesson in taking things day-by-day, because I remember if I, if I would look at the months ahead or even the week ahead sometimes, I would get so overwhelmed. But when I just took it one day at a time, and that's such a cliché thing to say, one, take it one day at a time, but you kind of have to, because otherwise it just feels like too much to bear.

Ali Domar:
Well, and hopefully every person listening, I'm going to say the same thing is going to happen when you're pregnant after infertility. Like, it feels like I'm never going to get through to the second blood test, I'm never going to get to the first ultrasound, I'm never going to get through the first trimester, and you just have to take it day by day.

Kristyn Hodgdon:
Absolutely. Well, thank you as always, Ali, and thank you all for tuning in. We'll chat with you next time.

Kristyn Hodgdon:
Thank you for tuning into this episode of Dear Infertility. We hope it helps you find calm during this incredibly stressful time. Whatever you're currently struggling with, Rescripted is here to hold your hand every step of the way. If you like today's episode and want to stay up to date on our podcast, don't forget to click Subscribe. To find this episode, show notes, resources and more, head to Rescripted.com, and be sure to join our free fertility support community while you're there.

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