I’m currently in the two-week wait following my fourth frozen embryo transfer, and honestly, it feels like the stakes couldn’t be any higher for us than they are right now. On one hand, I’m hopeful: we did a whole slew of testing following our last failed transfer, and my doctor changed up my protocol due to the results of my ERA (Endometrial Receptivity Analysis).
On the other hand, I’m terrified. In the past year, I have had an early miscarriage, moved forward with PGT-A testing, and grieved two failed transfers with euploid (normal) embryos. Since I’ve had a successful pregnancy before, there seems to be a lot of head-scratching as to why my body can’t seem to do it again. And while we think we have a plan for moving forward if this embryo doesn’t stick, I am finding myself very uneasy about what it means if this cycle is unsuccessful.
While I’m in the dreaded two-week wait – this gray area of uncertainty where I’m filled to the brim with equal parts hope and fear – I thought I would share what to expect after an embryo transfer, so that if like me, you happen to be going down a Google rabbit hole right now, maybe you’ll land on this article and be assured that you are not alone.
What can I expect after an embryo transfer?
First of all, congratulations! Whether you’ve been through multiple egg retrievals or just one, making it to an embryo transfer is a huge accomplishment in and of itself. If you’re reading this before your procedure, transfer day can be an emotional experience filled with lots of hope. Afterward, you’re officially PUPO (Pregnant Until Proven Otherwise), and you’re one step closer to your goal of a healthy baby. But next comes the hard part, the dreaded two-week wait.
Let’s face it: the two-week wait after an embryo transfer is the worst kind of emotional rollercoaster. Put simply, you’ve made it this far, but it feels like you still have a long way to go. And for those of us who have been through infertility and pregnancy loss, it can be a catch-22: you’re terrified of not getting pregnant, but you’re equally as afraid of what will happen if you do.
While navigating the unpredictability, it’s important to remember that two things can be true at once: you can be hopeful and fearful at the same time. It’s only natural to guard your heart when you’ve already been through so much heartbreak, so try to cut yourself some slack and focus on taking care of your mind and body during this time.
So, what happens after an embryo transfer, day by day?
Now, for the science (kind of). Depending on whether you’re doing a fresh embryo transfer or a frozen one, once a blastocyst is transferred into the uterus, it typically takes 9 days until hCG levels are high enough to detect on a beta blood pregnancy test. Whether or not to test early at home is completely up to you, but during the days following an embryo transfer, this is what you can expect, both physically and, in my case, emotionally:
Day 1: The blastocyst begins to hatch out of its shell.
This is usually when I am the most at peace following an embryo transfer. Will this finally be our time?
Day 2: The blastocyst continues to hatch out of its shell and begins to attach itself to the uterus.
Still keeping my cool, HBU?
Day 3: The blastocyst attaches deeper into the uterine lining, beginning implantation.
Okay, so, is this implantation bleeding or my period? (Furiously searches Google)
Day 4: Implantation continues.
*Starts wondering if a home pregnancy test would be positive if I took one now*
Day 5: Implantation is complete. Cells that eventually become the placenta and fetus have begun to develop.
This is around the time when my nerves start kicking in. I could take a test, but what if it’s negative? If it’s positive, will the line continue to darken, or will it be another chemical pregnancy? The hypotheticals are endless.
Day 6: Human chorionic gonadotropin (hCG), the hormone that signals a developing pregnancy, starts to enter the bloodstream.
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To test, or not to test. That is the question.
Days 7 and 8: Fetal development continues and hCG continues to be secreted.
It’s taking everything in me not to test early right now. Or maybe I already did and am wishing I hadn't.
Day 9: Levels of hCG are now high enough in maternal blood to detect pregnancy using a blood test.
Wake, pray, it’s beta day. Here goes nothing!
For those of you who have been down this road before, did I miss anything? Currently, I’m on day 5 post-embryo transfer, and I still have no idea how this cycle is going to go. Will I test early? Maybe. Will it be positive? Hopefully. If not, will we move forward with another egg retrieval, or should we get a second opinion? I honestly have no idea. I thought I did, but now I’m not so sure.
One second, I’m manifesting a healthy baby at the end of all of this, and the next, I’m planning out my next steps if this cycle doesn’t work. Right now, I’m simply taking it day by day, and if that describes you too, that's okay. IVF is hard, and all we can do is give ourselves grace and let ourselves feel all of the feelings during the wait. After all, what else is there to do? Until we know for sure what the future holds, I’m sending you love and good vibes for a big fat positive.