Congratulations, you’ve made it! You’ve done all the necessary preliminary testing, you’ve gone through stims and egg retrieval or the process of selecting a donor, you’ve worked your way through your pre-embryo transfer protocol calendar, and your transfer day has finally arrived. 

After the procedure, you’re sent home with instructions from your provider, and a strong recommendation to avoid taking an at-home pregnancy test. Instead, you’re directed to wait until your next appointment – an hCG (Human chorionic gonadotropin) blood test – to find out if your embryo has settled in for the long haul. 

Understandably, the days post-transfer can certainly be nerve-wracking and filled to the brim with anxiety. Mentally, you may be all over the place. But physically, what is happening to your body between transfer day and your hCG blood test?

The Post-Transfer Timeline for a 5-Day Transfer

Once your embryo has been transferred, the waiting period begins. This waiting period spans from the time of transfer to the time your hormone levels rise enough to indicate a pregnancy:

Day 1: Your blastocyst will begin to hatch out of its shell, and its cells continue to multiply.

Day 2: Your blastocyst continues to hatch. As it does, it starts the process of attaching to your uterine lining.

Day 3: Your blastocyst attaches more deeply into the uterine lining. This is the day that implantation is most often considered to begin.

Day 4: The blastocyst continues attaching, both more deeply into the uterus as well as to your endometrial blood supply.

Day 5: By this point, the blastocyst’s implantation is generally considered complete. The cells that will eventually grow into a fetus and a placenta are now developing.

Days 6 through 8: hCG begins to be secreted by the placenta cells – this is the hormone that is picked up to confirm a pregnancy in blood tests and at-home tests.

Day 9: In a successful embryo transfer, hCG may now be present enough in the bloodstream to confirm pregnancy. Your first beta blood test will generally be ordered anywhere from 9 – 14 days post transfer.

Signs of Implantation

You’ll likely find yourself analyzing every tiny twinge of a feeling or possible symptom during your two-week wait, the time in between the date of the embryo transfer and the date of the follow-up blood tests used to confirm a pregnancy.

While there is unfortunately no surefire sign to tell you that implantation has occurred, there are a few common symptoms that may be indicative of implantation. However, these symptoms may also occur for many other reasons, so be mindful that the only way to know that transfer was successful is a positive hCG on your post-transfer blood tests. With that in mind, here are some of the most common symptoms that may indicate the occurrence of implantation:

  • Light spotting, often referred to as implantation bleeding
  • Cramping
  • Fatigue
  • Bloating
  • Sore breasts

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To Test, or Not to Test? That is the Question

After the embryo transfer, you’ll likely be sent home with instructions not to take an at-home pregnancy test, but rather to wait until the blood tests at your follow-up appointments. There are many sound and logical reasons for this advice – however, I will be the first to admit that sometimes a sound and logical mind goes out the window during the two-week wait, which can feel more like two years.

While I personally found the temptation to be too strong (I tested at home against advice on my third day post-transfer), the consensus among professionals stands strongly in the position that the best course of action is to wait it out. Even if you experience any or all of the implantation symptoms listed above, the reasons for waiting are plentiful. You may experience a false negative or positive on an at-home test, and your follow-up blood tests will provide more information on the exact hCG levels and how they are rising in order to indicate success.

Getting Through the Wait

  • Don’t panic if you feel “normal." Just because you haven’t felt any symptoms of implantation, doesn’t mean that the worst is imminent. There are plenty of people (myself included!) who didn’t experience much of anything out of the ordinary after the transfer, only to have strong beta hCG numbers 10, 12, 14, or 16 days later.

  • Find ways to fill your time with self-care and things you enjoy. Having a plan ahead of time for activities to fill the two-week wait can help you be prepared with plenty of distractions. Plan a show to binge-watch, a book to read or listen to, lunches with friends – anything that brings you joy and peace is the way to go during this sensitive time.

  • Have an accountability partner – this can be your parenting partner, a member of your infertility support group, a calendar buddy with the same general transfer timeline, or anyone you trust with whom you can make a pact to not test early.

If you’re in the midst of the longest two weeks of your life, if your days have become all-consumed with tentative excitement or anxiety or fear of the unknown (and most likely an all-of-the-above combo), know that you’re not alone. There is a community of support with you every step of the way.

Lindsey Williams is a library worker and writer who lives in Arizona with her husband and their dog, Peaches. After 5 years of trying to conceive with dual-factor infertility, she is currently expecting her first child conceived with the help of IVF.