Excerpt from The Doctor and the Stork book
Part 4: The two week wait
In the last leg of IVF, the week of waiting for news, I managed to distract myself with Friso, who was finishing puppy obedience school. We’d do hours of “sit” and “down” commands, as if cramming for PhD orals. He would respond about half the time but seemed to prefer cuddling in our laps or sneaking off to the kitchen to poop in a corner.
I found that the Internet world had a name for this last stretch before the big verdict: “the two-week wait” or, in infertility chat rooms, “the tww.” Its primary known side effect, agony, seemed to afflict almost everyone. For once I didn’t bother searching my physical symptoms online. If those takeout dry-fried green beans made me queasy, it could be almost anything. I wouldn’t allow a bunch of strangers online to get me riled.
Of course the new sofa and the call from Dr. Marion came at the same time. Two guys were downstairs, attaching wooden legs to an ottoman, when the phone rang. It seemed to happen in slow motion, the ring, the reach for the phone, the settling with Ken on our living room sofa. Our future was known—just not to us.
“I’m putting you on speaker,” Ken said.
“Hi, guys,” Dr. Marion said. I knew the news by her tone. “You are pregnant.” She even drew out her words, speaking at an unexpectedly leisured pace. “Your HCG levels are off the charts,” she continued, while we said back and forth, “Wow!” and, “Oh my God!” and, “We did it!”
When we hung up, we high-fived, hugged, and stared at each other with gawping fish mouths. Then we went downstairs and gave the sofa guys a fat tip. One of them handed us his card and asked us to write his manager. By noon we’d sent a glowing four-paragraph testimonial of commendation, gushing about their delivery skills. Friso, sensing the excitement, zoomed in loops through the room, leaping on and off the sofa, attacking the new fabric with paws and teeth.
“That little guy helped us get pregnant,” I told Ken. “Eighty percent puppy, twenty percent IVF.”
— K.K. Goldberg
Dr. Hinckley on the 9-day wait & the IVF results
Actually, it’s no longer a two week wait for IVF results. At our clinic it’s only nine days. But I do agree, nine days seems like forever, even for the physician as we wait expectantly, hoping to tell our patients they are expecting.
You could use home urine pregnancy tests to “cheat.” But they can be inaccurate and they depend on the dilution of your urine. If you have been dehydrated, your urine will be very concentrated and if you have stayed well-hydrated, your urine will be dilute. This may alter the results.
I can still remember several patients in tears when they came for blood draws, thinking they were not pregnant as their home pregnancy test was negative, only to call them later that day giving them great news. It’s not often the home tests are positive and then the blood tests are negative; the only time this happens is with a completely bad batch of kits, or with a patient who starts checking so early that she is picking up the hCG trigger shot given before egg retrieval instead of the hCG pregnancy hormone that the embryo is creating.
Nevertheless, when a patient comes in nine days later for that hCG test, it is a significant moment. If the test is good, between 70 and 120 mIU/mL at our lab, this helps a patient know she is currently pregnant, and has a good chance of keeping the pregnancy.
If the hCG levels are low, this indicates a poor implantation, which can mean an unhealthy embryo, or an unhealthy location. Occasionally this can mean a late implantation. This may translate into higher chance of miscarriage or a chance of an ectopic pregnancy.
If the hCG levels are high, around 250 to 300 mIU/mL, this indicates a twin pregnancy may have occurred. We won’t know for sure until the ultrasound, but these levels do give us some clues to what the future may hold.
Leave the worrying to your physician
So how does one deal with those nine days while waiting for the results? First thing is not to read into your symptoms too much. The hormones we make you take will often make you feel pregnant, and so it can be a sign of false hope. On the other hand, uterine cramping or spotting does not necessarily mean a negative pregnancy test.
The second thing to do is to try to distract yourself. While it seems logical to try to think your way through the pros and the cons of either test result and develop a plan if the test is negative, the psychologists do not recommend this as a coping strategy. Most mental health specialists recommend that patients distract themselves and defer thoughts about their next steps; this will be better in the long run.
Approximately 50 percent of patients will be pregnant at our clinic! So that means that 50 percent of patients have been worrying about getting a negative result, and have been worrying for nothing! I also don’t recommend choosing your baby’s name or the color of the walls for the baby room during the 9-day wait. This sets some people up for heartbreak.
I often tell patients when their brain starts to go to that place where they think about the outcome, they should try to focus on something else, like their next vacation or helping someone in need, or how they want to eat healthier and what they will cook. These simple distractions can be mind-saving.
And patients should remember that no matter what the outcome is, there will be a plan. That is what we, as physicians, are there for. We are there to assess your case, help you look at the options, and take the next best step. We want to help you in an expedient fashion, getting you on the path to parenthood as quickly as we can.
So don’t worry too much about the future in those nine days. Leave the worrying about the future to your physician, and instead go watch a good movie that will completely distract you!