The Two-Week Wait
The period between embryo transfer and your pregnancy test — commonly known as the “two-week wait” (TWW) — is often described as the most emotionally challenging phase of the IVF journey. During this time, the transferred embryo is undergoing the complex process of hatching from its protective shell (zona pellucida), attaching to the uterine lining (apposition), and embedding itself within the endometrium (implantation). These events typically occur between Day 6 and Day 10 after a Day 5 blastocyst transfer.
It is important to understand that there is nothing you can do during this period to influence whether implantation occurs — it is determined primarily by the embryo’s chromosomal health and the receptivity of the endometrium. Continuing your prescribed progesterone supplementation, maintaining a calm routine, eating well, and getting adequate sleep are the best things you can do for yourself during this time.
The Pregnancy Blood Test (Beta-hCG)
What Is Beta-hCG?
Beta-human chorionic gonadotropin (beta-hCG) is a hormone produced by the developing embryo once it implants in the uterine lining. It is the earliest reliable biochemical marker of pregnancy. A blood test measuring serum beta-hCG is significantly more accurate than a home urine pregnancy test, particularly in the early days after implantation.
When Is the Test Performed?
Your pregnancy blood test is scheduled approximately 10–14 days after embryo transfer — typically 9–11 days after a Day 5 blastocyst transfer, or 11–14 days after a Day 3 transfer. The exact date will be confirmed by your clinical team. It is essential to attend on the scheduled day, as testing too early can produce a false negative result.
Understanding Your Results
Positive result (hCG > 25 mIU/mL): A value above 25 mIU/mL is considered a positive pregnancy test. A second blood test is performed 48–72 hours later to confirm that hCG levels are rising appropriately — a doubling time of approximately 48 hours in early pregnancy is a reassuring indicator of healthy development.
Low positive or borderline result (hCG 5–25 mIU/mL): A borderline result requires a repeat test in 48–72 hours to determine whether levels are rising (possible early pregnancy) or declining (biochemical pregnancy/early loss). Your clinical team will guide you through the interpretation.
Negative result (hCG < 5 mIU/mL): A value below 5 mIU/mL indicates that implantation has not occurred in this cycle. While this outcome is understandably difficult, it does not define your overall prognosis. Your specialist will schedule a follow-up consultation to discuss the cycle in detail and plan next steps.
Early Pregnancy Monitoring
First Ultrasound Scan (6–7 Weeks)
If your pregnancy test is positive and hCG levels are rising appropriately, your first ultrasound scan is scheduled at approximately 6–7 weeks of gestation (4–5 weeks after embryo transfer). This scan confirms the pregnancy is located within the uterus (ruling out ectopic pregnancy), identifies the number of gestational sacs (important after double embryo transfer), and in most cases, detects the embryonic heartbeat — a critical milestone indicating a viable pregnancy.
Ongoing Monitoring (7–10 Weeks)
A follow-up scan at 7–8 weeks confirms continued growth and a strong heartbeat. Progesterone supplementation is typically continued until 8–10 weeks of gestation, at which point the placenta has developed sufficiently to maintain pregnancy hormones independently. At approximately 10–12 weeks, you will be graduated from the fertility clinic to your obstetrician or midwifery team for routine antenatal care.
Emotional Support During This Phase
The two-week wait and the early weeks of pregnancy can bring a complex mix of hope, anxiety, and emotional vulnerability — especially for patients who have experienced previous losses or unsuccessful cycles. This is entirely normal, and our clinic provides dedicated emotional support throughout:
Fertility Counsellor: A qualified counsellor is available to all patients for individual or couples sessions — before, during, and after treatment.
Support Groups: Peer support groups (in-person and online) connect you with others going through similar experiences.
24/7 Nursing Helpline: For any medical concerns, symptoms, or questions between appointments, our nursing team is available around the clock.
Mindfulness & Wellness Resources: We offer guided meditation, yoga, and stress-management resources specifically designed for the IVF journey.
What If the Test Is Negative?
A negative result after an IVF cycle is one of the most difficult experiences a patient can face, and it is important that you allow yourself time to grieve and process the outcome. At our clinic, a negative result does not mark the end of your journey — it marks the beginning of a thoughtful reassessment.
Your specialist will schedule a detailed review consultation (typically 2–4 weeks after a negative result) to analyse every aspect of the cycle: stimulation response, egg and sperm quality, fertilisation rates, embryo development, endometrial preparation, and the transfer itself. Based on this analysis, adjustments can be made to your protocol — such as changes to medication, stimulation strategy, laboratory techniques (e.g., adding ICSI, assisted hatching, or PGT), or endometrial preparation approach — to optimise the outcome of a subsequent cycle.
Many patients who do not succeed in their first cycle go on to achieve a successful pregnancy in a second or third attempt with an optimised protocol. Your prognosis is assessed cumulatively — across multiple cycles — rather than on the basis of a single attempt.
Frequently Asked Questions
We strongly advise against it. Home urine tests are less sensitive than blood tests and can produce false negatives in early pregnancy, or false positives if the trigger injection (hCG) has not fully cleared your system. A premature negative result can cause unnecessary distress. Trust the scheduled blood test for an accurate result.
Many patients report symptoms such as mild cramping, breast tenderness, bloating, fatigue, or light spotting. However, these symptoms can be caused by the progesterone medication rather than pregnancy. Conversely, the absence of symptoms does not mean the cycle has failed. Symptoms during the TWW are not a reliable indicator of the outcome.
Light spotting or pinkish/brownish discharge can occur and does not necessarily indicate failure. It may result from the transfer procedure itself, progesterone pessaries causing cervical irritation, or implantation bleeding. However, heavy bright red bleeding should be reported to your clinic immediately.
If your pregnancy test is positive, progesterone supplementation is typically continued until 8–10 weeks of gestation (6–8 weeks after transfer). Your specialist will provide specific instructions based on your protocol. Do not stop progesterone without medical advice, as premature discontinuation can jeopardise the pregnancy.
Cumulative success rates across multiple IVF cycles are significantly higher than a single-cycle rate. While individual cycle success rates depend on age and clinical factors, many patients achieve pregnancy within 2–3 complete cycles. A failed first cycle provides valuable clinical data that allows your team to refine the approach for subsequent attempts.
Most fertility clinics manage your pregnancy until approximately 10–12 weeks of gestation, at which point you are graduated to your obstetrician or midwife for routine antenatal care. By this stage, the pregnancy is well established, the heartbeat has been confirmed, and the risk of early loss has decreased significantly.
Once a heartbeat is confirmed and you are graduated from the fertility clinic, an IVF pregnancy is managed identically to a naturally conceived pregnancy. The risks and milestones are the same. Your obstetrician does not need to treat you differently because of IVF, though they should be informed of your conception history for completeness of your medical records.
Our fertility counsellor offers individual and couples sessions specifically for patients processing a negative outcome. There is no pressure to make immediate decisions about next steps — take the time you need. Our team is available to discuss options whenever you are ready, whether that means another cycle, a change in approach, or exploring alternative pathways.