Coping with the two – week wait

How to deal with the two-week wait post embryo transfer? How to make it more bearable and minimize stress connected to waiting for the big news? How to avoid taking the pregnancy test too early? If you are going through the two-week wait or you are preparing for IVF/egg donation treatment in the nearest future, this webinar is everything you are looking for. Watch the video recording above to find out how to make the most of this difficult time without worrying too much. Our guest speaker was Andreia Trigo from inFertileLife – a fertility coach and a TEDxSpeaker based in the UK. In the webinar, Andreia discusses stress-fighting techniques and strategies that you can use to effectively cope with the IVF two-week wait, to keep negative thoughts at bay and reduce stress to a minimum while getting on with your daily life. Make sure you check this webinar before your embryo transfer appointment.

Emotional rollercoaster

Andreia started with addressing all the emotions that accompany anyone who is going through their journey. The anger, the frustration, the worry, the fear, the disappointment. All of these feelings are normal, and no matter what you are feeling right now or during the two-week wait, you need to remind yourself that is normal. Andreia explained that helping patients deal with emotional distress takes around 80% of the work because if you can manage your emotions, you can carry on with the treatment. However, if you are not able to manage your emotions, that is the number one reason for people to stop fertility treatment. Many times we feel that we have an emotion that is triggered by an event in our lives. We feel that not only we cannot control that emotion, but we don’t know where it came from and that we can’t change it.  This roller coaster has a proper medical name, and it’s called the process of grief. Initially, when we are faced with a circumstance that we aren’t expecting, we might feel the shock and the denial. Then we might feel the anger, or we might feel depressed. The great thing about the process of grief is that we understand that it’s a process, and it’s naturally unexpected. The bad thing about a process of grief is that it’s not linear, so we go back and forth, and the two-week wait is precisely one of those times when we go back and forth with these feelings and emotions. Andreia highlighted that it’s completely normal and expected, so no one should be blaming themselves.

When I was initially diagnosed there was that time before and after I knew I had a problem. The time before when I was a young woman, I was a daughter, I was a sister, and I was part of a big family, I had an identity as someone who wanted to be healthy, and like any young 17-year-old, I wanted to grow and change the world. Then when there was this particular challenge of being diagnosed with infertility, all these roles and identities disappeared from my life, and I only focused on my fertility and what I could not have in my life. My journey since then was rediscovering myself and making sure that no matter what my fertility journey brings, there will be space in my identity and my life for it.

Hierarchy of needs

In the pyramid shown on the slide, Andreia names & explains the hierarchy of our needs:

• physiological needs
• safety
• love & belonging
• esteem
• self-actualization

Having all these other roles in your life is about meeting all these needs that are so important. We forget that we get so focused on reaching fertility goals that we completely forget all these other things. During the two-week, there are five important things, that any woman going through it might be experiencing. Andreia discussed all of them in detail and provided some useful strategies to overcome them. These are:

• obsessing about pregnancy symptoms
• thinking about ‘what-ifs’
• negative thoughts
• too much time
• no one understands

Schedule time to obsess about symptoms

As a nurse, Andreia assures there is no such thing as pregnancy symptoms, at least in that initial stage of two weeks. You might be, and you might end up with a positive pregnancy test, and you’ve had no symptoms whatsoever. Sometimes you have symptoms, and you end up with a negative pregnancy test. Therefore, the first strategy is scheduling time to obsess. If you schedule a time, let’s say 15 minutes from 8:00 to 8:15, it’s your time to obsess about these pregnancy symptoms. It might be the time when you go on Instagram, and you talk to your TTC crew, and you can ask about their own experience. You’ll have at least those 15 minutes where you think about it. The second strategy is called the quick state change. This is an easy technique. Usually, we feel that we cannot control our emotions, but with this technique, you will be able to change the way you feel about something. Let’s say you are sitting in a coffee shop, and you see someone sitting at a different table, you see that person is sad. Even without talking to that person, you can see that this person is sad. The reason why that happens is that when someone is sad, we assume a certain posture. When I think about a time in my life when I was sad, I would say that my shoulders were down, my head was down, my muscles were tensed, maybe I was crying, and what I also know about this time in my life is that I was focusing on something. Every emotion is associated with a certain body posture, and it’s because we’re using a certain language. The trick is that if we change one of these three things in the triad, we can change the way we feel. If you’re sad, anxious, depressed or if you have negative thoughts coming through your mind, you can change your posture. You can think of a time in your life when you were super happy, super excited. As soon as you think about that time, you’re changing your focus, and then your shoulders are back to normal, your head is up. For a quick state change, all you have to do is either change your body posture, your focus or your language. This is something that you can do if you are obsessing about pregnancy symptoms during the two-week wait.

Use relaxation techniques & write it all down

Usually, the what-ifs are things in the future that hasn’t happened yet, but they are occupying time in our minds. The first strategy is called the body scan. It’s a mindfulness technique that takes about 2 to 3 minutes, and you can find it on many websites. The body scan takes you through your whole body, it makes you relax several parts of your body. It’s a way of bringing you back to the present moment. There are also amazing audio recordings with breathing exercises, you will notice that if you are stressed or anxious, your breathing tends to be quite fast or quite shallow, so these breathing exercises will prompt you to breathe differently. That will change automatically the way you feel. Another exercise that will help you manage all the what-ifs is meditation. Meditation is about noticing your thoughts. You might be thinking, what if this doesn’t work, and instead, you try to say to your voice in your head: ‘thank you for sharing, now you can go’, and then you come back to the present moment. Meditation is about noticing, so, for example, there’s a glass of water, and you notice the shape of the glass, the size, the smell of the water and then you taste it, and that’s what mindfulness meditation is all about. Again, there are lots of recordings about mindfulness meditation and how to include it in our lives, it is proven that it prevents us from thinking about the past that we can no longer change or worry about the future that hasn’t had happened. This is one of the most powerful things we can do to manage all these ‘what-ifs’ in our minds. Another strategy is called journaling or writing it down. If we are feeling a certain emotion, we are filling it in a part of our brain called the amygdala. This is the emotional part in our brain, but as soon as we write down this emotion, so let’s say you’re feeling sad and you’re depressed, but as soon as you get at least of paper and you’ll write that you’re feeling this way, you are labelling this emotion. As soon as we are labelling it, it moves from the irrational part of our brain to the rational part of our brain.

Challenge your thoughts

Everyone has negative thoughts, we will always have them. There will always be a part of our brain that is going to think: ‘oh my god – this is not going to work’, especially if this journey has been going on for a long time. One way of changing it, and it’s our strategy number five, is with affirmations. Affirmations are a way of controlling these negative thoughts in our minds. In psychology, there is something called a self-fulfilling prophecy, this means that you have a thought in your mind, and it might be that this is not going to work, what the self-fulfilling prophecy says is that because I have this negative thought, all my actions that I’m going to take maybe unintentionally are going to lead me not to have these results. Affirmations are a way of changing these negative thoughts. You might be standing every morning in front of the mirror in the bathroom, and you’ll say: my body is healthy, and I am ready for this pregnancy, and you say it’s so frequently that it becomes a belief. Unintentionally, your body will take the actions to meet their beliefs, it is a very powerful way of managing negative thoughts. There is a lot of research involving gratitude and how it changes the waves in our brains. The more we express gratitude, the more we see it around us. It’s good to force yourself to identify at least 2 or 3 things each day that you are grateful for. If you are in a relationship, you don’t have to write it down, but you turn to your partner and tell him that you are grateful for these last few days or you’re grateful because he called you at lunchtime or he did the shopping, whatever it is, just expressing gratitude can get you back on the right track. Strategy number six is a bit challenging, but it works. This is the technique of challenging our thoughts. We’re having negative thoughts, and we’re going to look for evidence that challenges these thoughts. You need to create a table, and the table will have thoughts, emotions (1-10), the evidence that supports that thought, the evidence that refutes that thought, and what will conclude that emotion. Let’s say your thought during this two-week wait is that: this embryo transfer is not going to work, and the emotion that is triggered in you is sadness or helplessness, whatever it is. Try to write that emotion, and put the intensity of that emotion, let’s say it’s 10, so the worst. Then, let’s try to look for the evidence that supports this thought: why do you think it is not going to work? You might think that this is not going to work because you’re not having any of those pregnancy symptoms. Look at what evidence you have to prove that this thought is not real, it can be that you have prepared much better this time, as opposed to the other two times when you’ve had an embryo transfer. It may be that this transferred embryo was of better quality, the clinic used a different strategy, this could be some evidence that makes you believe that this thought is not accurate. Therefore, write down all of these, the evidence that refutes the thought, the conclusion. Once you have reached this conclusion, that initial emotion of sadness will no longer be that extreme as it was at the beginning, it would no longer be that 10 out of 10 because you have put things into perspective.

Keep yourself busy

You might have a lot of free time during this two-week wait. Some people prefer to carry on doing work, and others prefer to take time off work. There’s no right or wrong way of doing it because there are people who avoid work and get pregnant, and there are people who go to work and get pregnant. However, if you have a lot of free time, one way of coping with the two-week wait is to keep busy. During this time, you might get a chance to engage in activities that you usually didn’t have time for before. It might be something that gives you meaning or pleasure, such as reading a book, going for a walk, cinema, having a massage, whatever it is something that gives you peace and pleasure. You can try and focus on something that gives you that sense of accomplishment. Strategy number eight is about putting yourself first during this two-week wait. No matter what emotions you are feeling just notice them, don’t fight them, it’s okay not to be okay and allow yourself to feel whatever you are feeling without judging. Protect your well-being and your mental health. If during this two-week wait you don’t want to be around people, don’t be. If you want to meet a particular friend, meet with them. Do whatever you need to do to put yourself first and your well-being.

Get Support

The last problem is that no one understands, and you are right, no one understands unless they have been through it. What you need to do is find other people who have been through it because they will understand. We’re talking about getting unbiased professional support, it might be an NLP or CBT Coach, it might be a counsellor, a psychologist. These people will have the ability to give you some outside help with some practical strategies and techniques. These strategies might help you manage your emotions or help you manage some conversations, for example, with your partner or family, friends. These people who specialize in fertility support will be able to help you during this two-week wait. Finally, professional support is not the only way of getting support, especially during the two-week wait when no one else understands. It’s extremely important to find your network, it might be family, friends or you can look for support on social media. There’s a lot of Facebook groups, there’s a huge community on Instagram where you can be completely anonymous, create an anonymous name for yourself and just find this gigantic crew of people who are going through it. People who will listen to you when you complain, or when you are unsure or when you are anxious, so it’s an amazing place to be. Finding your support network either from any of these resources will be so helpful.