The two week wait (TWW): What to expect

The two week wait — often shortened to TWW — is a popular topic on fertility forums. You may have seen it referred to as “the dreaded TWW,” sometimes accompanied by a gritting teeth emoji. 

But what exactly does it mean? Even if you’re familiar with the TWW, there can be a few misconceptions around the time between potential conception sex and finding out whether you’re pregnant. Here, Dr. Sara Twogood, obstetrician and gynecologist, Cedars-Sinai Medical Group, California, US helps us decode what may be going on in your body during this time. She also shares tips for getting through the TWW because it’s important to be kind to yourself while you wait.

Key takeaways

• When you’re trying to get pregnant, the two week wait (TWW) is the time between ovulation (when you release an egg) and the start of your period — or a positive pregnancy test. 
• The reason it’s a two week wait is because you can only find out whether you’re pregnant or not when your period is due. This is when you’ll get the most accurate result from a home pregnancy test, which picks up levels of the pregnancy hormone human chorionic gonadotropin (hCG) that start to rise when you become pregnant.
• If you test earlier, your hCG levels may not have risen high enough to be picked up in a pregnancy test, so you could get a false negative even if you’re actually pregnant.
• Some women notice early pregnancy symptoms during the TWW, but they can be very similar to premenstrual syndrome (PMS) symptoms, so it’s hard to tell the difference.
• The TWW can be a tense time, especially if you’ve been trying to conceive for a while. But there are ways you can make it easier and look after yourself.

What is the two week wait (TWW)?

The time between ovulation and your period’s due date, when you wait to find out whether you’ve conceived this cycle, is often given a name in fertility chats: the two week wait. 

But while it’s a catchy enough phrase for people to remember and use, the name is also a little misleading because the wait isn’t exactly two weeks for everyone. In fact, the time between ovulation and your expected period could be anywhere between 10 and 17 days. So, it’s best to think of the TWW as a nickname for this phase rather than an exact description of how long it lasts.

The medical term for this part of your cycle is the luteal phase. It runs from the day after you ovulate until the start of your next period, and its purpose is to prepare your uterus for a potential pregnancy. After ovulation, an egg travels into the uterine (or fallopian) tube where,  for 12 to 24 hours, it can be fertilized by sperm. Meanwhile, your body produces higher levels of the hormone progesterone to get your uterus ready for implantation if a fertilized egg arrives. 

If the egg doesn’t become fertilized, or if it doesn’t implant for any reason, pregnancy won’t happen that cycle. This causes your hormone levels to drop, and the uterine lining is shed, which is what you know to be your period.

If the egg is fertilized and it attaches successfully to the lining of your uterus, you’ll become pregnant. But it’s a bit of a process, with studies suggesting it can take anywhere from six to 10 days to get from ovulation to implantation.

At that point, the cells that will eventually become the embryo and later the placenta begin to form and start producing the hormone human chorionic gonadotropin, which is what’s picked up in pregnancy tests. Levels of hCG vary from one person to the next, meaning some need to wait longer than others for it to show up in tests. On average, it can be picked up in a blood test around 11 days after the egg is fertilized. HCG may take slightly longer to show up on home pregnancy tests, which look for it in your urine. “That’s why we recommend waiting until the day your period is due to test — hCG levels may not be high enough before that,” says Dr. Twogood. 

What symptoms to expect during the TWW

When you’re longing for that big fat positive (BFP), the TWW can feel more like months. So you may be wondering whether there are any early signs of pregnancy you might use as clues before you miss your period. Everyone is different, and that’s completely normal, but some women report symptoms within one week of conception, around a week before a missed period.

So, how might you tell? Early pregnancy symptoms can include:

• Breast tenderness: Your breasts may start to feel swollen, sore, and/or tingly during the early stages of pregnancy due to hormone changes.
• Feeling much more tired than usual: Again, this is due to your body adjusting to new levels of hormones during early pregnancy.
• Light spotting, known as implantation bleeding: When the fertilized egg implants, it can sometimes disrupt some of the blood vessels in your thickened uterine lining, leading to some very light bleeding.
• Needing to pee more often: This is because your body’s blood supply is increasing. Your kidneys filter the blood and remove the waste, which leaves your body as urine, so when there’s more blood, there’s more pee.
• Mood swings: Feeling unusually weepy or more sensitive is a common symptom of early pregnancy, thanks to those hormone changes.

The confusing thing is that this could easily be a list of PMS symptoms, too. “The symptoms [of pregnancy and PMS] are very similar, and the timelines overlap. If you have implantation bleeding, for example, that could be shortly before your period is due, when lots of women have spotting,” says Dr. Twogood. 

However, getting to know your own cycle may be helpful, she adds: “Tracking PMS symptoms helps you get to know what’s normal for you, so any differences to your usual pattern might tip you off. For example, if you have breast tenderness [during] this cycle, and that’s not a typical PMS symptom for you, it may potentially be a sign of early pregnancy.” An app like Flo can help you track your symptoms alongside your periods so you get to know your normal.

No symptoms at all? You can’t read much into that, either, says Dr. Twogood: “A lack of symptoms doesn’t rule out pregnancy — lots of women don’t have obvious signs.”

Unfortunately, there’s no way to know for certain whether or not you’re pregnant this cycle until your period is due, which is why the wait can feel so long. But hang in there — we have some tips to help. 

How to care for yourself during the TWW

Depending on how long it’s taking to get pregnant, you could be finding the two week wait either really exciting or incredibly stressful. Either way, “it’s important not to let the wait take over,” says Dr. Twogood. “Instead, see it as a time to put self-care into practice.” This may sound easier said than done, but there are things you can do to manage any nerves and look after yourself while you wait. 

What to try

• Have some fun. “See your friends and do nourishing things you enjoy — it helps to keep some balance in your life, plus it’s a good way to release stress and take your mind off things,” says Dr. Twogood.
• Learn anxiety-busting strategies. “You could use this time to find things that will help you stay calm through the TWW and [potentially throughout] pregnancy itself — whether that’s walking in nature, journaling, or meditating,” says Dr. Twogood. 
• Distract yourself. Two week wait survival tips in Flo’s Secret Chats space include getting creative with art, decluttering the house, and doing puzzles. 
• Have quality time with your partner. Share your feelings with each other, and stay physically intimate. Flo members say having just-for-fun sex, cuddling, or massaging each other can help you relax.

What to avoid

• Alcohol: “Don’t risk it,” says Dr. Twogood. “If you’ve had unprotected sex in this cycle, there’s no way of knowing for sure that you haven’t conceived until your period’s due.” Of course, try not to stress too much if you’ve had a drink before finding out you’re pregnant. It happens, and you can continue the rest of your pregnancy following the health advice we have, which is that alcohol isn’t generally recommended.
• Symptom spotting: If you spend each TWW researching early pregnancy signs and comparing symptoms in chat rooms, that’s totally understandable. “But it can become a harmful cycle and may start to affect your mental health. Plus, stress isn’t helpful to pregnancy,” says Dr. Twogood. Try some stress-relieving activities, like a walk in the fresh air, journaling, a good TV show, or some gentle exercise if you feel up to it. If you’re still finding it a difficult time, Dr. Twogood suggests: “See a health care professional to get a handle on your worries. They may recommend cognitive behavioral therapy, a talking treatment.”
• Being inactive: “There’s no reason to stop or change your usual workout,” says Dr. Twogood. “In fact, staying active is important for managing stress, as well as your overall well-being.” It’s also a good idea to keep as healthy as possible while trying to conceive, so find a form of exercise you enjoy and try to carve out time for it.   

Taking your pregnancy test

When you’re counting down the days, it takes serious willpower to resist sneaking in an early test. “Most people do it,” says Dr. Twogood. “But there’s a high likelihood of a false negative pregnancy test because hCG levels may not yet be high enough. You’re just wasting money, and it can be more stressful for you to keep testing,” she advises.

Here’s the textbook approach: “Test the day your period is due,” says Dr. Twogood. “If you’re pregnant, your hCG levels should now be high enough to detect, so you’re likely to get an accurate result.”

What if you get that longed-for BFP? “Stop testing and book an appointment with your doctor,” says Dr. Twogood. “If you get a negative, and your period still hasn’t arrived, repeat the test two days later. It’s possible you ovulated slightly later than you thought, so hCG levels may not have been high enough on the day you took the first test.”

A negative test can be very disappointing, so try to share your feelings with your partner or other loved ones if you feel comfortable. But also remember it can take time to conceive. For 85% of couples, it happens within a year of trying. If you’re under 35 and it’s taking longer than a year to get pregnant, schedule an appointment with your doctor. If you’re over 35, go after six months, and if you’re 40 or above, it’s best to go right away.

For the best chance of getting pregnant, one thing you can do is to get to know your own cycles. It can help to know the different ways to track ovulation, and an ovulation-tracking app like Flo can help you learn your body’s fertility signals.