Why I See IVF Patients Twice During the Two Week Wait

By Emily Marson, L.Ac. | Aphrodite Fertility Acupuncture, San Diego

Acupuncture during the two week wait will not force an embryo to implant, and I will not tell you it does. What it does, with reasonable evidence behind it, is lower cortisol and cut anxiety during the nine to twelve days between your embryo transfer and your beta. I see most of my San Diego IVF patients twice in that window, around day 3 and again around day 7 or 8. The reason has less to do with the uterus than with the nervous system running the whole show.

Why the two week wait flattens people

You have done everything. Weeks of injections, a retrieval under sedation, lining checks, a transfer that took eight minutes. Now the instruction is to go home and wait.

Three things stack up at once.

• You have no task. Every earlier phase of IVF came with a job attached. Inject at 8pm. Monitoring at 7am. Trigger at 9:15 exactly. The two week wait hands you nothing to do, and for women used to managing hard things, that vacuum fills with vigilance.
• Progesterone counterfeits pregnancy. Progesterone in oil, vaginal suppositories, or both will give you sore breasts, bloating, fatigue, mild cramping, and constipation. Those are the exact symptoms you are scanning for. There is no way to sort one from the other, so every twinge becomes evidence for hope and dread at the same time.
• Cortisol stays up. Anticipatory stress does not behave like acute stress. It does not spike and clear. It sits.

What the evidence supports and what it does not

Compared with no added treatment, acupuncture alongside IVF has been linked to more clinical pregnancies and live births, with a relative risk around 1.30 in a widely cited analysis. 

The stress part

A 2022 randomized trial in Psychoneuroendocrinology found lower cortisol in women receiving acupuncture through IVF. A 2025 University Hospitals study found meaningful drops in anxiety, stress, and pain after a single session. Those are not baby promises. They are measurable changes in a body that has been in fight or flight for two months straight.

Acupuncture from a licensed practitioner trained in fertility carries close to zero risk. The cost of white knuckling nine days alone is not zero. That is the math I work from.

How I schedule the two week wait

Session one, day 2 to day 4 after transfer

This one is about coming down. Point selection is conservative. Nothing on the lower abdomen, no strong moving points, no electrostimulation. I am after parasympathetic tone, so the session runs long on purpose, usually 30 to 40 minutes on the table with the lights off.

We also troubleshoot side effects. Progesterone in oil injection sites turn lumpy and sore by day 3. Warm compress before the shot, ice after, rotate sides every night, and let me needle around a tender site rather than into it.

Session two, day 7 to day 9

This is the hard stretch. By day 7 most women have started testing at home or are white knuckling the urge. Symptoms are loudest here, and so is the internal narrative. The treatment shifts toward sleep and rumination, and I spend more of the visit talking than I do in almost any other appointment.

What else I treat in those nine days

• Sleep. Waking at 3am and staying awake is the single most common complaint I hear during the two week wait.
• Constipation. Progesterone slows gut motility. Magnesium at night, water, and a daily walk handle most of it.
• Headaches. Usually estrogen support plus dehydration plus four nights of bad sleep.
• Breast tenderness and bloating. Expected. Not diagnostic.

What to skip until your beta

• Heat on the lower abdomen. No heating pads, hot tubs, infrared sauna, or hot yoga.
• Moxibustion over the lower abdomen.
• Deep abdominal massage, castor oil packs, or visceral work. Those belong before transfer, not after.
• New supplements. Nothing starts during the two week wait. Ask your reproductive endocrinologist before adding anything.
• Hard training. Walking is fine. Heavy lifting and high intensity intervals can wait nine days.

Symptom Spotting

Symptom spotting does not work. I have had patients with zero symptoms get a beta over 300, and patients with textbook implantation cramping get a negative. No amount of searching will settle it, because the information does not exist yet. What I can offer is a place to put your body twice in nine days where nothing is asked of you and someone who has watched a thousand of these cycles is paying attention.

Frequently asked questions

Does acupuncture after embryo transfer improve implantation rates?
Against no added treatment, acupuncture with IVF has been linked to more clinical pregnancies and live births, with a relative risk near 1.30. I also expect lower cortisol and lower anxiety, which the trial data supports.

How soon after embryo transfer can I have acupuncture?
Same day is fine, and many of my San Diego patients do on-site acupuncture before and after transfer. If you did not, the first two week wait session works well 2 to 4 days after transfer.

Is acupuncture safe if the transfer worked and I am already pregnant?
Yes, when your acupuncturist is trained in fertility and first trimester point selection. Several points are avoided once you may be pregnant. This is the reason to see a fertility acupuncturist rather than a general acupuncturist during IVF.

How many sessions should I book during the two week wait?
Two for most patients. One around day 3 and one around day 7 or 8. Patients carrying high anxiety or a history of failed transfers sometimes add a third.

What does two week wait acupuncture cost in San Diego?
At Aphrodite Fertility Acupuncture a new patient visit is 250 dollars and return visits are 118 dollars. We accept HSA and FSA cards and provide superbills for out of network reimbursement.

Ready to find your answers?

If your transfer is on the calendar, book your two week wait sessions now rather than after. Appointments cluster around clinic transfer days and they go fast. Book online at aphrodite.janeapp.com or text 858.333.7688. More at www.aphroditeacupuncture.com.

Related reading: nervous system regulation on embryo transfer day and our frozen embryo transfer acupuncture protocol.

Emily Marson, L.Ac. is the founder of Aphrodite Fertility Acupuncture and has helped more than 1,000 San Diego women conceive across 8 plus years of practice. She partners with every major San Diego fertility clinic and provides on-site acupuncture for embryo transfer. Located at 2970 Fifth Ave, Suite 320, San Diego, CA 92103.