Decision to transfer one or two embryos?

[Anonymous]

FYI abbreviate you are looking for is stim, not stem. ("stimulation")

[Anonymous]

abbreviation, not abbreviate (Ha! Maybe your mistake was an auto-correct as well?)

[Anonymous]

Anonymous wrote:Just a point of clarification. A PP said they did IVF 6 times. Is that 6 ETs or 6 stem cycles? To me those are different and play into a decision whether to transfer 1 or 2. My first stem cycle, I did two ET, neither worked. First ET was 1, second was 2. But they were from the same 'batch'/stem cycle. Then we did another stem cycle, transferred 2 and got one baby. But that was all we had available on that cycle. I firmly believe that the 2nd cycle produced better blasts, because SG was familiar with my cycle, maturity of eggs, follicle performance, etc. Full Disclosure - no known fertility issues. Just genetic considerations.

It was 6 separate full stim cycles. We never had a high enough quality to freeze any.

[Anonymous]

I appreciate everyone sharing their experiences, and perspectives, on this...was helpful to read and think of things to consider as we move toward more aggressive IVF or possibly donor eggs (am age 43).

[Anonymous]

It was 6 separate full stim cycles. We never had a high enough quality to freeze any.

Thanks for clarifying. You are a tough one.

[Anonymous]

Oh, and I do know it's stim, not stem, but the spell-check worked against me this time!

[Anonymous]

37 and own eggs.... without a doubt I woudl transffer multiple if I had them. Freezing is more damage potentially to embroys and many starting to have family at 37 would be able to handle twins (although not ideal medically I understand). The stress and process of going through transfers and freezing embryos, I would avoid as much as I can. However, if I had a ton of eggs, i may do PGD testing and that woudl really help limit the efforts. I think in a few years, that will be standard on all IVF cycles.

[Anonymous]

I did two elective single embryo transfers with my own eggs after age 40, and had two healthy singletons. However, both my embryos were highly graded day 5 blasts that had tested genetically normal.

My RE pushed hard to get me to transfer two (his success rates were at stake, after all), but when I pushed back, he acknowledged that the risk of serious complications such as pre-eclampsia, cervical incompetence, cerebral palsy, micropremies is at least 5x higher with twins than singletons. Although the chance of clinical pregnancy was statistically higher following a two-embryo transfer rather than an e-set, I felt strongly that my goal was not pregnancy, but delivery of a healthy baby. I would have loved it if someone handed me full-term healthy twins, but I didn't think I could live with myself if I lost the entire pregnancy or had a child with serious health issues due to my desire for an instant family and stat.

If you can financially and emotionally handle the idea of doing an extra e-set or two to make up for the slightly lower pregnancy rate, and if your embryos are relatively good quality, I'm a strong believer in e-set. Also, my OB said that the biggest mistake she sees older moms make is trying to have their kids in multiples, because those are the pregnancies where age-related issues like pre-eclampsia can really pose a problem.

[Anonymous]

I ended up with identical twins from an eSET. I had an uncomplicated pregnancy and healthy babies , but I was extremely fortunate, as I know many twin moms who had serious pregnancy complications and/or babies with health challenges (which is why I did an eSET). Even being so fortunate, twins are a real challenge and I can't even imagine managing higher order multiples, so I am SO GLAD I didn't transfer more than one.

[Anonymous]

Anonymous wrote:I ended up with identical twins from an eSET. I had an uncomplicated pregnancy and healthy babies , but I was extremely fortunate, as I know many twin moms who had serious pregnancy complications and/or babies with health challenges (which is why I did an eSET). Even being so fortunate, twins are a real challenge and I can't even imagine managing higher order multiples, so I am SO GLAD I didn't transfer more than one.

Amen.

[Anonymous]

Anonymous wrote:I did two elective single embryo transfers with my own eggs after age 40, and had two healthy singletons. However, both my embryos were highly graded day 5 blasts that had tested genetically normal.

My RE pushed hard to get me to transfer two (his success rates were at stake, after all), but when I pushed back, he acknowledged that the risk of serious complications such as pre-eclampsia, cervical incompetence, cerebral palsy, micropremies is at least 5x higher with twins than singletons. Although the chance of clinical pregnancy was statistically higher following a two-embryo transfer rather than an e-set, I felt strongly that my goal was not pregnancy, but delivery of a healthy baby. I would have loved it if someone handed me full-term healthy twins, but I didn't think I could live with myself if I lost the entire pregnancy or had a child with serious health issues due to my desire for an instant family and stat.

If you can financially and emotionally handle the idea of doing an extra e-set or two to make up for the slightly lower pregnancy rate, and if your embryos are relatively good quality, I'm a strong believer in e-set. Also, my OB said that the biggest mistake she sees older moms make is trying to have their kids in multiples, because those are the pregnancies where age-related issues like pre-eclampsia can really pose a problem.

Amen. I didn't have success with my own eggs, but I stuck to clinics that STRONGLY advocated eSET for DE. I think it's the ethical stance, the one that considers the health of mother and baby rather than clinic stats.

I was willing to do multiple eSETs to avoid twins, but when my donors produced more than one embryo, I got pregnant on first transfer each time.

[Anonymous]

Unless you truly want twins and would be thrilled to learn you've got double trouble on the way, go with a single embryo transfer. I am repeating what has already been said, but I'll throw my positive experience onto the pile anyway. When we turned to IVF for #2 we already had a 2.5yo. So I knew how much work even a single baby is, plus I felt twins would put too much pressure on our marriage, finances, and basic energy levels. So although IVF was a torture I never wanted to repeat, we only put back a single embryo. And now here he sleeps beside me, a beautiful little boy, and IVF is a distant memory (I come on these forums occasionally to share encouragement). Obviously, we were fortunate. But overall you want to feel thrilled when you get your BFP and not immediately afraid it will be twins. Plus it is 100% true that pregnancy is hard on your body, as is delivery...set yourself up to be in a doable situation and not overwhelmed.