Transfer three 8 cell embryos on day three?

[Anonymous]

I am 40 (turning 41 in a few months) and trying to decide how many embryos to transfer after what is our second and last IVF cycle. I have a daughter conceived naturally when I was 35. I've done one previous IVF cycle in which I ended up with two grade 1 embryos on day three, one 8-cell and one 9-cell. We transferred both and ended up with a single pregnancy that miscarried after 5 weeks. I've also had one previous miscarriage from a spontaneous pregnancy two years ago, although at that time I had an untreated thyroid disorder that may have contributed to the miscarriage. This time around, I had a better response to the medications and ended up with four grade 1 embryos -- three 8-cells and one 9-cell. I am trying to decide on how many to transfer. I'm interested in hearing anecdotes about the experience of others faced with this choice. I am leaning towards three, which is what my doctor has recommended (the risk of twins at my age is no more than 30%) but for obvious reasons I am struggling with the decision. Husband favors three, but is also feeling conflicted.

[Anonymous]

Are you trying to decide 3 vs. 4? or 2 vs. 3? I was in nearly your exact situation and transferred 3. I did not get pregnant from that cycle and it haunts me to this day that I did not transfer all 4. At at minimum I would transfer 3. Good luck.

[Anonymous]

OP here -- thanks so much for your reply. I am trying to decide two versus three. They did not raise the possibility of transferring all four and I did not think to ask.

[Anonymous]

I would transfer all 4 but that's just me. I transferred 3 good looking ones +2 crappy ones and didn't get pregnant (at 40).

[Anonymous]

If all look good, I might transfer 2 and hope the other two make it to day 5 for freezing. But it's a tough call.

[Anonymous]

I would transfer three. You have several factors: age, previous miscarriage, final try AND it is what your doctor recommends. We were in the same situation and the result was singleton.

[Anonymous]

At your age, I would transfer three or four. My 40 year old friend transferred 5, was originally pregnant with 3, which naturally reduced to 2.

[Anonymous]

Looks can be deceiving, so (3) Grade 1 embryos can still be abnormal--I'd transfer 3.

[Anonymous]

At 38,I had 3 transferred on day 5 twice. First time, nothing. Second time, my singleton DS. I would do 3.

[Anonymous]

My 2 cents... I wanted to do our best to avoid all the complications of a triplet pregnancy or S/R so we only transferred what we agreed we could carry and parent. We have two little ones already and the risk of carrying and potentially having triplets with potentially special needs and the impact on our other children was not a risk we were willing to take. IMO it might be different if you have no children, as for me, the impact to my current children definitely played into our decision making.

Good luck!

[Anonymous]

Anonymous wrote:If all look good, I might transfer 2 and hope the other two make it to day 5 for freezing. But it's a tough call.

+1

[Anonymous]

I was in a similar situation, except that I only had 3 to transfer. My first cycle (in which we implanted two) ended up in an ectopic. My next cycle (also at age 40) we retrieved 9, 7 mature, 3 fertilized. I don't remember the grades (everything is pretty much a blur) but we did a day 3 transfer and after much discussion, we decided to do all 3 and hope for the best. We had 1 really strong one, 1 middle of the road and 1 weak one. We ended up pregnant with two, but one ended up being a vanishing twin (had a heartbeat at 6w5d but stopped by 8w5d). I am currently almost 37 weeks pregnant with a singleton. It was a difficult decision and one we didn't take lightly, but it was the right decision for us. If faced with the choice again, we wouldn't change a thing. Good luck with whatever decision you make!

[Anonymous]

Thanks to everyone for sharing these thoughtful and helpful responses. I decided on three. Perhaps the last one will make it to the blastocyst stage and be suitable for freezing, but my doctor was not optimistic. So this is likely it. At a minimum, I am happy to be done with IVF procedures.

[Anonymous]

Good for you... As long as you research and think things through and discuss them with your husband you can't go wrong with your decision.

[Anonymous]

Unless you want multiples why not transfer just one, and if it doesn't take, transfer the second the next cycle, etc.? Your chances of pregnancy are the same, but your chances of complications with multiples are much reduced. Obviously, this means it could take 3-4 months to get pregnant rather than 1 month, but given the risks with multiples I think it's a sound decision. I had 3 good embryos and transferred one (at age 39) and was lucky to get pregnant with the first embryo. I know people who have had serious problems after transferring 3 and having triplets, so I think SET is worth strong consideration.