Single Embryo Transfer

[Anonymous]

I am a new mom of twins, and while of course I love them, I dearly wish my husband and I had stuck with our guns and done SET. If you are having doubts about your ability to care for multiples, I cannot stress enough that you have to advocate for yourself. Someone is going to be that 1 of the 1 in 4 and if you aren't prepared to be that 1, do not compromise. We will be ok, but this is the hardest thing I've ever had to do.

Just wanted to put that out there for people who are torn.

[Anonymous]

Was this your first IVF cycle? My first IVF was an eSET and it was negative. I am in my second IVF cycle now and I just don't know if I can stomach another eSET cycle. You say that you wish you had stuck to your guns and done SET; did your doctor encourage you to transfer more than one?

[Anonymous]

I completely agree that you should think long and hard about transferring more than one embryo if you are under 35 and your ovarian reserve is decent.

I'm a Shady Grove patient.
Cycle #1 transferred 2 blasts and got pregnant with twins. I was overjoyed at the time (so glad to be finally pregnant!) and pretty excited about having twins. Then I had the pregnancy from hell. 3 months of bedrest, 10 hospitalizations, constant fear of having micropreemies as my cervix continued to dilate despite lying flat on my back for 3 months (only leaving the bed for a shower every 3rd day and being driven to an OB appointment every week). It was just not fun. I ended up delivering at 35 weeks. Of my friends who have twins (we now know 10 other twin families well due to a multiples group, etc), almost exactly half had a similar pregnancy and I'm the only one who actually ended up delivering at a reasonable gestation. The others with issues delivered at 27, 27, 30, 31, and 34 weeks. NOW the other half of the twin moms I know delivered at >35 weeks. Mostly at 37 and 38 weeks and they had relatively normal prenancies. It really seems like 50% of twin moms will have a huge struggle with pregnancy and the other 50% will have the exagerated discomforts that come with gestating 2 babies instead of 1. The thing is, you never know which side of that stats you will fall on until you are pregnant. I was a long distance runner and as healthy as could be and yet I had all sorts of issues.

Moving on to cycle #2
Electively transferred 1 blast (this past year) and got pregnant with one baby. The experience has been NIGHT and DAY over being pregnant with twins. I barely feel pregnant. I go jogging daily and hiking on many weekends. I had half the nausea and vomiting that i had with the twins. I haven't had a single perceptible contraction (and I'm 30+ weeks). With the twins I had a few thousand by this point.

I love my twins dearly but I too have thought a million times over how much easier this entire experience would have been had we only transferred a single embryo each time. I would encourage others to really contemplate the option of single embryo transfer especially since the pregnancy rates (in medically appropriate women) are proving to be the same with one blast or two.

[Anonymous]

Thanks for these comments. They make me feel better about my decisions to do eSET. All the best to you!

[Anonymous]

OMG!! Holy Cow! I'm so glad I read this post! I thought having twins would be a great thing for my husband and I! I am such an idiot and didn't realize how MANY complications you can have during the pregnancy. I could not handle bed rest!

Does anyone know of anyone who has had a semi uneventful pregnancy with twins? Is it always this bad?

[Anonymous]

I had a semi-uneventful pregnancy with twins. However, one died shortly after a full term birth. Then, I started reading the statistics on twin death, and they are amazingly grim.

Something like 1 in 150 twins die, compared to 1 in 3,000 singletons. Deaths due to NICU, birth defects, etc. Everything that can go wrong goes wrong much more frequently with twins. Our bodies are set up to reproduce one baby at a time. Generally, more than one can work, but not without real stresses. . .

And I thought I'd won the lottery at my fertility clinic

[Anonymous]

We are currently pregnant with much wanted twins after IVF and before reading this thread I have been really excited! The ms is off the charts but we are hoping for better things in the weeks and months ahead. I understand the OP's reasons for posting but I think I have to stay away until this thread falls off the end. Not sure how I will keep myself away though. Sigh!

[Anonymous]

Thanks for this post, OP. I am going to do IVF early next year, and I am very against having twins, particularly because of the pregnancy complications more than actually taking care of two babies. I really want to stress this with my RE (not sure if alot counsel you to go with eSET or transferring two blasts)? I am under 35, have no known problems, and responded well to an injectible IUI cycle, it just didnt work for me.

[Anonymous]

My sister had twins (naturally...no fertility treatments). She went to 38 weeks and had a healthy 8 pound boy and a 6 pound girl. She was never on bed rest and had a "normal" pregnancy (although she was definitely large and uncomfortable!!)

I also have two friends that delivered healthy twin babies at nearly full-term with no bed rest.

I know there are very real increased risks for twin pregnancies and I certaily don't want to downplay those risks, but I just wanted to put some positive stories out there too for the twin moms.

[Anonymous]

OP, I totally understand your need for posting this info about twins, my twins are 12 yrs old and very healthy, but I still haven't forgotten how hard pregnancy can be with multiples. I was 31 yrs old when I delivered and I was in great shape prior to pregnancy, incredibly happy about being pregnant, (two yrs of IF tx) and I still had a difficult time carrying them to term, (born 33 wks). My Mother was able to carry three babies that weighed more than my two combined so I had no clue that I was not suited to carry twins full term. I know how hard that decision can be on transfer day...

[Anonymous]

My 4'11 aunt delivered twins in her late 30's no problem. I'm 29, 28 when I delivered my first. My first IVF I transferred 2 blasts, and it ended up a chemical pregnancy. I went on to have 3 FETs, 1 with 3 blasts, 2 with 2 blasts and those resulted in 2 more chemical pregnancies, and a negative result. My 2nd fresh IVF, we transferred 2 blasts. One I delivered and one ended up to be an empty sack. We are trying for #2 and I have no hesitations about transferring 2 again. I always think about the one I lost. It would be tough to have twins, but it was so much tougher to have all of that loss and emptiness all those years.

[Anonymous]

Anonymous wrote:Does anyone know of anyone who has had a semi uneventful pregnancy with twins? Is it always this bad?

I had an uneventful twin pregnancy. It was extremely uncomfortable during the third trimester, but I had no complications and the babies were born perfectly healthy after 38 wks. However, the OP is absolutely right, it is VERY difficult taking care of two newborns. We had the advantage of experience (twins are from second pg), and it was still unbelievably mind-boggling. But I wouldn't trade it for anything in the world .

[Anonymous]

It's also important to take into account the day of transfer (3 day versus 5 day versus 6 day) and the quality of the embryos or balstocycts when deciding how many to transfer - I wish I had understood that better with our first IVF. I was very adamant about doing a single embryo transfer and our RE also really pushed for it. I was 32, had had a previous pregnancy and our main diagnosis was MF. I had a great antral follicle count, but borderline high day 3 FSH. I ended up producing a good number of eggs, but I think the quality was not great. With our first IVF, we did a 6 day transfer (after having 8 "great-looking" embryos on day 3, they pushed us to a 5 day transfer, but none of the embryos were blasts by day 5, so we got pushed to day 6 and transferred the best looking (still not great quality) blast that day). The cycle was negative. For the second cycle, I had a much more detailed talk with our RE about our "decision tree" for how many to transfer. We settled on 2 if we did a 3-day transfer, 2 if we did a 6-day transfer and 2 for a 5 day transfer unless the blasts were of excellent quality, in which case we would transfer 1. We ended up with a 3 day transfer of 2 embryos and I am currently pregnant with a singleton.

I think you need to be prepared for twins whenever you transfer 2, but also remember that day of transfer and quality of embryos effects the success rate of each individual embryo.

[Anonymous]

Medically I had an uneventful twin pregnancy and went though until 37.5 weeks but physically it was very tough. Much different to my earlier singleton pregnancy. I was in a lazyboy almost 24/7 after about week 22. My lungs would allow me do nothing and I am used to being a very fit, active and tough person. Both of mine were 6.5lb+ and came straight home after delivery. However we had pretty much no help, and one of our twins was a rough baby so I have to admit the first year was absolutely horrible - I was full time home with them. It was tough on our marriage also. However they are now progressing toward their second birthday and I am so in love with having twins. They are so much fun compared to a singleton. In fact these days they are a complete riot. New Mom - hang in there, I had those exact same feelings during the first year and now they never even cross my mind! It is such a tough decision knowing how many to transfer - good luck to all that have to make it.

[Anonymous]

Everyone, thank you for posting to this, it is one of the most intelligent discussions I have encountered regarding this tough issue. I was lucky to have a great RE (Dr. Gordon, Dominion Fertility) who understood my desperation to have a child, but cautioned me about being too eager. We did a single embryo transfer and it turned out to be a high risk pregnancy, delivered at 32 wks, so he was right to be cautious despite my eagerness to transfer 2!
http://100infertilityquestions.blogspot.com/2007/10/how-many-do-i-put-back.html