Two PGS normal embryos and age 36 - what would you do??

[Anonymous]

I'm looking for some crowd-sourced advice from this knowledgeable group!

I just received word that out of 9 embryos sent for PGS testing, only two are normal. This was my first IVF cycle and I just turned 36 this month.

Husband and I would like two children. He is an only child while I grew up in a family of three, and we would just really love to have more than one child.

Now I feel like I'm faced with a dilemma. Given that implantation rates are around, what, 40-50%, it seems unlikely that the two PGS normal embryos would materialize into two healthy pregnancies.

Do you think I should go through another IVF round now, before attempting FET and potentially having a pregnancy, in order to hopefully get more embryos in the bank while I'm still young-ish? Or is that un-called for bet-hedging, and we should therefore just proceed with FET and see what God gives us? I will note that IVF was hell for me -- blood pressure spiked, terrible headaches, lots of adverse symptoms. But I'm more than willing to do it again if it's what we need to do.

Or, if we decided to try for pregnancy now...anyone have experience with getting pregnant through IVF, having a baby, then going through IVF again at a later age? How soon after breast-feeding/pregnancy can you go through an IVF round?

[Anonymous]

Anonymous wrote:I'm looking for some crowd-sourced advice from this knowledgeable group!

I just received word that out of 9 embryos sent for PGS testing, only two are normal. This was my first IVF cycle and I just turned 36 this month.

Husband and I would like two children. He is an only child while I grew up in a family of three, and we would just really love to have more than one child.

Now I feel like I'm faced with a dilemma. Given that implantation rates are around, what, 40-50%, it seems unlikely that the two PGS normal embryos would materialize into two healthy pregnancies.

Do you think I should go through another IVF round now, before attempting FET and potentially having a pregnancy, in order to hopefully get more embryos in the bank while I'm still young-ish? Or is that un-called for bet-hedging, and we should therefore just proceed with FET and see what God gives us? I will note that IVF was hell for me -- blood pressure spiked, terrible headaches, lots of adverse symptoms. But I'm more than willing to do it again if it's what we need to do.

Or, if we decided to try for pregnancy now...anyone have experience with getting pregnant through IVF, having a baby, then going through IVF again at a later age? How soon after breast-feeding/pregnancy can you go through an IVF round?

I'm going through the exact same thing and proposed a similar question not too long ago. You can see my OP here:
https://www.dcurbanmom.com/jforum/posts/list/765664.page#14019210

Long story short-unless you have DOR I wouldn't bother banking. If your insurance pays for it, I would bank. If not, then assuming you don't have DOR, I wouldn't bother banking. Good luck!

[Anonymous]

Thank you very much! And apologies for the repetitiveness.

[Anonymous]

I would implant one now and save the other instead of implanting two.

DD is from a fresh cycle at the age of 35 and DS is a PGS tested embryo from that same batch.

[Anonymous]

would bank more. getting back on the IVF saddle with a toddler is a totally different game than doing IVF without kids.

[Anonymous]

I would bank more.

[Anonymous]

question is whose paying for the banking. OOP or insurance. Insurance may not pay for banking unless medically necessary such as DOR (not always) or some Cancer/chemotherapy. If OOP then decision is totally up to you. If you can afford it then do another fresh and see what you get. every cycle has different outcomes

[Anonymous]

If money weren't an object, and I could stand the delays and stress, I would try to bank more.

Then I'd transfer one at a time.

GOod luck OP.

[Anonymous]

Pregnancy rate should be closer to 60-70% and live birth 50-60%.

But even with those stats, two PGS normals is more likely to lead to 1 baby than 2.

Practically-speaking, I'd say you should do another banking cycle if you want a 2nd. It's still possible to miscarry with PGS and that can delay things several months. And of course, actually getting pregnant delays things longer. You are relatively young in IVF world at 36, but 2 out of 9 normal isn't a great number. And it will probably feel like a relief to have enough embryos banked for two and only FETs (so much easier) going forward.

That said, IVF can be physical and emotional hell. If you just don't have it in you to try again immediately, that's okay. Go ahead and transfer one and see what happens. You can always do another IVF cycle between FET 1 and 2 if FET 1 doesn't work.

Someone told me to just focus on getting to baby #1 versus obsessing over having 2 and I think that's wise advice. Right now, you have no baby and a very tired body. If you can get to that first baby, you will have immeasurably more joy than you have right now. And then who knows... you may not feel as strongly about a 2nd, the second embryo banked may work, you may do another IVF later that works or you may make peace with DE for a 2nd. You can't really predict. But getting to 1 baby is going to feel so much better than where you are now.

[Anonymous]

Anonymous wrote:Pregnancy rate should be closer to 60-70% and live birth 50-60%.

But even with those stats, two PGS normals is more likely to lead to 1 baby than 2.

Practically-speaking, I'd say you should do another banking cycle if you want a 2nd. It's still possible to miscarry with PGS and that can delay things several months. And of course, actually getting pregnant delays things longer. You are relatively young in IVF world at 36, but 2 out of 9 normal isn't a great number. And it will probably feel like a relief to have enough embryos banked for two and only FETs (so much easier) going forward.

That said, IVF can be physical and emotional hell. If you just don't have it in you to try again immediately, that's okay. Go ahead and transfer one and see what happens. You can always do another IVF cycle between FET 1 and 2 if FET 1 doesn't work.

Someone told me to just focus on getting to baby #1 versus obsessing over having 2 and I think that's wise advice. Right now, you have no baby and a very tired body. If you can get to that first baby, you will have immeasurably more joy than you have right now. And then who knows... you may not feel as strongly about a 2nd, the second embryo banked may work, you may do another IVF later that works or you may make peace with DE for a 2nd. You can't really predict. But getting to 1 baby is going to feel so much better than where you are now.

OP here -- thanks so much for the thoughtful post. Wise advice indeed! I have to admit...going for FET now like we had planned is what is in my heart. You are right that we could always change our minds after FET 1 if it doesn't work. At least then we'd know we were in for another IVF round and might opt to do it sooner. I also need to get more information from my insurance on whether it will pay for banking at this point. We are very lucky to have had insurance coverage for most of the first round. But money is a factor, somewhat.

Many thanks for all of the responses so far!

[Anonymous]

God doesn’t have much say here. I would bank more Embryos.

[Anonymous]

2 normals out of 9 about right. Definitely bank, unless $ is an issue. You can get a bump in # of eggs from cycles that are close together and time changes things, so if it's working now I'd take advantage. Insurance isn't likely to cover a second cycle (if you had coverage for first). Mine made me use embryos before they'd pay for another cycle. Also agree with PPs who said transfer 1 at a time. My first transfer with a PGS normal worked.

[Anonymous]

i say bank. you're 36 now, which means you're likely to be 38 the next time you'd do an egg retrieval. 38, according to my RE, is when odds start to go down significantly. (i am 37 and she told me not to wait until 38 to start IVF).

2 PGS normals gives you a significant chance of 2 babies, but is by no means a guarantee.

PP is right that IVF with a toddler is very different than IVF without children to care for at the same time.

FWIW, my insurance covers banking.

[Anonymous]

I would bank with one more round of IVF.

[Anonymous]

Another vote for banking here. Definitely do another round of IVF now.

Even if you are "fast tracked" at your clinic, the timing of a transfer and essentially 10 months gestation (fingers crossed!) leads you to a year+ away. Then, many clinics make you wait 6 months after delivery before trying again - which will put you are closer to 38.

Bank now.