Single embryo transfer?? Thoughts?

cassiea
Member Offline
Ok, this is obviously a very private and individual decision, but I am wondering how people decided whether to implant one or two (or more) embryos if they had them. Yes, doctor recommendation is important, as is how the embryos look I gather. But I did some research on PubMed (National Institutes of Health log) and see a lot of studies (European) that suggest that putting one in followed by a frozen try if that's not successful is just as effective. Spoke to the doc about it (after he was suggesting two or all of the three we have because freezing one wasn't 'cost effective'), and partly, I just can't shake the feeling that there is a bias towards more than one because of success rates etc. for the doctors out there. Not to say that I think he is bad or unethical, but I partly wonder too how up to date doctors in the field are with current research. And I'm trying not to be the annoying 'well, I looked it up on the web' person, but I did use the best source possible, not just random places. So, given very imperfect information, how do others decide whether to put one or two in? This is our very first try, we're not covered by insurance at all, and we really don't want twins (my biggest worry after having none). Thoughts???
Anonymous
I really think it is a personal decision. When we started down the IVF path it was due to my DH so I thought there was nothing wrong with me, but found out differently after 2 failed IVFs. During our 1st IVF cycle we transfered 2, but I was willing and even excited at the thought of having twins. Our 2nd IVF cycle we had 3 embryos that survived to day 3 so we decided to transfer all 3. The RE only suggested transfering 2, but I did not think it was with cost to only transfer 2 and freeze one. Plus if I didn't get pg I knew I would always wonder if transferring the 3rd embryo would have made a difference. And I was willing to take the risk and potentially be on bedrest with triplets. So you really need to do what you and your DH are comfortable with. You need to ensure you are happy with the decision and won't second guess yourself too much. The RE's will always have their opinions but do what is best for you and your family.
Good Luck!!!
Anonymous
It is a very personal decision. If you KNOW you don't want twins then I think that right there is a good enough reason to only transfer one. Another thing to consider is what day you do the transfer. For example, my clinic (Shady Grove) has statistics that show in their experience if you transfer 1 good quality five day blast, you have almost exactly the same chance of getting pg as if you had transferred two blasts - yet you only have a 1.2% chance of twins vs. a 42% with 2 blasts. That helped me make my decision and I would say it was the right one for me. I am now pg with one healthy little baby after that 1 embryo was transferred. I wish you well in whatever you choose!
Anonymous
How old are you? I think that really makes a big difference. If you're under 35 and don't want twins, then definitely do eset.
Anonymous
The success rates at best for one embryo is 10-15%. And that's the top clinics and labs in the country. Thereby, to achieve a 30%-40% success rate, you need to transfer at least 2 embryos. It is very rare that the first transfer, 1 embryo is successful. Sorry to give you the bad news. I've been doing IVF for 5 years and just this month got a positive.

Good Luck!
cassiea
Member Offline
Thanks everyone! Just transferred today (I'm under 35, BTW, problem is with DH) - just one. We have two more in the chiller...we'll probably try two next time if this one doesn't take! The doc said that the other two looked good (at day 5, blastocyst), and the one implanted looked 'very good'. So keep your fingers crossed for me!
Anonymous
good luck!
Anonymous
Good Luck!

If you meet the right criteria (under 35, etc) then Shady Grove recommends Single Embryo Transfer as they are get great success rates with it (67%) and fewer multiples. Here is the page showing their stats: http://www.shadygrovefertility.com/eSET
Anonymous
Good luck to you OP!!! If IUI does not work for us, DH and I are also planning to do single embryo transfer (I am 32). Although I think that may change if the first 1 or 2 IVF cycles fail or if the embyros don't look that promising. Our RE was very understanding of our desire to avoid having twins and encouraging of us doing single embryo transfer. I really don't want twins, but I think all of this is so personal that everyone has to make the right decision for themselves. For reference, I found these recommendations online from SART/ASRM. They recommend considering single embryo transfer for some patients under 35. www.asrm.org/Media/Practice/NoEmbryosTransferred.pdf
Anonymous
We're also headed that road, it seems like. And we'll be facing the same dilemma of one or two transfers...

We had two successful pregnancies (2 and 3 years ago) with the first and the third try, respectively. The second resulted in our first child. Now, all of a sudden, we're having problems TTC our #2. It's been almost a year and I'm turning 40 next year. Ah, well, we had two failed IUIs and we are not sure if IVF is the only after alternative. (1) Anything else we can do before embarking on the IVF trip? (2) And, does anyone know if IVF is covered by any insurance? (3) Also, what is the range of the total cost?

Sorry to hijack the thread. OP, please keep us posted. Best of luck to you and DH.
Anonymous
To respond to last comment...IVF is really not so bad. I had a successful experience. Shots take some getting used to.

Some insurances cover it (if your insurance is in MD, there is mandated coverage of IVF if you meet the criteria for medical necessity). Some insurances cover 50%, some not at all...Prices range depending on where you go & what procedures you do (ICSI, Assisted Hatching, frozen embryo storage, etc). On average I'd say the bottom basic IVF will cost you around 10-$12,000 plus about 2-$3000 in medications (again, if your insurance does not cover meds)...There are some "Shared Risk" programs . At Shady Grove the SR program is $22000 (I think?) for 6 tries (+ fozen embryo transfers) & if you do not get a live birth or you change your mind, they refund your money 100%.


Good luck...
Anonymous
Thanks a lot, PP. This is quite useful.
cassiea
Member Offline
OP here - thanks to the posters a few up who left the other useful links. I found that to be quite helpful. During my research, here are the studies that I went off of that convinced me to do just one try. - http://www.ncbi.nlm.nih.gov/pubmed/18518874?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=4&log$=relatedarticles&logdbfrom=pubmed
http://www.ncbi.nlm.nih.gov/pubmed/15618254?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=3&log$=relatedarticles&logdbfrom=pubmed
http://www.ncbi.nlm.nih.gov/pubmed/15550492?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=4&log$=relatedarticles&logdbfrom=pubmed
http://www.ncbi.nlm.nih.gov/pubmed/17955795?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=4&log$=relatedarticles&logdbfrom=pubmed

Otherwise, at Columbia Medical, I can testify that the costs for the drugs are about $2500, the cost for the cycle (including freezing extras) was about $14,000. For me, none was covered by insurance, but that's totally dependent on your insurance. And then, to try with frozen embryos, it's around $4k-$5k.

Good luck to all.
Anonymous
I had a successful twin IVF pregnancy at age 31 and am hoping to have a third baby now at age 34. We'll be doing a eSET and will likely keep doing them (freeze and/or frozen) until one sticks. I'm also a patient at Shady Grove and they are STRONGLY encouraging women <35 to only transfer one embryo.
As a mom of twins, I don't want another set. I love my twins to death but pregancy, delivery, and infancy were really rough. I feel like I'm just coming out of the fog and my twins are 2. If I could do it again (and could dictate these things) I absolutely would have my children back-to-back.

Good luck!
Anonymous
oops, my last post should have read (fresh and/or frozen)
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