I had done two rounds of natural cycle IVF, one stim round and got no embryos from any of them.

My fourth round was at CCRM Nova. I got 1 healthy embryo. We were pretty sure that we only wanted one child, but I couldn't bear the thought of transferring that one and it not working, so I did another round immediately after, which yielded two healthy embryos. We did not ask about the gender of any of the embryos, but the dr accidentally revealed that the first embryo was a boy.

We asked the dr to choose which embryo from the 3 he felt would have the best chance and we went with that embryo. Turns out our now 3 year old was that first embryo. The other two are still on ice. I can't seem to part with them even though I know we are one and done. My dr did say that there could have been some "priming" that happened that helped the 2nd round. Who knows. I am torn, part of me wishes we had just transferred the first one, but I know if that hadn't worked I would have been upset to then do another round.

It really depends on a couple of factors:

1.) Age -- if you are over 38, that leans towards doing multiple egg retrievals first. As some clinics say, "Make hay while the sun shines." Failed retrievals and miscarriages can take up a lot of time
2.) How many eggs are you expecting? -- if few, that leans towards doing multiple retrievals first. It takes about 3 PGT normal embryos to get a 95% chance of a live birth
3.) What is your insurance coverage? Some such as the MD marketplace only count a cycle as a transfer (and you get three per live birth). If you have the MD marketplace, go ahead
4.) What are your finances?

When I started at 36 for number 2, I thought I'd be one and done. 5 transfers/2 miscarriages and 13 retrievals later (I banked for 6 cycles because of my insurance coverage so I have some embryos still to transfer), here we are still going and finding all sorts of problems (blood clotting, possible second infertility induced auto-immune issues or something else). I got my 3 PGT normals and still no baby. In hindsight, I would have learned about the marketplace insurance before starting, got on that, banked a ton, and then tested for everything possible while I was doing retrievals.

Decision was a combination of the fact that I had insurance coverage (and no guarantee I would have that same job, and this coverage, a few years later). The retrieval is the most expensive part. I figured I could pay out of pocket for an FET later if I found myself without coverage. Other factor was I wanted to hedge my bets and have as many embryos as possible for a chance at a live birth. I have no moral problem discarding extras, though I know it is a concern for some.

Having gone thru this, and having a child from IVF, worrying about your clock ticking and when to start another retrieval process after the first is born is stressful. Impacts when you stop breastfeeding, etc.

Anonymous wrote:We got one good embryo from the first round and decided to move forward with transfer rather than start a second cycle. I didn’t feel mentally tough enough to go through back to back cycles without first seeing the process through, if that makes sense. Ultimately, we were successful and now have a beautiful 10 month old. I’d planned on starting another cycle at 1 year pp, but had significant complications during delivery that have landed me squarely in the one and done category. Our decision ended up being the right one for our family. I was 34yo at the time of transfer and delivery, with male factor infertility.

This was also my thought process.

Sometimes PP I feel like every decision in the process is the wrong decision if you know what I mean.

We got 3 blasts going for testing.

26 follicules - 13 mature eggs - 11 fertilized - 3 day five blasts. How do people make it work with such crappy numbers 26 to get only 3?!

Crossing my fingers for good news for you, and some clarity in decision making. As someone said above, it really is a personal decision and there’s no right/wrong when you can’t predict the future.

Anonymous wrote:Sorry to hear about your prior losses, OP. That's so hard.

For us it was a combination of age and at the time only thinking we wanted to have one child. We also used a "shared risk" plan at SGF where you could not do multiple retrievals if you had embryos that could be transferred. And I was doing a fresh transfer without PGS since I had a different history and profile. But Like you I was also tired of all the waiting and eager to see if it would work (though of course so hard of it doesn't on the first try).

Good luck OP! I did feel like my RE was pretty clear on what she thought would be a waste of time (more IUIs in my case) vs what was just a personal decision - hopefully you are getting that guidance to help farme your decisions.

We haven't gotten there yet - tomorrow I find out how many made it to day 5 and then still wait 7-10 days for the genetic testing to learn how many normal we have.

I do trust my team, but trying to understand how others weighed the cost / benefit.

Sorry to hear about your prior losses, OP. That's so hard.

For us it was a combination of age and at the time only thinking we wanted to have one child. We also used a "shared risk" plan at SGF where you could not do multiple retrievals if you had embryos that could be transferred. And I was doing a fresh transfer without PGS since I had a different history and profile. But Like you I was also tired of all the waiting and eager to see if it would work (though of course so hard of it doesn't on the first try).

Good luck OP! I did feel like my RE was pretty clear on what she thought would be a waste of time (more IUIs in my case) vs what was just a personal decision - hopefully you are getting that guidance to help farme your decisions.

Thank you both for your thoughts. I'm 38.5 and while I tolerated the hormones ok (despite high risk for OHSS) I don't want to put off a pregnancy. We're 2 years since we lost a far along baby boy and many since him. So I'd rather not "waste" more time. But if I miscarry, obviously that's wasting time too.

We got one good embryo from the first round and decided to move forward with transfer rather than start a second cycle. I didn’t feel mentally tough enough to go through back to back cycles without first seeing the process through, if that makes sense. Ultimately, we were successful and now have a beautiful 10 month old. I’d planned on starting another cycle at 1 year pp, but had significant complications during delivery that have landed me squarely in the one and done category. Our decision ended up being the right one for our family. I was 34yo at the time of transfer and delivery, with male factor infertility.

I got three PGS normal embryos over three retrievals.

I decided to try one last one before my fertility ran out (I was 40 with diminished ovarian reserve and knew I was unlikely to have a successful retrieval after a pregnancy due to my age).

For the fourth retrieval, my FSH had shot up, I only got five eggs and zero normal embryos. I took it as a sign that my body was maxed out and started transferring.

The first transfer was a miscarriage. The second was my daughter. The third is still frozen.

We're only hoping for 1 child so in theory we only need 1 good embryo but I'd like at least two. How did you decide to do more egg retrievals vs moving forward with what you have?