Decisions, decisions: tough choices on transfer day

Will and I are trying to wrap our minds around how many embryos to transfer, which has been a decidedly challenging task.

The facts of our situation are what they are:
1. I'm over 35.
2. I have a history of chemotherapy and radiation exposure.
3. I have had multiple failed IVFs.
4. I've had three prior miscarriages due to chromosomal abnormalities.

Over the course of our IVF cycles (not including the current one), we've made 31 embryos, which sounds really good, except that of all these embryos, only 2 have made it to the blastocyst stage (one of these took, but turned out to have multiple chromosomal abnormalities). And out of 31 embryos, we've never had a single embryo that was good enough quality to freeze.

After our last failed cycle, we consulted with Dr. Schoolcraft at CCRM, and he theorized that most, if not all, of our embryos may be chromosomally abnormal due to my medical history. We don't know if he is correct or not. But we do know that even should we be so lucky to get pregnant, there is (at least) a 20-25% chance of miscarriage in the first trimester, as is true in any pregnancy at my age.

We looked at the data this way and that way. We have talked and slept on it and talked some more. We have consulted with our RE. But ultimately we are left to decide how to proceed with our embryos now culturing in the Womb Away From Home.

The crux of the dilemma is this, as written by a poster on this topic to IVFConnections.com: "We've wrestled with the question of how many to transfer and here's how we solved it: Which do you want more? To have a baby, even if it means you have to deal with the issue of selective reduction, because you transferred so many OR to avoid selective reduction no matter what, even if it means you reduce your odds of conceiving?"

How we would answer this question has changed as we've progressed through the journey. IVF cycles 1, 2, and even 3, we could not imagine risking the possibility of higher order multiples (and the looming question of reduction if we conceived triplets and the certainty of reduction if we conceived more than that).

We put in two blasts, then one embryo, then three embryos. Almost two years later, we still have nothing to show for any of it. We're starting to feel fairly beaten down by the process of multiple IVFs and multiple miscarriages. We're starting to consider things we never considered before.

We want - and we know our RE wants - to be more aggressive, but how aggressive is too aggressive? We will speak to our doctor a little later today to hear more of his thoughts and also will get the embryology report on how the gang of 11 are fairing. Around 2pm, Will and I will meet back at the IVF OR suite for the transfer.

What is a reasonable number of embryos to transfer, given our situation? We honestly don't know.

One thing is for sure. There are no easy answers.

Mo