Wednesday, September 15, 2010

Your embryos are frozen - why would ever transfer more than one?


It's getting to be decision time.

Here we are - in the fortunate - can't-even-believe-we-could-be-so-lucky - position of having eight chromsomally normal frozen embryos. Four that developed typically and on time.

And now we are faced with the question of how many to put back when we go to transfer.

A few people have asked us, Since they are frozen, why would you even consider putting back more than one? Why not just do a single embryo transfer? You've got eight, after all, and a singleton pregnancy is lower risk than a twin pregnancy.

These are good questions. Tough questions.

Of course our hope, and our goal, is to have a healthy baby. We are balancing our deep desire for a good and safe outcome with a reality that may be harder to understand, but I'll give it a try anyway.

Folks, we are seriously running out of stamina. The past seven IVFs and our five losses have taken us to the mat. All the treatments and surgeries over the last three-plus years, including the most recent two months of depot lupron, have taken a deep toll on us individually and as a couple.

To put it starkly, I don't think we have eight tries left in us emotionally. That's just the facts at this point. If we don't succeed fairly soon, I think we may be packing it in. Chromosomally normal embryos or not. There is also the practical matter that having already spent two weeks "vacationing" in Colorado this year, I don't have enough time off left for eight separate tries either, but that seems like a more surface explanation.

These may not be the best reasons to put back more than one embryo, but it's as honest as I can be.

This may seem weird to say, but after everything that has happened, and despite our genetic results, I can't imagine getting pregnant. And I can't even come close to imagining staying pregnant.

Would I be happy with one baby? Definitely. Happy with twins? Yes - although the idea is a bit daunting. Do I realize that a twin pregnancy is a higher risk pregnancy? Yes, I do.

We'll talk to Dr. Schl. soon. We'll get his thoughts on what our odds are, given our history and situation. We will tell him our thoughts. And then we'll go from there.

Promise to keep you posted.

Mo


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47 comments:

  1. Eight, what fantastic news!!!

    Sounds like it would be smart to transfer more than one. And my experience (though I didn't go through the pregnancy..) is that twins are fantastic. Yeah, hard work, but IVF isn't??

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  2. I would absolutly transfer more than one, and anyone who's experienced the level of infertility that you(and i) have experienced would Totally understand, this battle is exhausting and takes so much from us emotionally, physcially. Sending you good vibes!

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  3. I'm glad to see you back and on the verge of moving ahead.
    Agree that this is hard, and I've totally been at the "2 vs 1" place, although without nearly as much history and pain, and after two cycles (2nd frozen) of putting in 1 each, I broke down and pushed for another fresh cycle and we put in 2.
    Long way of saying, you probably know the right answer in your heart already, and whatever that is, that will be the right decision.

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  4. I completely understand your thoughts. Personally, I would put more than one back. I can't even begin to understand how exhausted you two must be at this point.

    I can say that the exhaustion continues if you get and stay pregnant. We can feel the effects now of the extra (only 2 for us) years of IF on top of our pregnancy/baby/twin exhaustion. Twins are exhausting, but so worth it. Even with all we went through with preemie twins, we wouldn't change anything we did. But I'm glad they refused my pleas to put back three embryos!

    Thoughts to consider because I've already counted on this working for you!

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  5. I totally get where you are coming from and I haven't even gone through as many cycles as you. There is only so much you take emotionally. When you throw in the practicalities of vacation time and money etc it's even harder. I know that you are strong enough to do what you think is best. I just hope that this is it for you! Crossing all fingers and toes.

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  6. It's a very tough situation to be in, but I'm so very glad that you have to make this decision. And I mean that in a good way....you have 8 healthy frosties! Hip hip hooray! Your decision will come from your heart and you will know it's the right decision for your family. You have been through so much and I hate the thought of you suffering anymore. I think it's great if you want to put 2 back. I'm speaking as someone who has never been pregnant and never cared for twins, but I understand that you have your limits of how many FET's you can handle. You will know what is right for you guys. Not much longer now...

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  7. It is such a personal choice and when the road has been long, you especially do what you can to stack the outcome deck in your favor. Now, that can mean different things to different people and an SET with a clinic whose success rates are high for SETs is no better than transferring two with a clinic who doesn't do many SETs.

    And, given the stats, transferring two drives up the chance of success of getting pregnant but the odds of having twins are not dramatically higher.

    You know yourselves and you deserve to make the decision that feels right.

    I'll be cheering you on no matter what.

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  8. I suppose my questin would be why WOULDN'T you put back MORE than one. You've been through alot and your chances are better if you transfer more than one. So you end up with twins...bonus!!!

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  9. I know it's different for everyone, but I did one IVF and and one FET and we put two embryos in each time. I got pregnant both times with one baby (1st pregnancy ended in m/c). Just throwing it out there.

    Everything crossed for you two!

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  10. I am in the same boat as you...I think we'll transfer just one but a serious dose of "doubt" is messing with me. You discuss some very candid reasons why you choose two vs. one and the ONLY thing that matters is what you are comfortable with. Good luck to you!!

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  11. Totally get your reasons for considering a transfer of more than one. Totally. Would also understand if you did just one. I'm supportive either way:).

    Just do me a favor... don't transfer more than three:):)

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  12. I say go with your gut.

    Just because two go back in doesn't mean you will get two babies - hell we know just because one goes back doesn't mean you'll even get one baby, so why WOULDN'T you up your chances of scoring one baby by putting two back and if you score TWO babies well that's a bonus!!

    And as for the person who asked if your priority was to have a healthy baby - did you turn around and tell them that no you were doing this for fun? Unbelievable!!

    Good luck xxx

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  13. I totally think it makes sense to transfer more than one. It's got to be such a physical and emotional toll each time you do a transfer, and all the drugs involved, and trips. And really, it's not like twin pregnancies are uncommon or even really something to be afraid of these days.

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  14. I'm so glad you posted this. Our RE has recommended putting back two in our case as well, and while twins is a little much for us to wrap our heads around, eSET (elective single embryo transfer) is only recommended by SGFC if you are younger than 37, have a normal uterine cavity, have had a prior IVF pregnancy or it's your first time, AND if you have 1 or 2 Day 5 blastocysts available for transfer.

    To be honest we were hoping to put back one, but because we've never had an embryo make it to day 5 to freeze, we're not an option. And yes, twins is a much higher risk for their everyone involved, but if all goes well it's also twice the blessing. And just because you put two back doesn't mean you'll get two babies. We put two back and had one baby, and we have two friends who put two back and both got pregnant with triplets. You just never know. I say go with what you feel is right for you and Will and what you can handle.

    I don't blame you for not feeling like you have 8 more tries in you. I'm not sure I have one more in me, and I've not had all of the experiences you have!

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  15. I totally get your thought process. We were the same way with our DE transfer. We had been through 6 failed cycles with our own eggs, and had just had enough. I am now very glad that we put in two, as we just found out today that one of them isn't going to make it. I just couldn't take another failure at this point. I think you are headed in the right direction, and if you get twins, you know the risks and you will do everything you can to minimize them. And you will be able to handle two babies after everything else you have been through - a piece of cake!

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  16. I love it that you have eight, but I totally get what you say about possibly not having eight more 'emotional' transfers in you. We were at the same place. So we did two. And now have a singleton pregnancy.

    Good luck x

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  17. I have so much hope for you both and am so excited about the possibilities ahead! I would put back two and even possibly three, but I'm crazy like that I guess. Out of our five fresh cycles we did 3 (got pg w/twins, lost one, have Chase), put back 3 (nothing), put back 4 (chemical pg), put back 3 (got pg w/twins, m/c both), put back 2 (have our daughter). Just remember putting two in does not guarantee twins. Keeping everything crossed and sending lots of prayers!

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  18. This comment has been removed by a blog administrator.

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  19. You and Will are in the boat R and I were in back in April, although I was leaning the opposite direction of the way it sounds like you're leaning. And as you know, I outvoted R, we transferred just 1, and we have nothing to show for it. Next time around (assuming we do another transfer), we will transfer two, and cross our fingers, and hope for the best.

    All you can do is make what feels like the best decision for you at the time, and then accept the outcome, whatever that may be.

    But believe me, I totally hear you about not having 8 more transfers in you.

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  20. I'm one of the folks who asked that question, but I also totally get (as I hope I made clear when I asked it in the last round of comments) why you'd put back more than one. This stuff is so tough, beyond tough, and you've already been through so much. Whatever decisions you make, I hope they bring you the healthy baby (or babies) you dream of.

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  21. Congrats on having 8 embabies first off!! There have been so many comments on your post, and I have to say that I agree with most of them! I think in your gut you know what you want to do, and whatever decision you make will be the best for you and your family.
    I absolutely understand wanting to transfer more than one - out of 3 transfers we always transferred 2 embabies (I'm 29). And there are no guarantees, which you know all to well as well! Our first IVF = BFN, 2nd transfer = BFP, m/c @ 8 weeks, 3rd transfer = BFP - currently 32 weeks with twins. We never in a million years thought we would actually end up with twins, we thought that even if we got pregnant with two we would probably lose one (morbid I know). I actually pushed transferring three this time with the RE, but she refused. I'm so glad she did. . .the what-if's are overwhelming! Who knows though - she could have transferred 3 and I could have gotten a BFN - there's no way to know.
    Just know that regardless of what decision you make your loyal followers will be here to root you on! I'm so glad FET time is getting close!!!

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  22. I would transfer 2 or even 3. You want the best possible chance of coming home with a baby (or two). I certainly would put back more than one. But you need to do what is the right decision for you. I did IVF only twice at the age of 39. Put back 3, got BFN, put back 2 (all I had) was twins for 7 weeks, resulted in my son who is now 12.

    I am praying and sending you good thoughts.

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  23. congratulations!
    I vote for two also.
    Our first transfer we were conservative - had great lining, perfect embryo so we tried one.
    No go.
    Second time we had perfect lining great frozen embryos we tried two. Got pregnant with twins but one did not make it beyond about 6 weeks. I was so freaked about having twins, then excited when found out we were having two, then a little relieved when it turned out to be only one. It's such a hard call, but I know you will make the right decision for you and your family:)

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  24. congratulations!
    I vote for two also.
    Our first transfer we were conservative - had great lining, perfect embryo so we tried one.
    No go.
    Second time we had perfect lining great frozen embryos we tried two. Got pregnant with twins but one did not make it beyond about 6 weeks. I was so freaked about having twins, then excited when found out we were having two, then a little relieved when it turned out to be only one. It's such a hard call, but I know you will make the right decision for you and your family:)

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  25. It's completely up to you, you guys have to be comfortable that you can live with twins (or higher multiples), and if you can live with that - go for it. I think the twin pregnancy thing is just scare tactics. Plenty of people have perfect twin pregnancies, and plenty of others have horrible singleton pregnancies.

    I know what you mean about doing so many cycles - I would be inclined to do the first one as a single embryo transfer and then doubles with possibly a triple as the last one (In Australia there are no triple transfers - amazing how different things are)

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  26. I would be right there with you. What if it took all 8 transfers? That would be another year and 7 more failures to shoulder aside from the time and expense for your travel. You've been through enough.

    For what it is worth by my 4th IVF I could never imagine getting a positive beta and by my 6th I couldn't imagine carrying a baby. It is your mind trying to protect itself.

    Best of luck with whichever you choose.

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  27. Schoolie will tell you to transfer two, no question about it. I elected to do a SET, and he really questioned our choice. It is a hard choice, and don't think anyone would find fault with your decision, either way. It is a personal decision, and no one can tell you what is right for you and Will. For me personally, I would rather have many transfers versus carry twins (I doubt my cervix too much!). But I understand transferring two, and we thought long and hard about it.

    How is the estrogen treating you? Feeling better?

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  28. I understand exactly what you mean about not being able to emotionally handle much more. Been there, done that. On our final try with IVF, we transfered 3 and now have a beautiful set of boy/girl twins! Go for it! Transferring more than one also means better odds at a pregnancy...single or more. I'm cheering for you Mo! Best of luck.

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  29. We transferred 3 (but they weren't the best quality) and 1 stuck. If your embryos are "A" grade then why not transfer 2? You'll get a higher chance that one will stick. And if you happen to end up with twins then you won't have to worry about going back to Colorado for a long time!

    Good luck. My fingers are crossed for you.

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  30. Congrats on your embies!

    I found your blog through the BlogHer ads on MY blog! I guess those ads DO work!

    We have adopted the "creme de la creme" quality egg donor embryos and we put back two, twice. Both were BFNs. My doc still doesn't want to go for three this time around, he is convinced that it was just luck of the draw and there is no reason to think that one or both won't take this time around.

    Best of luck, and consider me a new follower!

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  31. Oh, Mo! Just saw this post. I hope that comment didn't cause you any angst. You know I hear you loud and clear on this. You have been through so much. This shit has been kicking your butt for too damn long! My road wasn't anywhere near as hard, yet I decided to be aggressive with my last transfer, because I JUST NEEDED THAT PART TO BE OVER. I was more prepared to deal with the possible consequences than another failed cycle. Sucks to have to think this way and face these hard choices. Big hug.

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  32. Hey Hey,
    I stumbled over your blog today and I just had to tell you I'm enjoying your blog. Your awesome. I became a follower and I'm looking forward to keeping up and leaving comments. I hope you will check out my blog, and become a follower. I have a button, and I'd like to add you to my blog roll. I hope you have a lovely weekend. God Bless You and Yours

    http://diaryofhappilyeverafter.blogspot.com/

    Love,
    Jess

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  33. Mo, I know this is a rough call, but I would transfer more than one. If your Dr thinks you could carry twins and YOU think you can carry twins relatively easy, DO IT!! Get this over and done with. I know your exhaustion, I know your weary, I know your desires and it's time for you to be a mom!!!

    Keep us posted... I am getting so excited for you!!

    By the way, my blog URL changed, not sure if you knew:
    http://ababybumpjourney.blogspot.com/

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  34. Mo, I know this is a rough call, but I would transfer more than one. If your Dr thinks you could carry twins and YOU think you can carry twins relatively easy, DO IT!! Get this over and done with. I know your exhaustion, I know your weary, I know your desires and it's time for you to be a mom!!!

    Keep us posted... I am getting so excited for you!!

    By the way, my blog URL changed, not sure if you knew:
    http://ababybumpjourney.blogspot.com/

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  35. I agree with Pie. Schooly will tell you to transfer two. I literally had to lobby for my eSET. Also, even after getting everyone on board with the idea and it being written in my file a million times, the day of transfer the lab still called me to "confirm" we were transferring two and I had to correct them!

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  36. It seems like a classic risk-benefit question. If the idea of twins doesn't terrify you, then running that risk with a multiple transfer seems like a perfectly logical choice.

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  37. I completely understand and agree with you. We transferred two high-grade blastocysts for both of our cycles and each time only one took. We also only went through 2 IVF cycles compared to the battery of crap you and Will have had to endure. At times we were ready to gouge each others eyeballs out, can't imagine how you guys are feeling. The emotional cost of all this can be so terribly high.

    I have everything crossed for you, everything looks so good!! Hang in there and good luck, good luck, good luck!!

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  38. Oh Mo!! Your transfer is getting so close now. Seems like you have been working to get to this point FOREVER so I am excited to think it's just around the corner. I haven't commented much but have been reading and following and thinking of you.
    Without a doubt I would transfer more than 1 embryo. The points you raised are all ones that I believe in completely, you've been through enough and the emotional side of things has to be considered. Wishing you much luck, you deserve your happy ending.

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  39. Mo, you don't need to explain. Anyone who's been through this insanity knows that even 2 chromosomally perfect embryos don't guarantee twins. Further, you neglected to mention the expense of this all. If the FET's were free...well...maybe it would be worth considering. But there is that expense and the expense of travel and stay in Colorado. It's draining, emotionally, financially and physically.

    I say, go with 2 since you're fine with twins.

    It will be nice to get pregnant and STAY pregnant at last!

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  40. Eight transfers?! Egads. I did four. No way. Too hard emotionally and expensively :)

    We transfered two at a time each time until our last -- transfered three.

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  41. I'd also transfer two in your shoes, and do plan to transfer two when we end up doing an FET in the future. Even then, our RE told a cycle buddy of mine that the chances of a BFP with transferring two were likely about 15-25%. Not stellar. So bad that I'm losing hope of ever having a sibling for K.
    With 8 normals, and transferring two at at time, you're bound to get pg. I guess the only reason I'd think about transferring only one in your case would be that you did manage to get pg many times, you just had all those losses because of the chromosomal issues. Implantation doesn't seem to be your issue.
    Hm. I wonder what Dr S will suggest for you....

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  42. This is such a hard decision. We are gearing up for another IVF cycle (after success) and I still debate daily over how many to put back this time. Good Luck with your decision. I can't wait to hear what your doctor says.

    BTW: I just stumbled upon your blog. I look forward to following your journey. Best of Luck!

    Aly
    www.infertilityoverachievers.com

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  43. Mo, having 8 embryos is incredible. If I were in your shoes, I'd skip the eSET and transfer 2. We transferred 3 and have triplets despite the odds. But it's rare for that to happen.

    Although it's definitely hard some days, raising triplets is also the greatest joy I've ever experienced. Knowing we never have to go through IVF again is bliss.

    I can't even begin to imagine how exhausted and depleted you and Will must be after all you have endured.

    Follow your gut.

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  44. that why would you transfer more than one question makes no sense to me. of course, transfer two. we all want you to get pregnant and stay pregnant as soon as possible. so up the odds the first time! although, i don' think more than two is a good idea.

    oh, i just can't wait for october!

    twin pregnancies are not necessarily all that bad. i have heard a completely unscientific statistic, that if you have trouble getting pregnant, you have a fairly easy pregnancy. mine was pretty easy. I'm thinking yours will be a walk in the park!

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  45. Thanks for answering the question. I was curious and completely understand your thinking. You guys have been through so much, I deeply hope this transfer results in the baby/ies you've been waiting so long for, I'm crossing all my fingers for you!

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  46. Dearest Mo,

    I have stumbled across your blog from a friend's, a fellow Land of IFer. I am moved by your posts and feel your sentiment, and am so thankful to have another woman appreciate the feeling that 'the end is near'. I have had 5 losses myself, one of which was stillbirth at 6 months. There are no answers for me, and I am on the edge of wanting to try again. Thank you for this post and especailly for the post about your trip to Japan (Creme de la Creme Awards). You have brought me some peace today. All of the best in your journey, whatever you decide. Wishing you joy and happiness in the year ahead.

    Michelle

    Should you find the time or just want to know, you can find me here at:
    jones-seriously.blogspot.com

    ReplyDelete

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