Number of Embryos to transfer (child & loss mentioned)

famiylgrl86

Hi, A little about my background.. I went through IVF back in 2017. I had 1 5 day embryo transferred which resulted in my son & 5 embryos I was able to freeze (none of them have been tested). I went back late last year to grow my family. I transferred 1 embryo which resulted in a positive, unfortunately I was getting very low HCG numbers. They did a handful of ultrasounds, I even saw the heartbeat, but then a week later I miscarried. 

The doctor sent me his report on this last cycle & the recommendation for going forward. It said that for my upcoming cycle I could transfer 1 or 2 if I wished. I see a lot of conflicting data on the internet so thought some you ladies could share your experiences on what you decided, if 2 did you end up with multiples? I have an appointment with my doctor at the end of the month so will definitely be asking him these questions as well, but it would be very helpful to hear some first hand experiences. Also wanted to add when I went in for my transfer this last time the computer recommended I should be transferring 2 embryos. Not sure if this is because of the "grade" of the embryos or what. I'm 34 so I don't think it would be an age thing. 

mbradfo2

My doctor gave me the option for 1 or 2 embies for transfer; we went with 2 due to my previous history of losses. There's only very shaky evidence that transferring 2 gives higher success rates, but a lot of doctors will give you the option if you have a history of loss and aren't high risk (over 35, health issues, etc). 

Both embryos did implanted and we had 2 heartbeats at 7 weeks, but at 8 weeks, one had stopped developing (showed enlarged yolk sac so was likely abnormal -- it was a loss similar to my previous loss which was also due to abnormality). We ended up with a healthy singleton. 

Vanishing twin is very common with double embryo implantation and I know there are many ladies on this site who have experienced that. Two embies don't guarantee twins; I think it's more like giving yourself another chance for a healthy baby. 

cashewchicken

I think it depends on your comfort level with having twins. While transferring two embryos doesn’t guarantee twins, it significantly increases the chances of becoming pregnant twins, compared to eSET. Since you had your ER in your early 30’s and you had a successful pregnancy in the past, even with a recent miscarriage, it doesn’t warrant transferring two. You can look up ASRM’s guidelines for embryo transfer and they highly recommend eSET for a case like yours. 

FuzzyDust

My husband and I always say what we wanted twins until we had one and realized how much work it is 😂
It all depends on what you're comfortable with. Statistically speaking, you actually have a greater chance of ending up with a born healthy baby if you do two single transfers than one double transfer. That's mostly because the chances of having at least one of them stick are about the same in both cases, but the chances of further complications are greatly reduced if you're only pregnant with one.
Also, take into consideration the chances that even one can split into two (which is more common with reproductive treatment cases than in natural pregnancies).
I would consider implanting 2 only if I do IVF after 35 and don't do the testing (since the chances of normal are greatly reduced by then), but at your age, it's most likely that the majority of your embies are good.

mtpbadger

It totally depends on your RE, you, and even your OB. I made sure my OB would be okay with me having a twin pregnancy and she was, so after 3 failed single transfers, we moved on to transferring 2. My successful pregnancy, we transferred two but only one stuck. Looking back, I'm VERY glad only one stuck b/c I ended up going into labor with my water breaking at 32 weeks. Moving forward everyone recommends only doing single transfers b/c I'll be considered high risk for early labor in the future. 

mbradfo2

Ah, yes, I forgot that the only reason we were allowed to transfer 2 was because we didn't test them. Only one PGS norm would have been allowed otherwise.

famiylgrl86

Thank you all for your inputs!! Lots to consider. I keep going back & forth. I met with my doctor today who gave me some statistics. Basically transferring 1 of my embryos will be a 30% change of pregnancy with a a 2% chance of identical twins. 2 embryos would bring my chances up to 45% chance of pregnancy with an 18% chance of twins. 

FuzzyDust

famiylgrl86, instead of comparing transferring one or two, compare "transfer one twice" and "transfer both at once":

Transfer once twice (based on your above % for single transfer + some math): 51% of at least one pregnancy, 4% chance of at least one set of twins
Transfer both at once: 45% of pregnancy, 18% of twins

I mean, with the only difference that you'd have to do the FET twice (and pay twice), the chances are actually way better with eSET.