advice from those of you that did IVF?

perry7285

i have a question; i posted this on the SAIF board as well, but i thought that the ladies on this board might have some helpful insights.

my DH and i are moving on to IVF in january, and the doctor we're working with is pretty flexible, so (assuming we have lots of embryos), it's up to us whether we transfer one, two, or three. i am torn between two and three. to those of you who have been through this decision: were there any good sources of information on risks, probabilities of success, etc, that were helpful to you? any thoughts or advice for someone going through this decision? (my background: i'm 28, DH is 31, and as far as we know our only problem is anovulation.)

TIA for any thoughts!

nygrl79

I didn't do IVF, but the next cycle after my BFP was supposed to be IVF and DH and I talked about this issue at length. The question to consider is do you want to have triplets?  Do you know the risks of carrying 3 (to both you and the babies)?  Most triplets are born around 33 weeks... What would you do if one of the implanted embrios ends up dividing into indential twins?  This happens, I believe there is at least one woman on this board that transferred 2 embrios and ended up with triplets.

I would not have transfered more than 2 embrios on the first IVF try (and I'm very surprised that your RE would even consider it on the first try).  You are still very young and so is your husband and it looks like you don't have major IF issues that cause people to consider transferring more than 2. 

Carrying 2 is automatically high risk as it is--why complicate things for yourself and your babies more than necessary?

prayin4ablssn

I had the choice of doing one or two. I chose two and had boy/girl twins on October 7th. Here is what I can tell you: the more you implant, the more babies you have a possibility of having. And that can be taken many different ways. Are you ok with multiples and the risks that go along with that?  I delivered my twins early at 31 weeks. Triplets you have an even greater risk. Do you have help like close friends and family that would help you with multiple babies? My advice would be to implant two. However, I think once your time comes to decide, you will know in your heart what to do. Wait until you see what kind of eggs you get and what their quality is. My eggs were OK, they weren't the worst and they werent the greatest. That was a heavy weight on our decision to implant two. Best of luck with your IVF too. And please keep your chin up, it's quite the process and demanding on our poor little anti-ovulating bodies. But I always thought of it as boot camp for my lazy you-know-what ovaries.

jenkm

I'm 33, my dh is 36, infertility reasons unknown (I had irregular cycles), and our RE told us he would only transfer 2 the first time.  Good thing too, as both took and we're having twins!  Our RE is one of the best in the state and I was really impressed with his knowledge and care.

Given your ages and lack of additional problems (endo, poor sperm morphology, etc.) I wouldn't transfer more than 2.  Unless you want triplets, that is!  Our RE told us that essentially, if you get good quality embryos, each one implanted has about a 50% chance of implanting and developing, so when you transfer 2 you're really trying for 1 successful pregnancy.  Obviously 50/50 is good odds for each one transferred, all things considered.

 I hope that helps, probably rambling a little as it's late and I'm wiped out.  lol  Good luck to you!!  Any IVF questions, let me know, I'm happy to help.

Addykins

I'm 26 and DH is 27. We were dx with MFI. We did IVF with ICSI and transferred 2 at a 5dt. We are having fraternal twins (or they are fairly certain they are fraternal). We knew going in that our chances for multiples.

My insurance allows us 6 IVFs. (I live in MA) We were lucky enough to get our BFP on the first try. Our RE had told us that she recommended transferring 2 until we got down to the very last IVF cycle that insurance would cover. If we got down to the 6th IVF then she recommended transferring 3 so we got the best chance at a bfp possible.

jenkm

Addykins:

My insurance allows us 6 IVFs. (I live in MA) We were lucky enough to get our BFP on the first try. Our RE had told us that she recommended transferring 2 until we got down to the very last IVF cycle that insurance would cover. If we got down to the 6th IVF then she recommended transferring 3 so we got the best chance at a bfp possible.

 Very good point to bring up...  We transferred 2 knowing we had 4 rounds of IVF covered.  If we only had one, or were paying out of pocket, we would have considered 3 (if that was an option).  But my dh and I discussed the potential for reduction at length when we were making our IVF decisions.  It's not for everyone, obviously, but we decided that we would reduce if we wound up with more than 2 embryos implanting.  We felt the risk of reduction to the other 2 would be better than the risk of the health of all if we went forward with 3.  We genuinely did not want triplets or more.

Again, sensitive topic and I TOTALLY understand and respect those who disagree with me...  I bring it up only as a consideration.  You should be prepared for what your options are should you wind up pregnant with multiples, and discuss everything ahead of time with your dh so you're on the same page as to what you'd do.

Again, all the best of luck to you guys!

Rose.9.6.03

At your age and your IF issue, I'd transfer either one or two.  No way would I consider 3 embryos on my first IVF attempt.  I'm surprised that your RE is even giving you a choice. 

Multiples come with risks.  Higher risk pregnancy, higher risks for birth defects.  While I'm so happy to have my twins, I know that I was very lucky to have a relatively uneventful pregnancy and two healthy babies. 

Personally, I see three embryos as taking an unnecessary risk at this point.  And I know that there are studies in Europe that say that transferring two embryos, instead of two,  only slightly increases your chances of pregnancy with IVF.

Whatever decision you make, I wish you the best of luck. 

blossom

I would only transfer the amount of embryos that you are actually willing & able to carry and care for. I never would have wanted triplets so I wouldn't have chosen to transfer three under any circumstances. I even considered only transferring one embryo.

My doctor recommended transferring no more than 2 during my first IVF and I was 34 w/pcos at the time. That cycle was a negative, but our second cycle worked (FET) and now we're expecting twin boys.

kiki408

We put back two, and ended up with triplets at the first u/s. One embryo split, resulting in identical twins and a singleton. At our 7 week u/s, however, we learned that the singleton was no longer growing. I just delivered our identical twin girls a little over 2 weeks ago. I think IVF with ICSI, which is what I did, is associated with twins, so I'm sure that's what caused the egg to split.

With that said, I will say that I've learned that IVF puts you in your own little "risk category". I never thought it would happen to me, but my high risk specialist started off by listing all of the things I was pre-disposed for just because of IVF, without even considering that I was carrying more than one (pre-e, gestational diabetes, shortened cervix, high blood pressure, etc.). At 26 weeks I ended up on bed rest (some hospital and some home) for a shortened cervix & was delivered at 35 weeks 4 days due to high blood pressure. My girls spent exactly 1 week in the NICU.

I think what I am trying to say is just to be cautious. The goal is to have one healthy baby born at term. Multiples sounds wonderful, AND IS, but I would be mindful of the fact that not only does a multiple pregnancy bring elevated risk factors, but IVF does too! I never realized how scary it would be to have a shortened cervix, high bp, or babies in the NICU. It's scary.

I think because it's your first time around with IVF and your only issue is an-ovulation (this is what I had, too), I would go with two embryos the first time around. The decision is yours, of course, but based on what I went through, I would only do 2.

Good luck!!!!!!! I wish you all the best )! I hope my blabber mouth helped!

lnle

I replied to you over on SAIF.

jamie217

I would only do 2.  You are young and with your dx, there is a good chance once your on stims you'll be fine. I have endo, a tubal factor and my ovaries behave as though I have PCOS.  It was along road to determine the proper level of stims, but once we did and had our ER my eggs quality is great.  I was put on such a low dose that we only got 4 eggs, 3 mature - we put 2 back and both implanted.

With IVF there is also higher chance of an embryo splitting, so even with 2 embryos there is a chance you could end up with triplets or even quads. Plus at your age you still still have a chance of doing FET or another round of IVF well before your 35 and your success rate starts to drop a bit.

joliemariée

My clinic - huge teaching hospital in Chicago - would not implant more than 2 embryos. We actually had to sign off that we were aware the would NOT implant more even if we wanted to. The reasoning is the complications, danger to the mother/babies in high order multiples etc...My RE Dr. said " we do not want to be responsible for the next octo-mom"

We were very, very blessed, we had 1 insurance covered IVF -  on our first try we implanted 2 embryos w/ICSI and I am pregnant with beautiful boy/girl twins!!!

 

Good luck to you & don't be scared of all the drugs/shots. It is alot to go through, but it is only a short time and It is all worth it!

k&b51907

We did IVF.  I'm 26 DH is 31. We had PCOS and MFI. The first cycle we transferred 2 on a 3dt.  That ended up being a failed cycle. The second cycle we were more aggressive as it was our last chance and we did 2 on a 5dt. That resulted in our triplets since one embryo split.

I would highly suggest having a sit down conversation with your dr.  That's what I did when our first cycle failed and he gave me a run down of all the pros and cons on transferring two on a 5dt.  He would never have transferred more than two given my age.

Good luck to you and your decision. Hope you get your BFP soon!

SPerry0376

I feel like I have good advice on that one. I have no known fertility problems (other than not ovulating often), our problem was a vasectamy. My RE said that if we transfered 3 emryos the chance for triplets was less than 1%, and twins would be 30%. BUT our chance of getting pregnant with atleast one baby was like 75%. We loved those odds and felt like it wasnt much of a risk towards triplets. We were also fine with twins should they happen.

Another thing to keep in mind was that it took two fresh cycles for me to get pregnant. Had I only transfered 2 embryos and not gotten pregnant, I would have been kicking myself. I feel like by transfering three the first time, even though I did not get pregnant, I did everything that I could.

You have to ask yourself two big questions, would you be okay with twins, and would you be disaapointed if you only transfered two and did not get pregnant.

Temp159135562506975

since this is your first IVF- i would personally not put in more than 2. I might even just do one.  Being pg with twins/triplets  is not a fabulous thing -- yes, our children are amazing and wonderful- but multiple pregnancies have a ton of risks associated with them- which is why most REs have the goal of ONE baby- ONE pregnancy... that is what mine aims for.

Knowing how many problems the many babies on the MoM boards I frequent have - I count my blessings every day that my twins are healthy. Twins or more = not just risky pregnancies- but often other health problems as they grow.... it's not something to take lightly. It seems you are not- which is why you are asking for advice- but I just want to stress how difficult it can be to be pg with multiples and other issues are common after birth, too.

Best of luck in your decision- and in your IVF cycle!

eileenm21

we did our first IVF in June and ended up with twins.  We transferred 3 embies on the first IVF -  when we talked to the dr. she felt strongly that we transfer 3 based on the quality of the embies and our ages.  Now we had a LENGTHY conversation about it and what would happen if all three took.  Both my husband and i were very concerned about transferring 3 and were going to change it to 2, but we did our IVF at Cornell which is considered one of the best so we decided to listen to them since they were the experts.  it was a hard decision and it took a lot of conversation, but here we are with b/g twins.  I am loving having multiples, but I am not going to lie - I worry every day about them and all the increased risk we are at.  I wouldn't trade either of them for the world, but it is not the same as having a singleton.  seeing your dx and your age, I would go with 2. 

efhoping2010

My RE and I think all of the ones in this state will only transfer a maximum of two embryos/blasts with a first time IVF for anyone under 40.  And he said the only reason they transfer two is that there is a higher chance of one sticking.  So transferring two does not mean twins.    Best of luck and I hope your cycle is a success   Stay positive and take care

EverAfterinMi

One of our embryo's split also giving us triplets.

Personally, I can't believe at your age and diagnosis that your RE would even consider allowing you to transfer three on your first IVF. You really need to see your embryo quality before making any kind of decision. The best advice I can give you is don't transfer more than you want to raise or carry! But there really needs to be many contributing factors before you get to the stage of transferring three. Age, embryo quality, failed cycles.. that kind of stuff.