RE asked us about selective reduction

Charmire · September 2010

When DH and I were at the RE's yesterday, she started to talk about the risk of HOM with injectable IUI (we are doing clomid plus injects next cycle). She then asked how we felt about selective reduction. I am having a hard time wrapping my head around it. I can see if you ended up with 8 children, thinking about it, but where do you draw the line of "this many is too many"? I hope that I am never put in a position to make that choice. I was curious though what others on the board thought about it.

Yellow_Daisy · September 2010

From what I understand most REs will talk to you about SR at some point. My RE did. Ultimately how many is too many is up to you and your DH, but I personally think a doctor who doesn't bring it up at all is being remiss in their duties.

thebeadinglady · September 2010

DH and I had a pretty extensive conversation about this before we ever started treatments. We came to the conclusion that anything more than quads and we would seriously consider it. I know myself and I know I would have a hard time actually going through with it, but at the same time I know what the two of us can handle, and I think four babies at once would be stretching it. We are open to it SR, but it would depend a lot on the circumstances and what all of our doctors had to say.

Dragonfly1226 · September 2010

I wouldn't trigger if I had more than three mature/close to mature follies. I know that I could never make the decision to go ahead with selective reduction, and I was scared of the risks for the babies and for me with HOM.

Good luck

sweetky_06 · September 2010

I'm curious now what your RE's policy is on moving forward with the IUI. Mine won't do IUIs with more than 4 follies. However - we were advised about the risks of selective reduction versus the risks of carrying HOM. The hospital our RE works with does not do selective reductions so we'd have to find another location.

My personal opinion - I am OK with selective reduction, but I hope that the other decisions we are making, regarding how many follies to trigger with our how many embryos we transfer, will keep us from ending up in that position.

abbe19 · September 2010

It's a really, really hard thing to think about. It's like, we are praying for babies so badly and then if we are 'blessed' with too many, do we seem ungrateful if we select to carry only some of them? My RE will trigger with more than 4 follies but she strongly, strongly advises not delivering more than 3. It's a totally personal issue and a byproduct, yet another complicated byproduct, of infertility. All that being said, I would reduce only because of the risks of carrying too many multiples.

k-mart · September 2010

sweetky_06:

My personal opinion - I am OK with selective reduction, but I hope that the other decisions we are making, regarding how many follies to trigger with our how many embryos we transfer, will keep us from ending up in that position.

I agree with this. It's "easy" to think that SR is the right thing to do, but I don't know if I could do it when and if I am actually faced with it. This is were DH and I have had many discussion - he doesn't think twice about it because of the field he is in, but I'm more realistic and emotional about it. I hope you don't have to deal with it.

kthappy76 · September 2010

sweetky_06:

My personal opinion - I am OK with selective reduction, but I hope that the other decisions we are making, regarding how many follies to trigger with our how many embryos we transfer, will keep us from ending up in that position.

This exactly. In very few cases is this even an issue if you make good decisions upfront. GL to you.

Faith722 · September 2010

Dragonfly1226:

I wouldn't trigger if I had more than three mature/close to mature follies. I know that I could never make the decision to go ahead with selective reduction, and I was scared of the risks for the babies and for me with HOM.

Good luck

This. While the idea of HOM is very scary, I know I could never be ok with selective reduction.

NicoleeBonsai · September 2010

on the day of ET, when the RE told us we should transfer three embies (we had always planned on two), his very next sentence was "if you become pregnant with three, at that point we can discuss selective reduction." it took me aback a little, and DH and I talked about it later. we never considered it before that because we never thought it would be an issue.

i was very resistant to it - i thought why would i go to all this trouble to get PG then conceive three miracles and SR one of them. DH was pretty adamant that i shouldn't carry three. we eventually came to an agreement, but it was shocking to have to consider!

missred75 · September 2010

Yellow_Daisy:
From what I understand most REs will talk to you about SR at some point. My RE did. Ultimately how many is too many is up to you and your DH, but I personally think a doctor who doesn't bring it up at all is being remiss in their duties.

This. I think it's a personal decision deciding how many is too many, but it's an important discussion to have BEFORE you get into that situation. If you're comfortable with it and your DH is not, that could cause some major problems. Good luck. ::hugs::

sb78 · September 2010

Friends of ours put 2 back in and ended up pregnant with 3 (one split). Her RE referred them to a psych and they had to talk to her about SR and their reason for NOT reducing. Both the RE and the psych were encouraging reducing one. I couldn't believe it. It's not like she had 6 in there. They obviously denied and now have 3 beautiful boys.

Our RE made us check a box that said "Yes we are open to the SR discussion" or "no, we are never open to that discussion." We chose Yes, but knowing that we would deal with it if necessary and we have never had more than 2 follies for an IUI. We are doing IVF now and will probably only transfer 1, so again, a non issue for us.

c0debabe · September 2010

It's very important to think about this and let your doctor know your feelings before you start taking hormones that will affect your judgement.

I know that I would not be able to go through with SR and so I let my doctor know that, so that he can be a bit more conservative in treating me.

Just Anything · September 2010

This question actually came up at our last IUI. The RE office will not do an IUI if there are four big follies but at our last IUI, I had one big follie and a few that were questionable. RE asked us if we would consider SR because if we were not, she would have to cancel our cycle because of the "questionable" ones.

The thing is that there are complications that you have to consider when carrying more than two. Even with twins, the chance of a high-risk pregnancy increases. Imagine if more than two!

It's definitely a difficult decision.

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