SAIF or IF Vetrans: Question on multiples

WatchPot · April 2011

I realize this may be a very sensitive or tricky question to ask but I'll do my best not to offend anyone.

If you went through IF treatments and were told at any point of treatment you had a risk for multiples:

1) did you change your protocol one way or another?

2) was your outcome what you had expected/hoped?

3) Would you have done anything differently looking back at your situation?

Basicly we are trying to decide if we transfer 1 or 2. We would have no problems with twins, and could handle it I'm sure but we have no family with in 2000 miles, I work FT and so does DH and I'm not sure I'm a strong enough person, selfless enough mom to handle multiples and a 3 YO. Of course we understsand that we are doing all of this out of our own will and beggers can't be choosers, but I'm terrified that I'll fail at being a MoM, and that's not something that i feel comfortable failing at!!

Just looking for some insight from someone who's been through it.

dmoreilly · April 2011

We went through IVF as several rounds of IUI did not work for us. They were able to harvest 13 eggs and 11 of them were successfully fertilized. After Day 3 there weren't any obvious "winners" so the doctor suggested waiting until Day 5 to the Blastocyst stage so we could have a better idea of the growth of the embryos. We had 9 that made it to that stage. The doctor asked us how many we would like to implant because there is a slightly better success rate at that stage. We decided to implant 2 as twins would have been okay with us but 3 would definitely have been more than we thought we could handle.

In the end, only one took from the two implanted and we have a beautiful baby girl. We would not have done anything different and are happy with our choice.

We also both work full time. DH's parents are 3,000 miles away and my parents and other family are 3 hours away.

Hope this helps! Good luck!

WatchPot · April 2011

dmoreilly:

We went through IVF as several rounds of IUI did not work for us. They were able to harvest 13 eggs and 11 of them were successfully fertilized. After Day 3 there weren't any obvious "winners" so the doctor suggested waiting until Day 5 to the Blastocyst stage so we could have a better idea of the growth of the embryos. We had 9 that made it to that stage. The doctor asked us how many we would like to implant because there is a slightly better success rate at that stage. We decided to implant 2 as twins would have been okay with us but 3 would definitely have been more than we thought we could handle.

In the end, only one took from the two implanted and we have a beautiful baby girl. We would not have done anything different and are happy with our choice.

We also both work full time. DH's parents are 3,000 miles away and my parents and other family are 3 hours away.

Hope this helps! Good luck!

THis is us too. 4 IUI's unsuccessful and we are in process of stims for IVF but they want to know on Friday our "intentions" on how many we plan to transfer, if all goes as planned and we have at least 2 at the 5DT point. Thanks for your insight. Our biggest fear is if we transfer 1 and that one doesn't stick. And I'm not sure I'm comfortable with that risk. The odds of mulitples with 2 transfered, at my clinic, is 30%. The odds of success from transferin 2 to transfering 1 goes down by 8%.

pixelvixen · April 2011

Go for it woman! You're a great mom and you could definitely handle two more babies... If you have a greater chance having even one baby by implanting 2 eggs, it seems like that's the route you should go. You've gone through so much to get this far... do it!!!

*fingers crossed*

Maddimom · April 2011

pixelvixen:
Go for it woman! You're a great mom and you could definitely handle two more babies... If you have a greater chance having even one baby by implanting 2 eggs, it seems like that's the route you should go. You've gone through so much to get this far... do it!!!
*fingers crossed*

YES YES YES! You would totally rock being a twins mom. I also say go for it.

Seattle_JiLLn · April 2011

I think a lot depends on what your infertility issue is. Like if you know your tubes are blocked and that's teh problem, then the odds are you're plenty fertile once those embryos get to the right spot. So I'd be more cautious. But if you think you have an egg quality issue, then it might be harder to get a sticky one, so I'd be more aggressive.

For us, if we had gotten 4+ mature follicles during IUI I owuld have cancelled. We were unexplained. We hadnt' gotten to the point of deciding with IVF so I can't speak to that...

MrsH_08 · April 2011

I was sort of on the other side of this, and wishing we'd transferred more. After 3 IUI's that didn't take (also never had many eggs), we did 2 IVF's. We did a 3DT for both because the embryos looked good, at that time, but the embryologist wasn't sure if they'd make it to 5DT (and the best place for them is in the uterus). And we had no frozens, either time.

For both IVF's, we chose to transfer 3 embryos. In both cases, one embryo implanted. As you know, we lost the first baby. And I'm scheduled to deliver this little guy in less than 3 weeks! However, I really wanted to transfer 4 embryos at the second IVF. We did a quick RE consult on the morning of both transfers, to get their best advice. I'm 39 and IVF is expensive (and mostly OOP for us). We knew that this would be the last IF treatment we could afford for a while. Those things factored into our decision, plus knowing that only 1/3 took in the first IVF. DH and I would have both been REALLY happy with twins. We were nervous about more than 2, though. The RE explained that adding a 4th embryo would not change our chances of getting pregnant. It would only increase our chances of triplets or quads. So, we went with the 3.

If we had it to do again (and we might when we TTC #2), there's a good chance we'll choose to transfer 4 embryos.

No one can decide what feels best for you, and no one can 100% guarantee your results. You just have to consider your RE's best advice and what works for your family. GL in your decision and the rest of your cycle!!

MrsH_08 · April 2011

Seattle_JiLLn:
I think a lot depends on what your infertility issue is. Like if you know your tubes are blocked and that's teh problem, then the odds are you're plenty fertile once those embryos get to the right spot. So I'd be more cautious. But if you think you have an egg quality issue, then it might be harder to get a sticky one, so I'd be more aggressive.

Yeah, I think there is truth to this. One of our issues was possible embryo quality, which is why we did 3DT's. That also factored into putting back either 3 or 4 embryos. We didn't even consider less than 3, to be honest. Even the RE said she thought we should do no less than 2, but think about 3.

WatchPot · April 2011

Seattle_JiLLn:

I think a lot depends on what your infertility issue is. Like if you know your tubes are blocked and that's teh problem, then the odds are you're plenty fertile once those embryos get to the right spot. So I'd be more cautious.

This is my H's thoughts too.

UGH This is quite possibly the hardest decision we've ever had to make.

WatchPot · April 2011

Maddimom:
pixelvixen:

Go for it woman! You're a great mom and you could definitely handle two more babies... If you have a greater chance having even one baby by implanting 2 eggs, it seems like that's the route you should go. You've gone through so much to get this far... do it!!!

*fingers crossed*

YES YES YES! You would totally rock being a twins mom. I also say go for it.

Awe, you guys are too sweet. I wish I had as much confidence in myself! Thanks for all the support Big Smile

KRoseToes · April 2011

I'm interested to see this conversation expand more. I know that there is a higher possibility of health problems with the babies if there are multiples. But I don't know percentage-wise the actual increased risk. To me it's not about having that many young children all at once; I'd be more concerned with long-term developmental disabilities. I honestly believe I would lean towards transferring 2 myself. But I'm not sure because I don't ever see a conversation including moms of multiples with disabilities.

WatchPot · April 2011

KRoseToes:
I'm interested to see this conversation expand more. I know that there is a higher possibility of health problems with the babies if there are multiples. But I don't know percentage-wise the actual increased risk. To me it's not about having that many young children all at once; I'd be more concerned with long-term developmental disabilities. I honestly believe I would lean towards transferring 2 myself. But I'm not sure because I don't ever see a conversation including moms of multiples with disabilities.

I can't find it now but Aetna released a study in proposition of IVF converage being madatory. The position is so that couples don't "put all their eggs in one basket" which leads to an increase rate of multiple and pre term births which cost way more than IVF in most cases. The arguement being if you didn't feel this was your only shot because of the cost, you'd be more cautious with the procedures and outcomes. I'll keep looking and email it when I find it.

mwhite5283 · April 2011

We did multiple iui's with 3 miscarriages so when we did round 1 of IVF, we were told that we had 25% chance of 1 in 4 taking. We transferred 4, but also understood that if more than one took, we would be willing to accept that. We got Miss G from that round. We did exactly the same thing the 2nd round of IVF and none took and I wish I had transferred more (my age, egg quality, etc. guidance was no more than 6). None of either cycle made it to day 5 to freeze. that being said, we have an awesome kid and we have accepted we won the baby lottery and are walking away happy with the one miracle we have. Good luck!

KRoseToes · April 2011

WatchPot- I can't quote your post because I'm on my phone. But I have heard that same thing about insurance coverage and taking less risk. This is the biggest reason I think IVF should be covered by insurance, because it saves everyone money and decreases stress and heartache. It sucks that money has to be a factor in this type of mediical decision. If insurance covered IVF I would absolutely start out with just transferring one. But because it doesn't I want to increase my odds so I will probably transfer two. (And please do email me the study if you can find it!)

Seattle_JiLLn · April 2011

I wanted to add that I almost never hear of people transferring just one. I always hear 2 or 3. Even one of my friends who found out during the IVF process that their entire issue was that his sperm couldn't penetrate her eggs. So they used ICsi to overcome that. An they still did two each time and got one baby each time. I would be scared shitless to have twins. But I woul have been more scared to have none. So the more I think about it and where my head was back then, I would have done at least two. But I woul also have trusted my RE and his assessment of our actual issues.

WatchPot · April 2011

Found it

I wasn't Aetna, but I heard the story originaly on NRP.

avann · April 2011

I'm usually over on SAIF but I thought I'd throw in my 2 cents. My tubes are blocked so IVF was our only option. I am fairly young and have good egg quality. I had great response with IVF #1 and we transfered 2 high quality blasts on day 5. One stuck and produced my DS. We were ok with and actually expecting twins the first time around.

Now I am pregnant again and we opted for a SET this time around. We had 8 frozen embryos from our first cycle and although I know I could handle twins, but the thought of twins and a toddler, financially, emotionally, physically, for my marriage...wasn't worth it to me. I would have rather had to do the transfer a few times then risk it. I think quality of life really goes into it the 2nd time around. We were lucky and got pregnant on our first FET with the single transfer.

Good luck to you. It is a tough decision to make!

MrsAmyB · April 2011

I'm going to be all over the place here. That is GREAT that you are pursuing IVF. I hope that you are successful right away!

I have love/hate feelings about IVF. Yes, I know, I didn't do IVF, or any fertility meds for that matter. I so wish there was infertilty insurance for all so that you wouldn't have to go back and forth wondering if you should do 1 or 2. Because I know, if you could do it 100 times, you would choose 1. My best friend can't afford IVF so she and her husband cannot have children and I so very much wish she could. I would give her one of my babies if I could.

(NOT directed at anyone) It bugs me a lot when people want to try and get pregnant with multiples. They just don't understand the risks. My pregnancy was VERY risky. I could have died. My babies could have died. It has nearly ruined my marriage a few times. As strong as we are, this is harder than anything we've ever done. It has put us near poverty and we'll stay here until they are in school. I think people find multiples as some novel idea and it's so much more than that.

There is a mama on the multiples board who had two eggs put back. It was a frozen transfer, which can sometimes cause a higher risk for an egg to divide and become ID twins. Well, one of her eggs did divide. TWICE. She is a proud mama to quadruplets. Identical triplets + a fraternal quad. They spent months in the hospital.

I'm not trying to scare you. I am just trying to put everything out there.

I wish you all the luck in the world. *hugs*

WatchPot · April 2011

MrsAmyB:

I'm not trying to scare you. I am just trying to put everything out there.

I wish you all the luck in the world. *hugs*

Thanks, Amy this is what I want, is honest feedback. I don't find multiples a novelty but want to carefuly come to a decision that makes sense for my family because I know this should not be taken lightly. Thank you for your honest feedback.

MrsAmyB · April 2011

KRoseToes:
I'm interested to see this conversation expand more. I know that there is a higher possibility of health problems with the babies if there are multiples. But I don't know percentage-wise the actual increased risk. To me it's not about having that many young children all at once; I'd be more concerned with long-term developmental disabilities. I honestly believe I would lean towards transferring 2 myself. But I'm not sure because I don't ever see a conversation including moms of multiples with disabilities.

Thank you.

Here is some perspective:

Singleton pregnancy: Flawless, midwife hospital delivery, minimal hospital costs, 40+ week gestation, has been the healthiest kid from day 1.

Triplet pregnancy and I was a rock star. So many MoMs have it much worse: weekly u/s's since week 12 (when we found out) with a high risk MFM, hospitalization for 1 week, 6 week premature delivery, 3 weeks and 6 weeks (x2) in the NICU, babies on cpap, .5 million in hospital bills, hydrocephalus, club foot, aspirations (x2), developmental delays, weekly physical therapy sessions, MRI's. And that is just in the first 11mo. They are always sicker than Meg ever was.

I can't even begin to explain how hard NICU life is. There are plenty of moms here who can agree. There are MoMs on the multiples board whos babies have worse disabilities than mine and who have lost babies.

That said, I would lean towards transferring 2 also. NEVER more.

MrsAmyB · April 2011

WatchPot:
MrsAmyB:

I'm not trying to scare you. I am just trying to put everything out there.

I wish you all the luck in the world. *hugs*

Thanks, Amy this is what I want, is honest feedback. I don't find multiples a novelty but want to carefuly come to a decision that makes sense for my family because I know this should not be taken lightly. Thank you for your honest feedback.

I'm glad. And I know that you don't

Seattle_JiLLn · April 2011

Amy I think a lot of IVF moms "want" twins because then they feel like they can just be done and not have to go through the heartache of infertility treatments any longer. I don't think it's because it would be fun to have kids to dress alike or have a big double stroller or anything. So I think it's less of a "novelty" and more of a "please let me complete my family so I can end this roller coaster".... just another perspective....

(p.s. Not that having one child makes your family incomplete. Just that a lot of people want more than one child... and two would be "enough" to call it good... )

MrsAmyB · April 2011

Seattle_JiLLn:

Amy I think a lot of IVF moms "want" twins because then they feel like they can just be done and not have to go through the heartache of infertility treatments any longer. I don't think it's because it would be fun to have kids to dress alike or have a big double stroller or anything. So I think it's less of a "novelty" and more of a "please let me complete my family so I can end this roller coaster".... just another perspective....

(p.s. Not that having one child makes your family incomplete. Just that a lot of people want more than one child... and two would be "enough" to call it good... )

I completely understand which is why I wish infertility treatments were covered by insurance. A $10,000 (i'm guessing) IVF treatment is 50 times less than the cost my insurance co paid for my pregnancy and NICU stay. Not to including the first year of life x3. It just seems more feasible for them to cover it than to not. Then, like I said, there wouldn't be a question over "should I put back 1 or 2?". I totally feel for her.

I know what it's like to want one more so badly and then to be totally crushed to feel like I hurt my family by having three more.

Seattle_JiLLn · April 2011

Yeah, it's asinine that fertility treatments aren't normally covered... It's so sad that when your reproductive system doesn't work right it's considered "elective" or "optional" to do something about it.

IVF is more like $15K at least, but still, definitely true. I know what it cost for Cooper in the NICU for 3 weeks.... and he just was waiting it out, not getting much special care. I can't imagine the costs associated with really early multiples if yours was already 1/2 a million!!!!! yowsa.

Mrs.Kiltlifter · April 2011

As someone who is on both sides of this hypothetical, I think ultimately it is a very personal decision. In regards to infertility if we had gone through IVF we might have transferred 3 accepting the risk. And that would have been based on current finances, heartache, and a desire to never go through it again. With our IUI's, each time we upped the anty on meds due to the lack of response. And we have two gorgeous children as a result of an injectible cycle. But had we known what we know now about how hard it truly is to raise multiples we might have thought harder about moving to IVF for more control over embryos versus hyperstimulation of my ovaries producing a lot of follicles and rolling with the IUI. As Amy said raising multiples is an effing tough job. Seriously it is always something you are dealing with. And I only have twins. I have no clue how Amy has survived this first year. The cost is extraordinary. The sleep minimal. And the stress is high. And if you have a child with special needs, then the job is even tougher. But man is it awesome to be a mom of multiples. Two smiling faces, two giggles, two times the love..... We are incredibly blessed.

kaitley44 · April 2011

DH and I thought a lot about this when we were going through our IVF cycle. We really didn't want multiples. Because my problem was blocked tubes and I am somewhat young, our Doc said we would be good candidates for single embryo transfer. With that being said, we were OOP and only had one chance. We decided that it was worth the risk to transfer 2 and accept the outcome. We decided that we would gladly accept twins over not having a baby at all.

Our cycle only yielded four eggs, and only three fertilized. We did a three day transfer of one excellent 8 cell and one poor quality 4 cell embryo. It was thought that the third wouldn?t make it, but they would so how it does in hopes of freezing it. That last embryo didn?t make it to freeze.

Both that were transferred implanted. I had a great pregnancy and made it to 38w 5d with out any problems. I love my children so much that I would do the same thing in an instant. With that being said, twins are soooo hard. I haven?t slept for more than 4 hours in a row in over a year. It caused some marital issues, which have been resolved over time. I now think they are pretty easy. The other thing to note about multiples is that you have to plan for at least 20 extra minutes for outings because you turn into a freak show and strangers constantly stop you telling you about the twins they know or to ask a million questions. It gets very frustrating after awhile especially when you just want to go shopping.

If IVF was covered by insurance we would have done SET and would for a future child. If we ever have the money to do it again OOP we would transfer 2 again. Two more babies are better than no more babies.

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