DE question -- are you required to transfer two?

AmCheri · May 2012

As some of may know, we're in the process of moving to DE. We're in the due diligence phase right now.

I noticed that as part of the DE program at our clinic, my RE requires you to transfer two. Is this just par for the course? I'm not sure how I feel about it yet.

Thanks for any input you can offer.

ETA-- major clarification. Two are required if you go with any version of a guarantee program. Sorry! That's a huge piece to the puzzle.

NMscubagirl · May 2012

That seems strange to me... I don't like it when any doctor has an always requirement. What about women with past cervical issues that aren't clinically indicated for a chance at multiple pregnancy. Sorry, I know I am not adding anything helpful, I just don't like it. GL though!

AmCheri · May 2012

NMscubagirl:
That seems strange to me... I don't like it when any doctor has an always requirement. What about women with past cervical issues that aren't clinically indicated for a chance at multiple pregnancy. Sorry, I know I am not adding anything helpful, I just don't like it. GL though!

Hi Scubadoo I'm tired. Had to work late. Forgot to add that you must transfer two for the guarantee programs. I suppose that's the answer.

krod2010 · May 2012

AmCheri are you concerned about transferring two because two might take? I am just wondering because I just did my second DE cycle (first one we put two "perfect" embryos in, one took but I miscarried at 9 weeks) and I just did my beta on Saturday where we had once again transferred 2 "perfect" embryos which resulted in a chemical pregnancy. I really wanted to transfer 3. My RE talked me out it saying these were leaps and bounds better than the first two (we had to cycle again with our donor) and was so confident both would take.

I won't be transferring two next time....

Good luck!

NMscubagirl · May 2012

AmCheri:
NMscubagirl:
That seems strange to me... I don't like it when any doctor has an always requirement. What about women with past cervical issues that aren't clinically indicated for a chance at multiple pregnancy. Sorry, I know I am not adding anything helpful, I just don't like it. GL though!
Hi Scubadoo I'm tired. Had to work late. Forgot to add that you must transfer two for the guarantee programs. I suppose that's the answer.

Ok, that makes a bit more sense, but still I don't like it that they force people into that situation just to get the benefit of a guarantee program. That shows how little they actually care about who they are helping and more about the money, but isn't that always the way with these types of companies. I am assuming the guarantee program is separate from your RE.

AmCheri · May 2012

krod2010:
AmCheri are you concerned about transferring two because two might take?

I won't be transferring two next time....

Good luck!

Thanks for your helpful comments krod. Yes, I suppose I am somewhat concerned about twins. I'm AMA so that does enter into my thought process. Although, at this point, it seems almost absurd that we wouldn't transfer two. I'm sure I'd do ok with twins, but it does give me some pause. I feel foolish even asking this question because it presupposes that a DE transfer would even be successful for me.

AmCheri · May 2012

NMscubagirl:
AmCheri:
NMscubagirl:
That seems strange to me... I don't like it when any doctor has an always requirement. What about women with past cervical issues that aren't clinically indicated for a chance at multiple pregnancy. Sorry, I know I am not adding anything helpful, I just don't like it. GL though!
Hi Scubadoo I'm tired. Had to work late. Forgot to add that you must transfer two for the guarantee programs. I suppose that's the answer.
Ok, that makes a bit more sense, but still I don't like it that they force people into that situation just to get the benefit of a guarantee program. That shows how little they actually care about who they are helping and more about the money, but isn't that always the way with these types of companies. I am assuming the guarantee program is separate from your RE.

No, it's not separate. It's my RE's DE guarantee program. Makes me nervous. We're 100% OOP so the guarantee program is generally attractive. I'm just not so sure about the transfer minimum.

krod2010 · May 2012

DE is hard enough and I thought there was no way I wouldn't get pregnant with twins the first cycle....and now we are having to do our third cycle. I have asked my RE to transfer 4 next time and she agreed. Our frozen embryos aren't rock stars like the two we just transferred so it doesn't concern me to transfer 4. I am kicking myself that I didn't have her do 3. Unfortunately I realize you can't judge a book by its cover....so regardless of my clinic grading our last two embryos as 4AA and 5AA they can still be chromosomally abnormal. I would trust your clinic to do 2. I am 41.....and I want twins but because I can't see myself doing this again if I had a singleton at 42 or 43. I am also a twin.

Everyone has a comfort level. I know for me that I can't take much more failure so I won't do two.

JM1977 · May 2012

This is a totally valid question!

We went through the Shared Risk/Split Cycle program at Shady Grove, and they highly encourage single embryo transfers. They ultimately leave it up to you, which I appreciated. On our transfer day, we chose to just transfer one. It was SUCH a hard decision. After so many failures, it seemed impossible that it could work, let alone with a single embryo, but it did.

Our embryos were great quality, and they said that transferring two would only increase the chances of success by a very small margin (this was a whole new way of thinking after cycles with low quality embryos). I also feel so grateful that we just transferred one since having one baby at a time really was our goal (we have two frozen).

So, all of that said - I also wouldn't be enthused about your RE's office having stipulations for the guarantee program about how many embryos to transfer. That is such a personal and individualized decision (and one that has some major health consequences) - it seems like it should be separate from the guarantee program...

I wish you all the best with your decisions!

Gregermis · May 2012

No where did I read that it was required, but with a c/p on a SET during our fresh cycle and losing both twins on FET #1, my RE is refusing to transfer just one

mtlaurel · May 2012

No. It's pretty standard, and we intend to, but I've never been told we had to. That would turn me off.

Edwina.McDunnough · May 2012

We always had the choice for a sET and we were not in a guarantee program.

reb259 · May 2012

When I had my phone consult with Dr. S.hapiro @ RBA, I got the impression that if you have 2 high quality embroys at day 5, they try to guide you toward a SET. They also have a guarantee program.

We are torn what do you...I would prefer not to have twins but as K said, I am not sure how much longer I can continue to do this. I guess I will have to see how they look at day 3/5 and what the Dr recommends.

lynn0926 · May 2012

I am in the success guarantee program and part of the agreement is to transfer two. Many people chose to do an eSet. It is personal preference really. It was never a doubt in my mind that I would transfer two even before knowing that is part of our contract with the success guarantee program.

Imanurse03 · May 2012

We did a shared risk but we could transfer 1 or 2. RE didn't have any requirements in that sense.

We transferred 2 for my sticky BFP cycle last year. We did have a vanishing twin. In my case, I wanted two transferred because of my miscarriage history. We have frozens and will probably transfer 2 again in the future.

I would think your RE would honor your wishes, shared risk or not. I know lots of REs have great Good luck!

njohnson1972 · May 2012

Well, this scared me at first!

We will be doing DE for #2 and I really, really, really, really do not want twins. The idea of 3 under 2 scares me to death. Especially as a working mom. I don't even want many embryos left to deal with after getting #2.

Ideally (yeah, I know it makes me laugh even typing this since when has anything ever gone ideally when it comes to IF), we would do a shared cycle, SET and get 1 baby and be done.

jcath · May 2012

I did the frozen program at RBA and at least my Dr was very open to a single embryo transfer - but we did talk through why or why not an eSET might work for me. I was very afraid of having twins b/c I had a recent second trimester loss and was concerned about the very real possibility of complications in a multiple pregnancy. We had done an IVF with PGD that showed all abnormal embryo's and have older children so we knew I didn't have a uterine issue. So we felt really good that if we got a good embryo in there, things would take.

We ended up having ID twins and am happy to report that I had a pretty easy pregnancy but still feel really good about my decision to do an eSET.

Here's some good info on eSETs.

https://www.cdc.gov/art/PreparingForART/ESET.htm

Whatever you decide to do - wishing you the best of luck.

harriet93 · May 2012

I'm also in a Shared Risk program at Shady Grove, as a previous poster mentioned. I'm using a 1:2 donor match. Our dr has recommended 1 or 2 based on the quality each time. There are no requirements to transfer a certain number.

Good luck to you!

harriet93 · May 2012

P.S. -- to clarify, they do usually recommend one for me, as the PP who mentioned Shady Grove mentioned. On our third cycle, the dr said he would "understand and support" us if we wanted to transfer two. We did, and we did on our fourth, also. He definitely left it up to us, and didn't try to sway us to transfer one.

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