Embryo's IVF/ICSI

kjf114 · May 2013

I wrote a previous post earlier regarding IVF/ICSI and twins. I am 27 everything good and DH with severe MFI. We are going in for ER May 29-31. We signed off on 2 embryos as I previously stated my RE said 25% with 1 embryo & 55% with 2 with (1 in 4 chance of twins).

On day 5 of transfer would statistics change due to quality of the embryo? I have over 10 follicles on both sides and he feels we will get a lot of good eggs. If we have great embryos did your RE recommend at the time 1 or 2??

DebateThis · May 2013

I'm 29, DH is 33, we're "most of the way unexplained IF". I had 25 eggs retrieved, 24 mature, 22 of which fertilized (half ICSI, half traditional).

We made the call to only transfer one embryo on a 5dt. The likelihood of success goes up with 5dt's and we weren't at all comfortable with the risks of twins. Especially for your first transfer and at your age, I would err on the side of caution (personally) and transfer one. Transferring two doesn't raise success rates - it just raises the risk of twins and I believe ASRM guidelines for your age and 1st IVF suggest you transfer 1 (if it's a 5dt and good quality).

All that being said, it also depends on if you're OOP or if you have insurance plus how well the rest of your embies are doing. We were comfortable with transferring one due to the risk of twins (as I said before) but also because we had a whopping TEN embies make it to freeze, so if IVF#1 hadn't worked, a FET could have soon followed. If we'd had only one or two embies make it to 5dt and none to freeze or if insurance wasn't covering it, the decision would have been a lot harder.

It's such a mindfuuck and I wish you all the best in your decision making.

PurpleIris30 · May 2013

I'd read the responses to your post below. Yes, absolutely quality makes a big difference in the statistics for success and the recommendations for how many to transfer.

tatianaazulay · May 2013

Quality males a diference, i ended up with 12 embryos, and on my first attempt we implemented 2, but after trying for soo long we were ok with twins. I am now pregnant with one baby! Ohh, I forgot to say, I am 27!!!

Gr8te · May 2013

We have MFI. RE only wanted to transfer one, but then recommended two since we lost so many embies between day 3-5. The sperm kicks in after day 3, so they were worried about embie arrest and implantation failure. I had two sacs, but only one healthy heartbeat. Our blasts were 3BA and 4BA. GL

PennyLane26 · May 2013

We had crappy embryos for our 1st IVF, we did a 3 day transfer of 2 embryos that ended in c/p.

Our second cycle was awesome. We had 7 blasts of the highest grade on day 5. We went in assuming we would transfer 2 like before. At the time i was veryvdisappointed that we didnt, but I'm grateful to my doctor for pushing us to transfer only 1. We froze the remaining 6.

This is sort of a game time decision for you and your doctor. If you are under 35 and have a stellar day 5 blast, it should be a no brainer to transfer only one.

Twins are a blessing, but any multiple pregnancy is a risk to both the mother and her babies. I ended up having serious complications at the end of my pregnancy and I can't imagine having the stress of a multiple pregnancy on top of it.

jadwedd · May 2013

It is such a hard descision because they don't know how things will work out. Right from the beginning my re said he would only put one embryo back in. But on day 5 only 2 out of 10 made it and they were in such bad shape that he decided to put both in and one made it. I would not stress now about the descision because at the last minute things can change. They saw no reason why my eggs would be bad. And up until day 3 8 of them looked pretty good but it went downhill from there. I hope that the same doesn't happen to you, I hope that you have tons of frosties and your embryos are all strong. But I just wanted to let you know that no matter what the re says until those little suckers start splitting they don't know what you will get. Good luck!

kjf114 · May 2013

Thank you all so much for your advice this will help me get sleep at night. Such a tough convo topic to discuss with dh he wants 2 no matter what because how long we have been trying. He had tears in his eye and said he can't bear to see another no : heart breaking moment but I want to make sure it's the right decision 1 vs 2. We will wait to see what embryologist says. Thanks again for all your help ladies!! Xox

TrixieGirl82 · May 2013

We had good looking embryos (7 of them). My RE gave me similar stats. He didn't really persuade us either way-but for how much we shelled out and such a stressful process we wanted to do what gave us the highest chance. Yes twins come with additional risks-but I trust my doctors. And if we didn't get pregnant I felt I would always regret not doing two. Both took for us and we were pregnant with twins, unfortunately we lost one sometime between 9 and 10 weeks. If we had to do it again I still would choose two.

Mitzi Bishi · May 2013

We have a similar diagnosis (severe MFI, only option ICSI) and we always had at least 2 blasts for a 5dt.

Cycle 1 - 5dt 2 blasts - BFN

Cycle 2 - 5dt 2 blasts - BFN, 1 frozen

Cycle 2.1 - frozen cycle - BFN

my husband took maca and had a varicocele surgery...

Cycle 3 - 5dt of 2 - 5AA blasts - positive, twins (+3 frozen). This was ~6 months after the surgery.

I'm now 16 weeks with b/g twins.

Gregermis · May 2013

Mine recommended 1 for fresh ET and 2 for frozen ET.

LuClo · May 2013

kjf114:
Thank you all so much for your advice this will help me get sleep at night. Such a tough convo topic to discuss with dh he wants 2 no matter what because how long we have been trying. He had tears in his eye and said he can't bear to see another no : heart breaking moment but I want to make sure it's the right decision 1 vs 2. We will wait to see what embryologist says. Thanks again for all your help ladies!! Xox

Just be careful of this. We all know how you're feeling, and how hard it is. You get so exhausted that you'd do anything for this to be the cycle. But you don't want to make medical decisions based on emotion.

We're MFI and did a single 5dt after icsi; we're 15 weeks pregnant now. One of the reasons our RE pushed for a single is that we were MFI. I'm 29 and really healthy. Our challenge was making a healthy embryo, but once we had one my body was ready to support a pregnancy. He felt like this gave us much better odds of it 'sticking' and didn't want to push it with multiple embryos. In our case he was right.

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