Transfer 2 blasts after two failed ESEts?

Viasatalyte · November 2013

Hello ladies! Congrats to all and hello to all my friends that graduated from IF. Hey September Sunflowers! Looking for some advice. I've had one fresh transfer of a 5AB blast, BFN. In October we transferred a 4AB also a BFN. Hysteroscopy ruled out uterine issues. Recent RPL panel looks good too. I have a 3BB, 5AB, 5AB remaining. FET is in January. What would you do? Transfer two? Does that really increase the odds?
Thanks ladies!

RosyGlow · November 2013

Hi @Viasatalyte! I have been thinking of you. I hope you are doing well - I am sorry for your latest BFN. I think I would continue with an eSET until I got a BFP, but it's a very personal decision. I think you're in a tough position, because you have gotten a BFN from a very high quality embryo...and it seems like there isn't much explanation for why. Did you do any chromosomal testing on the embryos? Even with a very good embryo that has been tested chromosomally, the odds of success (as in my case) was 70% chance of pregnancy. However, this doesn't always happen - there are still those 30% odds! It seems that you may have simply landed in that unlucky group. Did your doctor say anything about your odds of transferring two? I believe that with high quality embryos, transferring two doesn't really bring your odds up much more than say 10%, but it does double your odds of twins. I'm not comfortable with the idea of carrying twins since twin pregnancies are higher risk, so I am committed to only transferring one at each transfer. Like I said, it's very personal - I absolutely support whatever decision you would make because I know how ready you are for this to work. Hang in there, lovely lady!

Viasatalyte · November 2013

@RosyGlow, boy do I miss you and your sound, practical and encouraging advice. How is your pregnancy progressing? Please update me! I had my my wtf this week and doctor does feel like the odds have been against me. She then recommended transferring two and i broke down and cried. I am so afraid to do that for fear of failure. I feel like my previous little embies have gone to waste and the others will too. So sad. She recommended possibly doing further autoimmune testing after four failures, but the treatment is controversial and expensive. I told her i feel comfortable with transferring one, then if it fails maybe proceeding with the autoimmune testing. That would leave me with two. I was confident with that decision until I saw a new therapist that specializes in infertility counseling. She transferred seven and now has her 18 year old son. Anyway she recommended that i get a second opinion. So I'm doing that in a few weeks. Its so overwhelming. Btw, no I didn't do pgd.

sunflowermama42212 · November 2013

So sorry for your BFN. I had a BFN on my first IVF and my RE suggested transfering two with our second fresh cycle since my DH has very poor quality sperm she said it was likely we had a chromsome issue but the RE that did my transfer tried really hard to talk me out of transferring two because he didn't agree with my RE. Well I decided I would be okay with the risk/challenges of a twin pregnancy and transferred two anyway and one baby stuck. I think its a very personal choice and the two REs that couldn't agree on how many to transfer for me were the two top REs that have been at the clinic the longest. Every RE is different and everyone has different comfort levels with risks. I wish you luck with what ever you decide and I hope your next cycle brings you, your take home baby.

kflynn81 · November 2013

Like the pp said, its definitely a personal decision. We transferred one the first time and 2 for each transfer going forward. However, we would have been totally fine with twins should both of them had stuck so we were very comfortable transferring two each time.

Viasatalyte · November 2013

Thanks ladies! I have no fear of having twins, I fear losing two embies. That's what scares me. At this point hubby and I would welcome 1, 2 or 3!

Roeni · November 2013

If you are okay with twins go for it. The way I see things, if I had not transferred 2 I wouldn't be pregnant with this one, unless it was just this single one that was selected. Earlier this year we transferred 2 and one took. What if we had only transferred singles of the ones that didn't take?

ThereBeDragons · November 2013

Viasatalyte said:

Thanks ladies! I have no fear of having twins, I fear losing two embies. That's what scares me. At this point hubby and I would welcome 1, 2 or 3!

Im on my ipad, so no paragraphs, sorry. You're not really compromising either embryo if you are comfortable carrying twins. If they are both viable- they'll both stick. If only one is viable, only one will stick. If neither is viable- neither will stick. Unless you truly believe the problem is with some process other than the embryos (uterus, clotting or immune disorder, etc), the only difference transferring two makes is in raising your odds slightly and raising your odds for twins. If you do think the problem is outside of the embryos- that's the first thing to address. I've had three failed transfers, and two losses- 10 embryos that failed to make it to term (our 11th is hanging in for the moment). And 9/11 of those embryos were high quality day 5 blastocysts (2 were mourolas). We've had to tweak the process each time to see what we can do to help me carry to term. First I started taking PIO instead of crinone since my progesterone levels were utter rubbish. Then I got a huge loss panel since I miscarried even on PIO- which revealed MTHFR but nothing else so we added baby aspirin, extra folic acid, and metformin even though I have no insulin resistance/PCOS. Stuck with that cocktail for two transfers (including my late miscarriage) and now I'm on all of the above plus lovenox and extended my PIO to 12 weeks instead of 10. All this to say, your doc should keep looking for something to explain the failed transfers and adjusting your treatment as necessary. But unless you can find a good reason to believe that its a medication or physical failure- the only harm from transferring two is the increased chance of twins. I can't imagine how rough it would have been to have had 11 transfers over the last three years instead of the 6.

Crystal120410 · November 2013

I did two sET then ET 2 and originally pregnant with twins now 24w with a singleton.

Viasatalyte · November 2013

@therebedragons You are awesome. Thanks for taking the time to explain and share your experience. I think I am more afraid of factors other than embryo viability. So far uterine issues have been ruled out and I just did a loss panel. I should hear from my doctor soon regarding the results. I think that would help us to decide. We've discussed autoimmune testing as well. Good luck to you as your pregnancy progresses:).

ThereBeDragons · November 2013

Oh and one more thing to consider that shouldn't be an issue for you for a while- we found that my body really really doesn't handle stims/retrieval well. I am sick the whole time on stims and I'm always in more pain than expected and take longer to bounce back after retrieval. But I do awesome with FETs. No issues, feel great the whole time, etc. My two fresh transfers we transferred the best of the best and both failed. Both of my losses were with the best quality frozen embryos. When we did a third retrieval we made the decision to freeze all. No fresh transfer, with a FET to follow a few months later. So this last FET is the first time we've had the highest quality embryos going in with a rested and healed body. Both my doc and DH wre like "duh, of course you got pregnant again- FETs are your treatment of choice". Just a though if, god forbid, you need another retrieval down the line- FETs are really gentle on the body compared to fresh transfers

Viasatalyte · November 2013

@therebedragons Yes, my retrieval of 20 eggs was brutal. I was in pain and off from work up until my 5 day transfer. I attributed my bfn to my body feeling yucky. That why I was surprised that FET did not work. We did endometrial scratch and I was on prednisone for a bit longer. Lining was good at 12mm. I know there are no guarantees. It seems like the only thing we should do different this time is transfer 2. I don't know, but have until January to decide. Thanks again!

jschwind22 · November 2013

Have you for sure ruled out autoimmune testing? My RE tested for NK cells and a couple other things. There are only a couple labs in the US that run the tests, so mine was sent to California. I believe it was around $600, which in the grand scheme of things IF is not really that much. I did the testing right after I had a chemical pregnancy from transferring 2 during my fresh cycle (and my first ever BFP). It was found that I have high NK cells. The treatment for that is pain free (other than the IV) and relatively cheap as well. I am pregnant from my first transfer following that diagnosis. I know there were a lot of things different about my FET than my fresh cycle, but I do think the NK cells were a factor. Best of luck to you with whatever you decide!

whoberry · November 2013

I have lurked on this board and others long enough to see some very very sad situations with people carrying multiples. I am pretty terrified of a twin pregnancy with all its potential complications and whether the babies would come out healthy so we have only done single transfers. One fresh and two frozen. Before we did the third transfer we were all getting pretty frustrated, my doctor included. He said that if I wanted to transfer more than one this time he might let me talk him into it, but I wasn't ready for that. DH has been pushing for two so I promised him that if this transfer didn't work, I would be ready to do 2 on our fourth transfer (fortunately 3rd transfer worked). Despite being terrified of a twin pregnancy, I was getting frustrated enough and we had enough failures that I was getting ready to move on. I think it just depends on what you are ready for. Good luck!

Viasatalyte · November 2013

@jschwind22 thanks for info. We did talk about the testing. She mentioned that there is some debate about it. She did do some intermediate rpl testing but nk cells are not included. Did you test at Dr Beers center? It's less than 30 mins from my home. Maybe I should schedule a consult.

Peanutz21 · November 2013

this was tough decision for us. We had 3 frost babies and ultimately decided to attempt transfer of 2. DH and I were 100% ready for twins. Ultimately only 1 frost baby took. We would have been ecstatic with 1 or 2. You have to be mentally ready for 2 as a possibility if you decide to go with 2. Best of luck with your decision.

jschwind22 · November 2013

Viasatalyte said:

@jschwind22 thanks for info. We did talk about the testing. She mentioned that there is some debate about it. She did do some intermediate rpl testing but nk cells are not included. Did you test at Dr Beers center? It's less than 30 mins from my home. Maybe I should schedule a consult.

I live in Illinois, but my Dr. sent my bloodwork to a lab in California. I honestly can't remember what it is called, but can probably track down the paperwork somewhere around here if you need to know. Dr. Beers Center doesn't sound familiar though.

auntjessy · November 2013

I will definitely be praying for you!!! I can echo MaiTaiBeth - if you put in 2, you might get 2. I think if I were in your shoes, I'd try to do additional testing, especially since you have time before January anyway. Hugs and prayers to you!!!

Viasatalyte · November 2013

@jschwind22 if you can let me know the lab that would be great. If it's a burden no worries hun. Thanks for all the advice ladies.

lizrn1975 · November 2013

I put in 2 high quality embryos both on my 1st and 2nd fresh cycles; 1st was a 3 day, and it ended in a cp, the 2nd was a 5 day, and only 1 took. Good Luck!!!

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Transfer 2 blasts after two failed ESEts?

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NTNP 2009-2012 TTC since 2012:

IF, 5 losses, 1 son, 1 on the way.

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