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phishgirl29 · December 2013

Did anyone read this article about RE's trying to lower twin birth rates in 2014? One of the RE's at my clinic was interviewed for this and that has me wondering what my future FET later on this year will look like as I only have 2 embryos on ice. Not that I'm looking for twins, but given my vanishing twin with my sons pregnancy, I'd be nervous. What do you think?

https://t.today.com/health/not-twice-fun-fertility-docs-try-lower-twins-birth-rate-2D11674286

TJ1979 · December 2013

So I read this yesterday. And what really stuck out to me was where they talked about single embryo transfers being standard overseas... BECAUSE IT'S COVERED. I guarantee you a lot more people would prefer to do single transfers and not pay OOP. I don't really want to hijack your conversation, but it freaking ridiculous that IF isn't covered, yet sometimes lap band is.

I do agree though that twin pgs are harder and more dangerous, and the ideal should be one healthy baby. But sometimes things happen, like the girl who transferred 2 and one split and ended up with trips.

itsmevkb · December 2013

I think the goal of one healthy baby is a good one as twin plus pregnancies are a lot higher risk for both the mom and babies. However, I believe this is something to be decided between a doctor and patient, not something to be decided by say the government which has happened in quite a few countries.

When I did IVF I had insurance which covered IVF (after a HUGE deductible) but they wouldn't allow more than two embryos to be transferred no matter what the circumstances were. I remember at the time of my transfer my RE asked if we wanted to do two or three and not only did I not want to ever chance triplets, but I would have lost whatever insurance coverage we had so no way on that front too.

mdiblasi10 · December 2013

@TJ1979 Great point about insurance coverage. I am sure that is a huge factor here.

phishgirl29 · December 2013

I guess the concern that I have is the cost of 2 separate transfers and opposed to 1 if the first transfer doesn't work. We were lucky the first time that our first IVF worked. I was debating the whole month of that cycle to transfer 1 or 2 embryos, but when I got into the room they recommended 2. I was heartbroken when I lost baby B at my 10 week appointment with 2 "perfect" babies at my prior ultrasounds. 1 baby is/was the ultimate goal. Sigh...

Another reason IF sucks

JBDamonM · December 2013

I heard this on the news yesterday and just skimmed the article. I'm really bothered by this for a few reasons (which is why I did not finish the article).

First off, I feel as though this article is a poor reflection of a good RE. From the moment DH and I had to go to an IVF info session they began stressing to us that they wanted to avoid a multiple pregnancy....I truly feel as though a good RE will push for a single transfer whenever it's a viable option and don't like that this new "research" (articles and newstories) indicates that this is a new approach.

Second - I think it's despicable that everyone autmatically assumes if you have twins you had fertility treatments and if you have a singleton you took a roll in the hay with your husband/partner. This is a HUGE pet peave of mine. As if us ladies haven't had to endure enough? we shouldn't have to then get questioned about a private matter if we announce a twin pregnancy. Articles like this only add to the stereotype.

Third - Transferring one or two embryos is a very personal decision. At the end of the day there is no cookie cutter answer (in my opnion). Aside from the obvious factors that may push people one way or another, the news anchors don't bring attention to some of the other issues like eqq quality or repeat miscarriage history.... In other words, you rarely see two cases that are the exact same and therefore trying to push set guidlines is just ridiculous in my eyes. Maybe if these articles were written by someone who had survived IVF - you'd see much more the emotional realistic spin, rather than just medical fluff.

Sorry, that's a little bit of a rant - but this just urks me.

phishgirl29 · December 2013

@JBDamonM for president!

JBDamonM · December 2013

phishgirl29 said:

@JBDamonM for president!

bahahahhaha. tyrade anyone!?!?

queenbone · December 2013

Let me begin by saying that I did not end up needing to do IVF, so I really don't have a dog in this fight.

However, I was concerned with avoiding a multiples pregnancy as a result of my IF drugs. I think it is a good goal for drs to be more conservative in treatments. I think a big factor that would help to reduce the multiples rate is if insurance companies covered IVF, thus allowing the average IF patients to be more conservative when transferring embryos back in.

Mrs.AmyDylan · December 2013

I read the article. I have mixed feelings. I had a really crappy IVF cycle for several reasons. We did a day 3 transfer of two and ended up with just J. No frosties.

If we had followed the one rule, who knows what might have happened. We had one embie that made it to day 5, but they said it would never thaw. We had no second chance except for a new fresh cycle. I'm glad we did two.

However, I'm less likely to do two a second time since I don't know if I can handle twins and J. I also would prefer to naturally birth again (they don't do twins).

itsmevkb · December 2013

Do you wonder why there was/is zero discussion regarding the rate of multiples from IUI? The vast majority of HOM result from IUI and not from IVF.

As for coverage, I think there are some misconceptions in that American women think that things like IVF in England are fully covered. It's not. As just an example, see this article.

fabulouspinkmady · December 2013

I don't think this article gives patients enough credit. IVF patients are well aware that there is a chance of a multiples pregnancy when you transfer two, and I feel like you can request to transfer one if that's what you really want. I was 29 when I did IVF, but we went ahead with the 2 embies because we were okay with the idea of twins. Now of course I couldn't imagine it any other way

TJ1979 · December 2013

itsmevkb said:
Do you wonder why there was/is zero discussion regarding the rate of multiples from IUI? The vast majority of HOM result from IUI and not from IVF.

As for coverage, I think there are some misconceptions in that American women think that things like IVF in England are fully covered. It's not. As just an example, see this article.

Bc the article wasnt about HOMs. It was about twins.
I was merely quoting the article that said single transfers were mandated, and covered.

itsmevkb · December 2013

@TJ1979 I just mean in general. There are quite a few twins that result from IUI in addition to triplets plus. I just wonder what the world of infertility feels they should be doing regarding that situation. Or, is it because there are so many less ways to control an IUI that they aren't really considering doing anything other than continuing to encourage cancellation of cycles with large numbers of mature follicles (which can't stop a woman from going home and having sex.)

And, as to it being covered, well, if you have only one covered cycle (and partially covered at that since so few places cover anything fully) that you've waited three plus years to get I'm not sure how on board a ton of women here would be in having a single embryo transfer knowing that if it didn't work their next cycle would be completely out of pocket. Choosing it and having it mandated are two different things. I want to be able to make the right choice for me with my doctor as opposed to there just being some arbitrary rule saying I can only transfer one. I also don't want chromosone testing on my embryos (as this article is suggesting is the way to go to up success rates of single transfers.)

Why is the lap band covered and IVF not? I'm just guessing here but the lap band over the long haul will save money as hopefully losing weight will make someone healthier whereas IVF is a losing money venture. If it doesn't work and the woman continues to cycle, that's expensive and if it does work and she has one or more babies that is a lifetime of providing healthcare. It's sad that things often times come down to money but it is so often the cold hard reality and that's true whether it's insurance companies making the decisions or governments.

TJ1979 · December 2013

I understand @itsmevkb. And I agree with all of that. I typed out a huge response, then got frustrated and deleted it. Bc the fact is, IF is freaking unfair, and medical care and insurance is a jacked up mess. And there's nothing we can do about either of those things. And that's the sucky part.

Now I feel all Debbie Downer. Puppies and kitties!

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