AIBU to ask for double embryo transfer?

[Dexy007]

I'll try to give all the relevant information upfront:

in my mid-30s, my husband and I didn't feel ready to be parents but were conscious of our ages so we paid privately for two rounds of IVF (it's not that expensive in the country we live in - not Europe) and over those two cycles we ended up with 10 x 5 day blastocysts. I was 36 (exactly) and 36 and two months when we did these cycles.

Although no known fertility issues (we had never tried to get pregnant) clinic said my husband had lazy sperm so they did ICSI + IVF. I mention this because there is a slightly heightened risk of multiple births with ICSI, and to explain why we aren't tempted to try to get pregnant naturally (it seems likely it won't happen for us with my husband's sperm, and my frozen embryos are 2.5 years younger than I am now...)

I'm now 38. Do I go for double embryo transfer or single? What would you do if you were me? If I am lucky and the transfer(s) work I would be 39 when I give birth. My clinic has of course explained the success rates to me and I know the odds are stacked against us.

I hate the idea of pregnancy and birth (it is a factor in why we just didn't feel able to follow the usual 'get engaged get married get pregnant' pathway). The idea of completing our family with a twin pregnancy is so tempting. We would be getting a FT nanny because we have no family support (live overseas) and because we both work full time and have hectic jobs/schedules so I think we could manage 3 years of chaos and sleepless nights with twins as well as we could manage a newborn and a toddler. Maybe I'm naive.

But of course the pregnancy would be riskier and twins face so many more issues.

Argh I don't know what to do. AIBU to ask for two embryos to be transferred? My clinic doesn't have any rules about it as such, they have just said it depends on lots of factors.

I hate the idea of pregnancy and birth

Erm a multiples pregnancy and birth should be your idea of hell then - why would you consider a double transfer if this is what you think? I have twins from a double transfer. We all nearly died during the Birth. Husband couldn't hack having twins so left when they were aged 1.

I know lots of triplet mums from a double transfer

Only do it if you are prepared to carry, birth and raise more than one child at the same time

What an odd post

someone who doesn’t like the idea of pregnancy and giving birth would obviously prefer a 2 for 1 situation.

There's a lot of doom and gloom on this thread about twin pregnancies.

As I mentioned below, on my 5th IVF I got pregnant with twins (at age 47). The pregnancy was a breeze - no symptoms at all (not even a bit of nausea). Towards the end, my hips got a bit tired though. I hid the pregnancy in work till 25 weeks, then gave birth at 38 weeks as planned (lovely calm c-section). Minimal recovery from the c-section, and no pain, and no stretch marks.

The first few weeks/months were very difficult with lack of sleep, which is why I recommended a night-nanny a few times a week.

I don't see any issue with the OP having a nanny from 8-5pm. I do too, and work in a senior, stressful job. I sometimes get up early and work an hour before the twins wake up. I cook all their food from scratch and feed them lunch every day. I spend every evening with them and put them to bed every night (at about 8:15pm, so I've more time with them). I also frequently work with the US once they're in bed.

With twins, if they're your first children, you just get one with it, since you've nothing to compare it to.

@Dexy007 I'm not sure why everyone has questions about your thought process.
If I knew I would be in the situation I am now, and could have afforded to have an egg collection 5 years ago to be prepared I would have absolutely done that. It makes absolute sense when you're a career woman on a roll!! What's wrong with wanting to do well career wise and have a family?!
In regards to the nanny too, many countries outside of the U.K. this is a totally normal practice. Many Middle Eastern families have live-in help, it doesn't make it wrong in the slightest.
If I were you I would research the risks of a double transfer and weigh it up based on your own circumstances. If you want two children and can have them from one pregnancy with no more risk then why not.
YOU DO YOU and best wishes for whatever you decide to do xxxxx

@FfoxRedN Absolutely - wish I'd had the foresight to go straight to IVF at 36, rather than try (and fail) to conceive for 2 years.

@countrypunk exactly! Xx

Hi @Dexy007

I had a (completely unexpected, offered when I was already in the transfer room) double embryo transfer and ended up with B/G twins, hopefully I can share some experience and knowledge that helps you. 💐

• I think your reasons for wanting to use your frozen blastocysts now instead of trying naturally for however long are very reasonable. I’d do the same.

• I found the actual IVF process easy peasy physically. It was an absolute battering mentally and emotionally but I had very different circumstances to you. I can understand why you would choose it since you’ve already been through all of it except transfer, you already know you have good embryos sat there 👏

• Some people mentioned genetic testing of the embryos (PGT). The U.K. regulator HFEA classifies PGT as a “red” light intervention/add on. There is no evidence to support its use when there is not a known genetic condition that needs to be screened for (eg: Huntingdons). It doesn’t increase live birth rates and the additional manipulation/thawing and re freezing of the embryos risks damaging or destroying some of your precious 10.

www.hfea.gov.uk/treatments/treatment-add-ons/pre-implantation-genetic-testing-for-aneuploidy-pgt-a/

• The studies that I read say the opposite of what most people are saying. That a double transfer might actually help activate the responses of the endometrium more effectively and lend a very small % advantage over baseline. (I would have to go digging for those papers if anyone was interested)

• But you don’t want that tiny advantage when the cost is the risk of twins+. Multiples are the highest risk “complication” possible in fertility treatment. That’s a fact and there is a boatload of clear evidence of why “one at a time” is the safest for the mother and her baby/babies. There’s a reason that both the HFEA and RCOG in the UK have policies for single embryo transfer every time. Multiple pregnancy is no joke and as someone who it happened to, no I don’t think you truly want to knowingly choose that risk.

obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.14974

So what happened with me was I had ovarian failure and probably one chance at IVF before my ovarian activity was over (plus covid showed up 2 weeks later so that was my one shot). I got two eggs. They were growing slowly and looking poor on day 3, the embryologist was kind but discouraging. I showed up on day 5 for transfer thinking there was no chance and they had forgotten to ring me 😂

I got in the room and they said I had both embryos still but they had a 5% chance of success each. Neither were even close to good enough to freeze. They were very kind but basically told us there was very little chance of success with those embryos. Someone with a chance to try again would have been told to bin this time multiple times 😅 They were only prepared to transfer such crappy embryos because it was all I was ever going to get.

My husband asked what the risk of twins was and they gently said it wasn’t even remotely worth discussing 🫣They honestly thought I wasn’t getting pregnant at all.

So here I am with both of them. Twin pregnancy was hell physically and my body is wrecked. But I enjoyed being pregnant so much and I had a great vaginal birth at 37 weeks.

Being parents to twins with no family support is the worst thing that I have ever experienced. We tried to get nannies and couldn’t find anyone reliable or capable with twins. We are so grateful to have our miracle babies, we would make the same decision in that room a 100x over but we lament our experience of early parenthood every day. Twins are so so hard.

Choosing to deliberately have twins just to get it over and done with is not something I could ever recommend. Your experience will be nothing like that of first time singleton parents and you might feel aggrieved by that every single day…