HELP - IVF egg transfer - 1 or 2??

[Dragini]

I think I need some help ladies...

I'm 41 and have been ttc for around 100 years (well, around 10) with unexplained fertility, and finally made the plunge into the world of ivf. This is our first cycle and all has gone well so far...13 eggs were collected yesterday and I'm waiting for the call today to say how many are viable (fingers definately crossed!!)

DH and I went into this completely open-minded knowing that the stats aren't in our favour, given my age etc. At our consultation we were asked whether we would want to transfer 1 or 2 embryos back, if we were lucky enough to have the choice. At that stage we plumbed for 2 to maximize our chances.

Since then DH has been consulting Dr Google (I've tried to stop him!) and now strongly believes we should transfer only 1 because of the risk of disabilities in twins. Because I believe it's a transplant problem which has been stopping us conceiving, I still want to go for 2.

All the stats around success rates for SET are based on women in their 30s and so they don't give me too much comfort.

Can anyone help point out what might be bleedin obvious? Are we missing something which could help us agree on whether to go for 1 or 2??

Heart vs head - absolutely right! I'm not sure we could go through this again but I guess we could freeze and then look at FET - again with its own complications....arghhhh!

Thank you so much dogona - your experience is exactly why we made the decision for 2 originally, but I think we're now getting so het up about this process that we're questionning everything and trying to control.

It's tricky. My clinic likes to put two back for under 40s and for over 40s they like to put 3 back. They get higher success rates with putting two or more back- but they are very results orientated. I opted to put 2 back purely because I wanted a better chance of getting pregnant...and perhaps a secret hope that if I did have twins I would come off this rollercoster once and for all. But I wouldn't have had anything to freeze anyway. It did result in a twin pregnancy but it wasn't to be- I only got to 10weeks. Thankfully it wasn't later. It didn't deter me from putting 2 back again in Sep but they didn't take (poor quality).
My thoughts were that my chances of getting pregnant with twins were slim but I wanted to have a better chance of getting pregnant with one. I tried to ignore the risks and hoped for the best.

Oh and very best of luck whatever you decide!

hi dragini good luck - I hope you get the phone call soon, it's horrible waiting for it! We had just one put back, and froze 3. Have a single pregnancy. However, I am only 31. I think that for my first cycle I would probably put one back and freeze the others, but put back 2 in any subsequent cycle.

In fact, the success rates for a FET are actually slightly higher than for a fresh cycle - this could be because only the stronger embryos survive the process, or because the mother's body has had a chance to recover. I think it also depends on what the issue with conception was. We were unexplained. However if for example you knew it was male factor I'd think once the fertilisation issue was sorted then you'd have a higher chance of success than if it was some implantation issue.

I'd wait and see what the embryologists say on the day of transfer about the quality of the embryos as well - ie if you had excellent ones it might be better to put one and freeze, but if they were poor grades then put back 2.

It's a really tough decision - good luck with it and with the transfer etc.

It's a really difficult decision. We had always said SET right from the first appointment, largely for personal reasons. A twin mc nearly killed my mum (I was old enough to remember it) and I had seen my closest friend struggle through a difficult twin pregnancy (from SET funnily enough - the embryo split to form identical twins). However, on my second cycle we only had two low quality embryos and on ET day the clinic pressured us a lot to have both back and I agreed after much stressful agonising. It was a chem preg, so it didn't matter anyway in the end.

FET success rates are good as keep mentions, so if I had embryos of good enough quality to freeze, I would always opt for that over multiple embryo transfer.

At this stage I would wait and see how your embryos develop and not make any definite plans. I had 2 transferred because they weren't great quality. If they had been top quality then I would have had one. There are a lot of variables and the clinic will advise you. I was surprised that we were offered the choice to put 2 in because at my age the policy was only to allow SET but obviously the poor quality led them to adjust this. Only one stuck and I'm 12 weeks pregnant.

Thank you ladies. I've now had the call from the clinic and we have 4 fertilized embryos, which is great news. I spoke to the embyologist and she gave me some stats which helped - for women in my age group the risk of a multiple pregnancy from tranferring 2 eggs is negligible, but the chances of getting to a healthy single pregnancy increases by 4% from SET. No decisions are needed until we're ready to transfer but I now feel better armed to have the conversation if needed! Also great to hear success stories to remind me that this process really can work. Thank you!