How many embryos to transfer?

[Minimochi]

Hi,
We're about to start our next round to get ready for embryo transfer.
For context, we've been ttc for about 12 years now. DS was conceived after a laparoscopy to clear out my tubes after yet another ectopic. He's now nearly 7. We've been trying to conceive a sibling since he was 18 months old.
I've had two more ectopics due to natural pregnancies. With the last one, they removed my left tube. We then went through three rounds of ivf, which didn't work out. My eggs are apparently too old, although we still got a good number in each round and the fertilisation rates were good, and none of our embryos ever developed to blastocyst stage.
We then went with donor eggs. Got three lovely blastocysts, but none of them implanted for longer.
We've now got a donor embryo waiting for us and I'm hoping we can do the transfer in October. I'm just wondering,...
Reading online, it's suggested that patients over the age of 40 should transfer two embryos to get better results. I'm currently 40. The donors are both mid-20s, though.
Besides, is there anything else I can do to help it implant this time? I'm exercising and eating healthily most of the time. I'm taking vitamins. I'm considering giving the embryo glue another shot.

Any more suggestions?

Oh, I've had a hysteroscopy and an endometrium biopsy done before this attempt. They didn't find anything wrong with me that would prevent implantation.

Best of luck with it all, it's a tough road!

I would say only transfer two if you'd be nothing but delighted if it turns out to be twins!

Thanks. :)
We wouldn't be worried about twins, to be honest. We've got a 5-bedroom house and a 7-seater car already anyway, so space wouldn't be an issue.

I think DH is just a bit worried about sinking more money into this. The donor egg route took a huge chunk out of our savings and this transfer won't be terribly cheap, either...even with only one embryo. I'm just not sure whether it would make more sense or not.

Has your clinic offered any advice re number of embryos to transfer? I'd be inclined to do one at a time still but appreciate its just money stacking up.

In terms of what else to do...did you have progesterone after your last transfers? Presume so!

Otherwise I really don't think much makes a difference if you're already doing the healthy eating etc. I did take coq10 but not sure if it made much difference.

Also for what it's worth, I transferred two 'top grade' which was unsuccessful (I was 31) but the next round we went private and fixed some male factor issues and transferred one and it worked. So in my experience more embryos didn't improve chances, it was down to the actual quality of them.

Thanks. No, they haven't advised on it. They transferred one in the first round and then two in the second (because we had three in total and generally 2 transfers as part of our package). I think the general advice is to transfer 1 to avoid multiples.
I did have progesterone, yes. I also had prednisone during the last cycle.
Well, will keep my fingers crossed for this one and just hope for the best.

The transferring of 2 embryos is if youre using your own eggs, as the quality is likely lower, and that gives you a better chance.

I am 40, have just transfered a donor embryo from 2 young donors (egg donor was 22, sperm donor was "young" - I guess since male age matter less, they dont put it on the description) and it stuck.

my clinic never even considered transferring 2 embryos, as the risk of twin is high, and being over 40, THAT is when problems can start.

If the embryo is good, theres no point in transferring 2! best of luck!

The success rates depend on the age of the donor and not you.
I assume you are doing FET? I was always told the chance of having a baby is less with 2 transfers than with 1. Obviously there's huge variables but for me the chance of 1 working was around 60%, and the chance of 2 working was 50% (with a further 50% chance, ie 25% in total) of both working.
Be aware that the embryos could split too - identical twins are 3 times more likely with IVF pregnancies than in nature.

I'm sorry you've had a rough ride

My clinic never suggested two for the chance of multiples, as pp says it's more of a risk for all involved.

I didn't do anything differently when ours stuck, I do believe it's abit of a lottery.

Fingers crossed for you and I hope you get your baby.

My clinic didn't offer anything other than single transfer when we moved to donor eggs, they had been content to do double transfers when I was trying with my own eggs.
My donor egg single transfer was successful. If they had advised a double transfer I would have done so but they said there was (statistically) a better chance with one embryo of eventually having one healthy baby (and I suppose we didn't want to use more embryos than needed).

@ASGIRC congratulations!

Hi @Minimochi. I've just found out I'm.pregnant (yesterday!) after a FET donor transfer- donor egg, husband's sperm. We'd done a donor cycle last year - 3 individual transfers, all negative. I have a 12 year old (non assisted conception) and after the 3 failed transfers they clinic did further investigations into why they weren't implanting/sticking. Nothing was very conclusive but one blood test did show an increased likelyhood.of implantation failure. As a result they changed the protocol. . This time around I've had some extra meds added. I had a HCG uterine infusion 2 days before transfer - apparently some studies have shown this 'tricks' your body into thinking it's pregnant and makes it more receptive to the embryo. I also started on prednisone (10mg a day) 2 days before my FET. I also had a blood test to check progesterone - it was slightly under so started on progesterone injections the night before transfer. About an hour after the transfer, I had acupuncture (at the clinic). I found this really relaxing.
Very early days for me but I'm trying to stay cautiously optimistic. My clinic (in Spain) have always advised I have a single transfer (3 blasts last year, 3 blasts this cycle). There did offer to transfer 2 this time around,.however we got 2 that were AA and they said for this grade, they would only went transfer one. I don't know what has worked this time - different donor, the different meds, the acupuncture- could be a combination. It's so difficult but keep going and ask the clinic what they can do differently this time given the implantation failure last time. Your age is irrelevant here, it's all about the donors age. Wishing you every success x

I would transfer one as the rate of donor success is so high. Good luck!

I would transfer 1 too. I transfered 1 donor egg embryo. Which then split into twins, which was amazing. However glad I didn't transfer 2 embryos and risk triplets!

Congratulations @Hopeful2024 I hope everything goes well.
Thank you, everyone. I think we'll stick with one. DH would be happier with just one as well, I guess. I'm currently trying to lose a few more lbs, which will hopefully work before October.
@Donimo Congratulations. What type of embryo did you transfer? We'll be getting a blasto. They've reserved it for us now. Not sure about the quality, yet.

@Minimochi it was a grade A embryo. Apparently the top grade embryos are most likely to split. But it is rare to split. However saying that I've met 2 other mums who had the same thing!