One Embryo or Two

[Lolly2803]

Hey ladies,
Preparing for FET - had a freeze all IVF cycle in July due to fluid in uterus and lining not thickening enough for transfer. Thinking optimistically ahead to transfer and wondering whether to put 1 or 2 embryos back. It's such a hard decision just wondered what any of you ladies had done and how you made the decision. I would love twins so not worried about having 2 it's more the risks that I'm considering. Thanks ladies xxx

[bananafish81]

I agree entirely with LH that the plural of anecdotes is not data and personal stories are not very helpful

The HFEA website does have much more useful data to help couples make up their mind about single or double embryo transfer, with lots of helpful information to help understand the risks overall and the likelihood of multiple births at different age groups

We found this the most helpful source of unbiased info.

www.oneatatime.org.uk

[LHReturns]

Banana, while there is no doubt that your sentiment is correct - I hope you don't mind me pointing out that the vast majority of multiple pregnancies result in healthy babies.

Many women transfer two embryos for lots of good reasons. Indeed twin pregnancies are indeed riskier than singletons, but I also don't think many (reasonably intelligent) people approach the possibility as a buy one get one free option. I certainly haven't. My consultant and I spent an hour pouring over stats and risks before deciding I would transfer two blasts if we got them.

While there are sad stories about twin pregnancies, I also know many sad stories about singleton pregnancies. I hope you don't mind, I just don't want this thread to scare anyone who is making a different, but equally valid, decision for their own reasons.

[bananafish81]

For me that's another reason not to put two back.

If there is any doubt about the uterine environment, then to put two embryos back into questionable soil could be 'wasting' an additional embryo

I'm sure your consultant wouldn't let you transfer if they didn't think there was a good chance of success

But as someone with lining issues we decided it would be madness to put back two

At the other end of the spectrum, I also sadly know far too many sad outcomes with twin pregnancies

One was an IVF lady who had two embryos put back - one split into identical twins and she was pregnant with triplets. Sadly by 12 weeks one had died and it was twins. Then sadly at the 20 week scan both had died and she had to deliver her stillborn daughters

Another RL friend had natural twins. Sadly she went into hospital pregnant with two babies but only left with one, as her son died very shortly after birth

I know several parents of twins (mostly IVF) who all spent the first weeks in the NICU, unable to take their babies home for several weeks. They are healthy kids now but the early months were very difficult physically and emotionally

Twins really aren't a buy one get one free special, as tempting as it is when we're going through IVF to think if it as a two for one bonanza

[Lolly2803]

Thank you everyone - some great advice.

I have hormone issues too we think. That's why every month mid cycle I get fluid for a few days and uterus struggles to thicken. Had a hysteroscopy last week and everything was fine, nothing to do in there! Hoping we can figure this out in an FET!

[Beedoo123]

Lolly - I think she was keen for us to try 2 as my previous failed cycle my hormone levels had been a bit weird, and they weren't sure why. We had 2 excellent day 5 blasts and I'm sure she thought that was our best chance to get pregnant given that my hormones might not play along in an further cycles!
I was lucky to go full term, no complications so it worked out perfectly for us, but I realise this doesn't always happen.
Sounds like things have moved along loads in the last few years though and there's lots of good advice on here
Good luck whatever you decide!!

[bananafish81]

There's a big difference between putting back two day 3 embryos and two blasts

The twinning rate (and pregnancy rate) of two day 3 embryos is much less than the risk of twins with 2 blasts

Due to my pre existing medical conditions my Dr said twins were to be avoided at all costs. Therefore double blast transfer was off the table. However we agreed we would definitely put back two cleaved embryos

Think it's an important distinction to make.

[Sleepinghooty]

I had 2 put back when I was 28. But it was 11 years ago and seemed to be generally assumed you would have 2 put back. I now have 10 year old twins and was lucky the pregnancy went to term (39 weeks) and I had 2 big, healthy babies. I love having twins but there is no doubt it is tough. Sometimes I wonder what it would have been like to have the same 2 dc but a couple of years apart!

Good luck!

[Nan0second]

There is also now new research that shows that putting a poor quality embryo back with a good one actually decreases the likelihood of a successful pregnancy.

[Nan0second]

I had one back both times (one miscarriage, one toddler DD) and would never have two put back.
I'm an obstetrician and have seen horrific complications from twin pregnancies. Watching (unfortunately) multiple women slowly lose (usually IVF) twins over several days at 20ish weeks is the most horrific and miserable thing that I wouldn't wish on my worst enemy.

[Blondeshavemorefun]

And yes thaw one by one - luckily 4&5 defrosted well so only one thawed each time - tho abroad and their freezing process is so much better then uk

[Blondeshavemorefun]

As you are young I would have one put back

First attempt I had one back as that's all that survived at day 3. Prob would have had 2 back if had two

2nd cycle we had 3 put in. Clinic said best way to try and get pregnant and DF and I said we would prefer triplets then no baby when asked - and clinic said they prob wouidnt freeze well and defrost so it was use all or put in bin iyswim

3rd cycle and diff clinic said only one

4cycle same clini as 3rd gave us a choice - by which time I was 42 and didn't want twins

5cycle we did one and it bloody worked !!!!

You are young and have time and few frozen so personally I would try one at a time

[icy121]

Lolly I had 1 put back in on 14th sept and got a positive yday. I'm 29. They thawed 1 by 1 because we were doing a single transfer. The first one didn't thaw properly, so wait another hour and the second didn't either. The third was a perfect defrost. By the time I got to the clinic they said the 2nd had actually got some viable cells and did we want to do both. We went with the one because of the risks. My consultant was in complete agreement. Chances of miscarriage are already 20% in line with all pregnancies, given the cost and the nightmare and the headfuckery of the whole thing, I would fucking hate myself for "causing" it by doing 2 and not 1 and being greedy, if there was a problem. Just me though! One of the ladies from a barren board put 1 back which then went and split itself into two!

[Lolly2803]

Thanks so much for your advice ladies. I am going to carefully consider all options!

Beedoo that's great you got your twins!! Why did she hint at 2 do you know?

Thanks LH! My IVF cycle was awful and every time I went for a scan I was told I wasn't responding and that not to be hopeful for many/any eggs. And I got some great ones! So chuffed with that and now focussing on sorting the next issue(s) out. There's always bloody something right?!!

[Smidge001]

If you're only 29 I'd definitely suggest you only put back one.

Your embryos have a much greater chance of being good quality because of your young age, but it's not just embryo quality that impacts whether you get pregnant or not. (As you know from having to freeze in the first place). I've had 5 attempts at IVF and never got pregnant. Based on the statistics you are far more likely to achieve a baby by having your 3 embryos transferred on 3 separate occasions rather than doing 2 then 1. It can be heart breaking putting 2 back at once and getting the negative pregnancy test result, as you spend the rest of the time thinking what if it was something wrong with the uterus/procedure/hormone levels or generally something to do with putting them in rather than the embryos themselves. Feels like a waste of the second embryo that might have worked another month.

Sorry if that sounds a bit negative. I was like you and loved the idea of twins, but after several failed attempts I suddenly realised the aim is to have a baby... any baby, and the stats definitely suggest that 3 separate transfers are far more likely to achieve that than a double and a single.

As others have said, I think the consultants will advise you strongly one way or the other, but that's my advice.

[bananafish81]

Mine were thawed one by one because we were doing a single transfer

They thawed one and then called me to tell me it has survived the thaw

If it hadn't then they would have thawed another one and so on

Embryos frozen recently will have been vitrified and my lab said euploid embryos generally survive the thaw - any that don't (in their lab at least) are generally abnormal

So they shouldn't have to thaw more than you need...?

[LHReturns]

Lolly what an unbelievable haul you have!! How exciting, and we'll done.

[Beedoo123]

It might be best to keep an open mind and see on the day... IME they defrost in batches and keep going until they have one or two good ones, so the ones that were best when frozen might not defrost as well...
One of the fertility nurses almost half hinted we transfer 2 on ET day, (I was 29 too), we went for it and it was the best decision we ever made. If I saw her in the street I'd kiss her because we have our 2 amazing children...

[bananafish81]

That's for women under 37 LH - I don't know what the stats are for older women

If I'd wanted two blasts on my first transfer because I was aged under 37, and I had good quality embryos, I would have had to sign a waiver saying I was doing so against medical advice and understood the risks

[Lolly2803]

Thanks banana! Good to read through these. Although I'm still torn! Have a bit of time to decide at least! LH that comment about your husband really made me chuckle!!! Did you put one or two back?

How you doing Banana? xx

[Lolly2803]

Thanks banana! Good to read through these. Although I'm still torn! Have a bit of time to decide at least! LH that comment about your husband really made me chuckle!!! Did you put one or two back?

How you doing Banana? xx

[Lolly2803]

Thanks freckles! My consultant said they always advise 1 when you're young and have good quality embryos but ultimately it's my choice. I'm considering putting back my best and my third best. So keeping 3 in the freezer, my second best and the 2 day 6. Even the worst are still good apparently. I've got 3 X day 5 (4AA, 4AB, 3BB) and 2 X day 6 (5AB, 4BC). It's soooo hard!!

[LHReturns]

Banana, as I am pregnant are you saying I have a 50% chance of twins? For fxxk's sake please don't tell my husband.

[Tootsiepops]

Not sure which clinic you're with, but the decision may not be entirely yours. My clinic had criteria you had to meet before they would consider transferring two embryos. If your blasts are good quality then they may only put one in at a time.

[bananafish81]

And here's the twinning rates

[bananafish81]

Sorry those are the pregnancy rates.

These are stats from my clinic that show the pregnancy rates for 1 vs 2 blasts are around the same for women under 37

But amongst those who do get pregnant, the risk of twins is 1:2