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

I only ever had one put back as I looked into the statistics and the chances of a two embryo transfer working are not significantly higher than that of a one embryo.
However the chances of a twin pregnancy being damaging to the health of the babies or mother are much higher, given that I was 39 at the time.

But that was my thoughts. It is your choice to make.

I put two in each time because I am over 40. If I was below about 37, I would have definitely returned 1 and between 37 and 40 it would have depended on quality.

It's not just a risk of twins - a friend put back 2 and got triplets!

Hi OP, like NotSpartacus I am 40 and had two (blasts) put back in two weeks ago. I am now 4 weeks and 5 days pregnant and starting to BRICK myself just a little about twins. Will be going for an early scan at 6 weeks to see what we can see....

However, for now I feel very lucky. What will be will be and if it does turn out to be viable twins, and they both turn out to be genetically healthy at 12 week stage, then I will do everything in my power to look after them (and me) until their birth.

One baby would be better tho...:-)

See I am 29 and the embryos are good quality. I am so desperate for a slight increase in success (I have lining and fluid issues) that I am thinking of putting 2 back. If it's twins then great! I'd love them! But also worrying a bit about risks. It's such a difficult choice!!

Hi Lolly.

I was 28 when I had my 1st cycle, currently 13 weeks pregnant on my 2nd fresh (1FT inbetween) cycle and Im 31.

I was strongly advised on my fresh cycles to only return one due to my age and quality. I really wanted 2 the 2nd time around but I had to trust my consultant.

On my FT I had 2 but that was because I only had 2 on ice and the quality was not the highest.

I would advise talking to you're consultant as every case is different xx

Here are the stats for eSET vs DET for 3 day and blast transfer, and the rates of singleton vs twin pregnancies

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

And here's the twinning rates

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.

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.

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!!

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

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

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

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...

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

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...?

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.

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?!!

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!

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

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

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.

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.

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!