Embryo transfer 1 or 2?

[StaceySpyro]

I'm 35 next month, DH is 38. We've been trying on and off for a few years.
Where we live NHS only consider you if you're under 35 so we're going private.
We had an initial consultation and I asked how many embryos they recommended for transfer and they kind of talked around it but didn't make a recommendation.
I made the mistake of googling it and now I've spiraled!
Does anyone have any advice or can share what guidance you received please?

At 35 the recommendation would almost certainly be one embryo at a time unless there were big concerns about quality.

Usual circumstances is a single embryo transfer, especially at your age.

There are circumstances where clinics will do a double transfer in the UK - usually for patients over 40 and with low graded embryos. They are definitely only for certain circumstances though, and not the norm.

We did a double transfer but only as we had a BB and a CC and if we hadn't transferred both the CC would have been discarded. We didn't want twins but this was a risk we were willing to take.
We were told if the cycle was successful the chance of twins was 1/5.
If we had an AA and a BB we would have only transferred the one.

I have had 4 cycles of IVF from the age of 32 I always asked for double transfers but was refused due to my age after 3 failed cycles and getting to the age of 35 my clinic finally agreed to a double transfer of two good graded embryos luckily one attached and currently 16 weeks pregnant! I always think if I would of had a single transfer what if the wrong one was transferred i would of had a fail again. I would maybe try a cycle with one embryo and if that doesnt work push for the two. They was really reluctant to let me have a double transfer but i knew it was right for me.

I would only go for a double transfer if you are happy and able to look after twins. Go to a twins trust meet up or get more info online.

We had a day three transfer of two embryos due to ‘failures’. Have twins now. I love them so much but know their needs would be met better if we had them one at a time.

Some people get triplets from two embryos. It’s a risk I wouldn’t take again.

i do happily have three children from IVF but one a time is my advice

In my clinic if it was day 3 embryos and/or if you were over 38 years old they usually suggested a double transfer (I fell into this category and had a single birth from a double transfer).

At age 35 or using more typical 5 day embryos I’d be very surprised if they would suggest transferring more than one embryo at a time - as afaik it’s against HEFA guidelines (because if you are still early/mid thirties or with better quality embryos then it increases the chances of twins).

However if you transferred a few times (singles) and still had no success, then I think there’s more flexibility and a double transfer might then be suggested by many clinics- or if not, you’d certainly have reasonable grounds to suggest it yourself.

@usernameinserthere Can I ask how old you were when you made the embryos? I was 40 when I made my day 3 ones and assume my clinic will suggest transferring 2 (as they did before), but I admit twins would be really tough…

@IamnotwhouthinkIam - I was 38 and I do know how fortunate in fertility terms we have been. Just my tuppence.

I wasn’t suggesting at all that you weren’t aware you were lucky - I think everyone who has had a IVF baby(/s) knows just how lucky we are❤️

It’s just interesting that you are only 2 years younger than me but maybe that’s a lot in fertility terms? At age 40 my clinic were pretty insistent that transferring 2 embryos gave me a much better chance of a successful pregnancy without hugely increasing the chance of twins (I think they said my success rate would double but the chances of having twins was less than 5% -and they were right in my case but I can see how it might be scary if you were in the 5%).

Maybe it also depends on the embryo quality as well as age - although I don’t know how much they can tell from 3 day embryos compared to the 5 day ones 🤷‍♀️

I still wonder why they thought a double transfer would be more likely to be successful than two single transfers though - I asked but they said that was the experience of the clinic. I suppose I shouldn’t worry, since it worked! But now I’ve got to make that same decision again…

@IamnotwhouthinkIam there is statistically quite a large fertility difference between 38 and 40 (but obviously that is at population level - it will vary by individual).

The recommendation for more than one is usually because the success likelihood of any untested single embryo is considered lowish - an extra one gives two rolls of the dice. It may also depend on embryo quality though - the number of cells and fragmentation at day 3 etc. If embryos are the highest grade then two may not be recommended.