Limiting embryos created

[MayeJane4]

Has anyone else followed an IVF plan specifically designed to limit the number of embryos created and potentially left unused? Having quite a hard time at the moment deciding whether to proceed because of this concern. Would be really helpful to hear of others experiences

@MayeJane4 do you have a reason to think you could end up with a huge surplus pile? A lot more may be required for success than you imagine.

Best thing to do is talk to your clinic to get their opinion and whether they will agree. I think generally with private treatment you might have a bit more flexibility than with an nhs round.

The only way I think you could potentially do this is to ask for only a certain number of eggs to be fertilised through ICSI or traditional IVF. E.g. you get 16 eggs, fertilise 6 and ask 10 to be frozen.

But by doing this you would need to accept you’d be lowering your chances of a successful outcome. The drop off/ attrition rate in ivf can be big, for example…

• you might get 16 eggs,
• 14 fertilise normally
• 10 make it to day 3
• 6 make it to day 5 blastocysts
• 4 are euploid normal embryos

In theory this would give you 4 chances but euploids don’t always take either. Your numbers could be better or worse than this you wouldn’t know either way unless you try.

If you did freeze some eggs I think these have a lower survival rate than a fertilised embryo (don’t know exact percentage so may not be huge but still a consideration).

This approach would also be more expensive, potentially a lot more expensive depending how many rounds you need plus storage costs. You’re potentially looking at more time, more money and a lower success rate.

Is it for religious reasons? That’s the only argument I’ve heard before for creating fewer embryos. Maybe learning a bit more about the process and possibilities for any unused embryos might be helpful to think about?

Also, consider that everything may go to plan and you get 4 viable embryos and would like 4 children - what if your feel completely fulfilled with 1 child, what if your financial situation changes after child 1 or 2, what if a child has additional needs and adding 2 more siblings would put strain on your family, what if something happened to your husband and you became a single parent? What would happen to any unused embryos in these situations. You can’t plan or predict every eventuality.

It’s sensible to explore your options and only go ahead with what you’re comfortable with but be mindful that it might not all be smooth sailing. It could be, but there could also be hurdles you can’t control.

I believe in Germany (a poster on another thread was doing IVF there as she lived there and mentioned it) it's the law to only create three embryos max per round and the remaining eggs and sperm are frozen and once those three embryos are used up you can then create more (but as the poster above said frozen eggs have a lower chance of surviving the thaw than embryos I believe). So you could look into either doing IVF privately in Germany (it might be very expensive though) or asking your clinic to follow the same approach. I believe they chose three embryos max per round legally because statistically this might (!) give you a good chance at one. Do have a read through in case I got any of that wrong but that's what I recall.

@Strawberrryfields that's quite an optimistic attrition funnel for fertilisation and euploid rate - most people are not getting 4 euploids from a single round. Usually only very good, above average prognosis patients. Such as late 20s/ early 30s with tubal issues rather than gamete quality/ endo/ PCOS/ advanced maternal age etc.

@MayeJane4 if this is really important to you for ethical reasons then I'm sure the clinic will accommodate something but here's an alternative funnel for the 16 eggs example:

11 could fertilise (70% - can easily be less than this as well)
3 could reach blast (30-50% of fertilised eggs reaching blast is average, but it can easily end up less)
A couple could be euploid but there could also be zero from bad luck chance variation, or the grade could be low meaning there is reduced implantation potential

If someone does end up with 4 euploid embryos (though most in the UK don't test so won't know the status), the chances of a child are really excellent - as good as IVF chances get. But that assumes no other big problems, such as uterine or immune. If someone instead gets two euploid embryos from a round in theory that gives them a c.80% chance of a child but from another perspective it's not far off two coin tosses and expecting to get at least one heads. What the on paper probability is vs what can happen in a small sample size.

For all of these reasons people usually try to maximise available embryos. However, similar to the German example above (where they are very conservative about IVF procedures because of their past history with eugenics and PGTA is for instance banned), clinics will be able to work with you to limit numbers fertilised and progressed if that is a priority. It will just be more expensive.

Yes @sirensong fair enough. I probably made some assumptions based on OPs assumption that there would be surplus. Though did highlight that euploid doesn’t always equal live birth as many seem to think.

I was hoping it was based on your own good numbers/ experience 🙂

Unfortunately not 🫤 But I do have friends who’ve had similar/ better numbers so know it can be this way, wish it was for everyone!

Most people don't get enough to freeze any so you might be being too optimistic anyway.