Decision


#1

How did you decide how many blasts to transfer? What statistics did your RE provide in terms of success with transferring 1, 2, or 3? Also what did they say in terms of multiples? I keep reading contradictory information online! Thanks in advance :slight_smile:


#2

Hi Babyhope…sounds like you are thinking what I am.

We have previously only done a day 3 transfer and actually transferred all we had. (3 and 4 embryos) got a singleton with those successful cycles.

Now we have blasts…our fresh cycle we transferred 2 near perfect blasts…negative. Our frozenbabies were froze on day 6. I dont know if that makes a difference. My logic is we would transfer 2 since that is what we did in the fresh cycle. we only have 3 frozen embryos. So I did think maybe 1 at a time, because those are like gold to us. I personally have no problem with twins if it happens but I don’t want to make it happen. (I am a twin)
My doctor is a bit conservative. He and his wife did IVF and they only chose to transfer 1 embryo at a time. BUT lets face it, money was no object to them. For us it is close to $3,000.00 for a FET.
Consult your physician and go with your gut.


#3

[QUOTE=babyhope7]How did you decide how many blasts to transfer? What statistics did your RE provide in terms of success with transferring 1, 2, or 3? Also what did they say in terms of multiples? I keep reading contradictory information online! Thanks in advance :)[/QUOTE]

Because I only had 2 blasts left, RE suggested transferring both. We did. One split and I had triplets. Blasts don’t split often but they can. Talk to your RE and see what is suggested.

If I had more than 2 frozen, I probably would’ve pushed for 3 (because 2 didn’t work during the fresh cycle). If that had happened, I might have been pregnant with quads and that wouldn’t have been a good thing. Please be careful.


#4

[quote=BabiesAreCute]Because I only had 2 blasts left, RE suggested transferring both. We did. One split and I had triplets. Blasts don’t split often but they can. Talk to your RE and see what is suggested.
.[/quote]

Very interesting. Do day 3 embryos split more often than blasts?


#5

i guess you need to talk to your RE about it. I forgot the stats, i wanna say 25% chance of twins with transfering two, but i could be totally off on that. I transfered two each time and will transfer two again for our FET…my RE is totally on board with that…and we’re willing to take the chance with twins


#6

After one successful and then two failed single embryo transfers, my RE advised me to transfer two embryos the last time (it still failed, but that’s not the point). He said there is an increased risk of twins, but because I have had three full-term pregnancies (including two VBACs) he felt my uterus was very strong and that MY risks with carrying twins would be lower than average. So part of that risk/benefit calculation included an evaluation of my medical history and the determination that he felt twins would be less risky for me than it might be for another woman.


#7

We did two with our fresh IVF and we are thinking about FETs now. I would transfer two again.


#8

There are a lot of factors that go in to deciding how many to transfer. Age, previous failed cycles, embryo quality.

Women 35+ would probably do better to transfer 2 or 3 because more of their embryos will be chromosomally abnormal.

Women who have had multiple failed cycles would probably want to transfer more than one.

If you have a 6AA blast, transferring one would probably be a good idea, but if all you have is a 3CB and a 4CC or something like that, then you may want to transfer both.

It is really something that you, your DH and RE need to decide.


#9

The estimate will be different whether it is day 3 or day 5 embryos, and whether they came from a conception cycle. My estimate for [my 2010] fresh conception cycle with no ovarian issues, very good response, and great embryos was 50% per embryo. This is why I chose elective single transfer on the fresh one. Now, reading up on the frozens, it seems like they estimate that the probability is about the same as fresh… but I used my best fresh one already, so I would estimate mine in the 40-45% chance per embryo. This makes me think I might go one embryo per cycle for my FET (my insurance pays for a total of three cycles; I have used one for IVF, will use another one for FET, will likely pay myself for the second FET, and then use the last one for another IVF, should I need it). Now, in full disclosure, I am trying to avoid twins for personal reasons outside of health/fertility.

So, 5-day blast from a conception cycle - 40-45% per embryo
3-day embryo probably at 30-40% from conception, and around 25-30% from non-conception cycle
5-day blast from non-conception cycle - around 30-35%

To calculate probability of pregnancy with multiple embryos you need to calculate probability of non-conception by multiplying percentages. For example, let’s say you estimate your probability of take at 30% per embryo, and you use 3. So, the probability on a failed cycle is 0.70.70.7 = 34.3% - so the probability of pregnancy is 65.7%. And probability of triplets is 2.7%.

Here is the full outcome matrix (you cam make one yourself in Excel):
One Two Three One Two Three Total Probablity
30% 30% 30% 1 1 1 3 2.7%
30% 70% 30% 1 0 1 2 6.3%
30% 30% 70% 1 1 0 2 6.3%
30% 70% 70% 1 0 0 1 14.7%
70% 30% 30% 0 1 1 2 6.3%
70% 70% 30% 0 0 1 1 14.7%
70% 30% 70% 0 1 0 1 14.7%
70% 70% 70% 0 0 0 0 34.3%

Emb Chance
0 34.3%
1 44.1%
2 18.9%
3 2.7%

P.S. I am working with percentages for a living, but not in the medical area, so take this your own risk.


#10

Wait! This is fascinating! :slight_smile: So statistically speaking (a big caveat there, of course), if you have a 50% chance per embryo and you put back 3 embryos that would be:
12.5% chance of zero
37.5% chance of a singleton
37.5% chance of twins
12.5% chance of triplets

Did I FUBAR that?


#11

Back to back?

[QUOTE=michelemybelle73]Hi Babyhope…sounds like you are thinking what I am.

We have previously only done a day 3 transfer and actually transferred all we had. (3 and 4 embryos) got a singleton with those successful cycles.

Now we have blasts…our fresh cycle we transferred 2 near perfect blasts…negative. Our frozenbabies were froze on day 6. I dont know if that makes a difference. My logic is we would transfer 2 since that is what we did in the fresh cycle. we only have 3 frozen embryos. So I did think maybe 1 at a time, because those are like gold to us. I personally have no problem with twins if it happens but I don’t want to make it happen. (I am a twin)
My doctor is a bit conservative. He and his wife did IVF and they only chose to transfer 1 embryo at a time. BUT lets face it, money was no object to them. For us it is close to $3,000.00 for a FET.
Consult your physician and go with your gut.[/QUOTE]

I’m also on a similar situation. I just got my BFN this past Monday from my first ivf cycle. My dr transferred 1 blast day 5. He now wants me to do an FET in feb - I see that you are also doing it in feb and I was wondering if you had any thoughts on doing a Back to back cycle? For my next cycle we want to at least transfer 2 but we are considering 3. So many decisions to make


#12

We transfered 2 8-cell embryos for our first IVF cycle. We ended up having a chemical pregnancy. We then transferred two blasts in a frozen cycle. They were from our first fresh cycle and that also resulted in a chemical pregnancy. We had another fresh cycle and transferred 2 blasts and now are pregnant with twins. Our RE stated that if we had another failed cycle she would have transferred 3 on our next attempt. We are so excited to be having twins. We still have 2 blasts frozen but will probably do single embryo transfers from now on so we don’t have multiples again.


#13

[quote=Xerxella]Wait! This is fascinating! :slight_smile: So statistically speaking (a big caveat there, of course), if you have a 50% chance per embryo and you put back 3 embryos that would be:
12.5% chance of zero
37.5% chance of a singleton
37.5% chance of twins
12.5% chance of triplets

Did I FUBAR that?[/quote]

No, you did not - you are absolutely right.


#14

[quote=Luciluli1977]-----------------------
I’m also on a similar situation. I just got my BFN this past Monday from my first ivf cycle. My dr transferred 1 blast day 5. He now wants me to do an FET in feb - I see that you are also doing it in feb and I was wondering if you had any thoughts on doing a Back to back cycle? For my next cycle we want to at least transfer 2 but we are considering 3. So many decisions to make[/quote]

Depends on how you are feeling about multiples. I think your chances are pretty darn good given that you had a very good fresh cycle and many frozen. The one you transferred did not work out - but not every single one will. It may not be indicative of lower chances.