Implantation - How many Embryos?


#1

I started my IVF process January 9th and I am scheduled for implantation tomorrow. I am struggling with how many embryos to implant.

Lab suggested 2 due to my age but I have never successfully had a pregnancy in my uterus and I am afraid after all the time, money, emotions that it will not work. I ideally would like to implant 3 b/c I would like twins and I am completely more then fine with having multiples but I am terrified of this failing :confused:

Any suggestions???

F - 29 * lost tubes due to ectopics
M - 29 *perfect :slight_smile:

9/2009 - :bfp: :slight_smile: - 10 wk apt; blind ovum; DNC to follow

3/2010 - :bfp: started bleeding; woke up one morning tube burst. Emergency Surgery; lost tube.

1/2011 - :bfp: couldn’t find pregnancy; another ectopic treated with meds.

9/2012 - :bfn:
10/2012 - :bfp: weird b/c we weren’t trying; went to dr’s discovered another ectopic (2 months old) emergency surgery had to remove tube

1/2013 - Started first round IVF; smooth sailing (as smooth as lots of needles can be) so far.


#2

we put 2 in, 1 stuck and shes in my arms right now.

its different with ivf, they put the embryos directly in your uterus, so ectopic is less likely. responsible REs wont put more than 2-3 bac in someone your age. the risk to you and babies is too high with multiples.
GOOD LUCK


#3

[QUOTE=JMiller10]we put 2 in, 1 stuck and shes in my arms right now.

its different with ivf, they put the embryos directly in your uterus, so ectopic is less likely. responsible REs wont put more than 2-3 bac in someone your age. the risk to you and babies is too high with multiples.
GOOD LUCK[/QUOTE]
Congrats! I really want twins b/c I don’t know if I can go through this again which is why I am afraid to only do 2.


#4

Good luck with your decision and with your embroys implanting. Please keep us updated on your Beta results. :pray: You get your :bfp:.


#5

I had the same feeling as you. We also had low fertilization (12 mature but only 4 fertilized with ICSI) so I was really thinking of putting all four back in eventhough for my age (31 at the time) the RE suggested one or two. I decided to put back two and freeze the other two and I am SO THANKFUL I only put two back as they both stuck and I now have twins :slight_smile: At the time it’s easy to get caught-up in the “transfer more hoping at least one will stick” mindset but looking back, there’s a good chance that I may have ended up with triplets or even quads if I had put back the amount my emotions wanted me to, and not what my head said was the smarter move.

Whatever you decide I wish you the best of luck and a :bfp: !


#6

Plus remember…1 can always split.
You might also have some frosties. I have 6 frosties, so like i said you wont have to go thru the whole IVF process again, just another transfer.
eep us posted!


#7

Hey Stephc83,
Just a little info from my ET. I was 36 at the time and my RE was ok with putting back three embies. He did this only due to my age. My chance of triples and twins was extremely low so he felt comfortable transfering three. I do not know what I would do if I was your age. All I know is sometimes a RE will require you to sign selective reduction paperwork just incase you get pregnant with too many babies. You still have your age in your favor.

Good luck in which ever decision you make. Baby dust to you and keep us posted on your success!


#8

[QUOTE=stephc83]I started my IVF process January 9th and I am scheduled for implantation tomorrow. I am struggling with how many embryos to implant.

Lab suggested 2 due to my age but I have never successfully had a pregnancy in my uterus and I am afraid after all the time, money, emotions that it will not work. I ideally would like to implant 3 b/c I would like twins and I am completely more then fine with having multiples but I am terrified of this failing :confused:

Any suggestions???

F - 29 * lost tubes due to ectopics
M - 29 *perfect :slight_smile:

9/2009 - :bfp: :slight_smile: - 10 wk apt; blind ovum; DNC to follow

3/2010 - :bfp: started bleeding; woke up one morning tube burst. Emergency Surgery; lost tube.

1/2011 - :bfp: couldn’t find pregnancy; another ectopic treated with meds.

9/2012 - :bfn:
10/2012 - :bfp: weird b/c we weren’t trying; went to dr’s discovered another ectopic (2 months old) emergency surgery had to remove tube

1/2013 - Started first round IVF; smooth sailing (as smooth as lots of needles can be) so far.[/QUOTE]

I think just about everyone would prefer to have healthy twins, and my wife and I have had the same thoughts that you have. IVF is a taxing process and it’s tempting to want the “instant family” that multiples imply, but it’s also very, very important to remember that multiples are much more likely to have problems in utero and after birth. Doctors discourage the pursuit of multiples because, for society at large, the pursuit of multiples is a very harmful thing.

It’s easy to envision a rosy and picturesque outcome but you may want to temper those visions with a portrayal of other outcomes: the possibility of premature babies with lifelong health problems. I’m a fraternal twin myself and I was pretty below average in birth weight when I was born. My twin sister was twice my weight.

I don’t think it’s quite justified to transfer more than 2 the first time. If you end up needing later cycles, the outcome of your previous cycles will inform you as to whether transfering more than 2 is a good idea.


#9

I kind of agree. I would go with no more than 2. At your age, 3 is pretty risky. I did 3 but I was 38 at the time and one stuck and I miscarried it later. If you made it this far, there is a great chance you can have some frosties so you should freeze them and then if it doesn’t work or only one sticks you have a chance of a sibling down the road.

One thing to note. Twins - there is a 5% chance of a serious birth defect, with trips its goes to over a 50% chance of one having a debilitating defect, and the chance of having one of those trips with a defect is 95%! I realized this when I first started this process and they made me sign a form for selective reduction. It was my first medicated cycle and I had 4 eggs and they wouldn’t do it unless I agreed to do it. At the time I was so desperate for a family, I did it. I didn’t end up pregnant, but I couldn’t imagine how hard it would be to go through this and then have to reduce. To me, for those of us that go through IF, the pain of having to reduce would be too much! Just my two cents!
Good luck


#10

[QUOTE=stephc83]I started my IVF process January 9th and I am scheduled for implantation tomorrow. I am struggling with how many embryos to implant.

Lab suggested 2 due to my age but I have never successfully had a pregnancy in my uterus and I am afraid after all the time, money, emotions that it will not work. I ideally would like to implant 3 b/c I would like twins and I am completely more then fine with having multiples but I am terrified of this failing :confused:

Any suggestions???
[/QUOTE]

I just sent this to someone (26yo) deciding between 1 or 2:

“I find this a really difficult decision. You have great embryos, if they were poor quality, I would say 2. However, you’re young and have a high chance of pregnancy. At my clinic, in your age group, they say there’s a 42% chance of pregnancy with a single embryo transfer and a 48-50%% chance of pregnancy if you transfer 2. So putting in two certainly doesn’t double your chance of pregnancy but only increases it about 8%. The idea being that your uterus is ready for implantation or not. However, if you DO transfer 2 and DO become pregnant, there’s a 50% chance of twins. I worry a lot about the complications of twin pregnancies. That being said, I transferred two last time because they were only okay quality (my transfer was at 3 days). I think it’s a very personal decision you have to discuss with your partner.”

That being said, I would personally never transfer 3 unless 2 were 2 cell embryos very unlikely to grow (and they put them in for the extra hormones or whatever). It is very rare for triplets to not have significant issues with prematurity and it’s often significant detriments. My RE would never (her words) transfer more than 2 in my age group (32). I know it’s tempting to have an instant family but higher order multiples can cause serious maternal and child health problems. Good luck with your choice!


#11

In agreement with the prevailing opinion - young age, no ovulation issues, good cycle, good embryos means you want to stay on the low side. Your chances are very good now, and will be good for the next cycle should this not work out. I did an elective single transfer at 35. I figured, it was my first cycle, so it would be fine to continue on had that cycle fail.

Best of luck with your decision!


#12

[quote=stephc83]I started my IVF process January 9th and I am scheduled for implantation tomorrow. I am struggling with how many embryos to implant.

Lab suggested 2 due to my age but I have never successfully had a pregnancy in my uterus and I am afraid after all the time, money, emotions that it will not work. I ideally would like to implant 3 b/c I would like twins and I am completely more then fine with having multiples but I am terrified of this failing :confused:

Any suggestions???
[/quote]

SART/ASRM guidelines recommend transfer of 1 or 2 cleavage stage (day 3) embryos in a 29 year old, or else 1 blastocyst. If the prognosis is not good, then it’s 2 cleavage stage or 2 blastocysts.

They want to reduce the twins and avoid the risk of triplets for good reason.


#13

[QUOTE=Dianna]I just sent this to someone (26yo) deciding between 1 or 2:

“I find this a really difficult decision. You have great embryos, if they were poor quality, I would say 2. However, you’re young and have a high chance of pregnancy. At my clinic, in your age group, they say there’s a 42% chance of pregnancy with a single embryo transfer and a 48-50%% chance of pregnancy if you transfer 2. So putting in two certainly doesn’t double your chance of pregnancy but only increases it about 8%. The idea being that your uterus is ready for implantation or not. However, if you DO transfer 2 and DO become pregnant, there’s a 50% chance of twins. I worry a lot about the complications of twin pregnancies. That being said, I transferred two last time because they were only okay quality (my transfer was at 3 days). I think it’s a very personal decision you have to discuss with your partner.”

That being said, I would personally never transfer 3 unless 2 were 2 cell embryos very unlikely to grow (and they put them in for the extra hormones or whatever). It is very rare for triplets to not have significant issues with prematurity and it’s often significant detriments. My RE would never (her words) transfer more than 2 in my age group (32). I know it’s tempting to have an instant family but higher order multiples can cause serious maternal and child health problems. Good luck with your choice![/QUOTE]

I thought this was a good comment. It really is a case by case matter. If you have egg quality that are “hidden” at the blast stage, it might be prudent to do more than 2 transfers with the understanding that you have below average chances anyway.


#14

[QUOTE=Demian]I thought this was a good comment. It really is a case by case matter. If you have egg quality that are “hidden” at the blast stage, it might be prudent to do more than 2 transfers with the understanding that you have below average chances anyway.[/QUOTE]

I think we all tend to think of “prematurity” as the major complication of multiples, but it’s the organ damage that can happen from being premature that causes the issues. When you’re born at under 30 weeks (or even above 30 weeks in a lot of cases), you’re at risk for a number of things. The most immediately pressing issue is under developed lungs or RDS (respiratory distress syndrome), these babies frequently need to be intubated and may go on to have chronic oxygen needs/lung issues. Another terrible thing which is secondary to prematurity is IVH, intraventricular hemorrhage, which is basically a bleed in the brain due to fragile vessels which premature babies are at risk for. Bleeding can cause severe developmental delays. Also, of course, is the risk for CP (cerebral palsy) and PVL (periventricular leukomalacia) which can cause brain damage and movement/intellectual disabilities. There are of course more issues, such as NEC (awful) etc etc.

I don’t bring these things up to scare anyone, but these are real complications of prematurity. They certainly can also happen when a singleton is born prematurely but multiples tend to be born earlier. There are healthy twins that go home at the normal time without NICU time too, but I think you just have to outweigh the risks and benefits. I’m in a rush to have a baby as well, the sooner the better, but healthy is the number one priority. Good luck with your decision!!


#15

Just thought I would add here that I have a friend who got pregnant with twins and everything was going fine until about 20 weeks. Then she went into labor at 24-26 weeks (cant remember exactly). One of the twins was home after a couple of months in the NICU. The other twin is still there 9 months later. Can you imagine? This woman has not been able to work nor spend time with both of her kids together since they were born.

I know that many, many twins are born healthy - but many are not. just something to keep in mind when you are hoping for multiples.


#16

We to were in the same boat last year this time and I had tried many times and no baby. When transfer day came we had three great embryos and RE said she would let us do three if we wanted too but she would stick with two at my age 29, I asked what they would do with the 3rd embryo if we didnt transfer it and they said just get rid of it, it would not freeze again and there we transfered three! In the begining we promised each other we would give every embryo a chance at life and we were not about to throw a great one out! We both knew three babies would be a handful but what was suppose to happen would! The result of three perfect embryos … we now have 5 month old baby boy. Do what your heart tells you to do!! Good luck! Prayers to you and yours!! :pray:


#17

my clinic had a strict policy to transfer no more than 2 day 3 embryos or 1 blast in anyone younger than 35. i was 31 at the time. however, due to my DOR and poor response, they figured my eggs were crappy anyways and agreed to transfer 3 as a last hoorah (they basically felt sorry for me). you can imagine the shock they had when i was preganant and preganant with twins.

during my next retrieval cycle, they said that they would NEVER allow me to transfer 3 again given my success. they didn’t want me to get triplets the second time around (but i ending up freezing all that cycle and have still not transferred them).

so, for someone your age and history, i agree that 2 at most is a good number. you have a high chance of triplets if you transfer 3.

i had no problems with my twin pregnancy and my babies were born full term with only an hour of NICU time. if i knew that i would be successful despite my odds, i would never have transferred 3.


#18

Hi everyone, I am new to this site so this is my first posts! Just reading all your helpful posts above. We have our transfer tomorrow and I am so worried. We have 4 fertilised embies and they are all 12 cells today on day 4 (they were hoping they would be morulas today). Im not sure if anyone knows what the success rate is like transferring 12 cell on day 5? It’s so frustrating :grr: and not sure how many we should transfer either. I am 35 (just yesterday!). Good luck ladies with all your journeys and I find reading these posts a lot of help :grouphug:x


#19

[QUOTE=bunnyfeet]Hi everyone, I am new to this site so this is my first posts! Just reading all your helpful posts above. We have our transfer tomorrow and I am so worried. We have 4 fertilised embies and they are all 12 cells today on day 4 (they were hoping they would be morulas today). Im not sure if anyone knows what the success rate is like transferring 12 cell on day 5? It’s so frustrating :grr: and not sure how many we should transfer either. I am 35 (just yesterday!). Good luck ladies with all your journeys and I find reading these posts a lot of help :grouphug:x[/QUOTE]

:welcome: and happy birthday! I’ve heard 6-12 cell embryos are good, so I wouldn’t worry, you’ll have to see where they are at tomorrow. I would transfer no more than 2 at age 35 but ask your RE to see what he/she recommends. :cross: