Higher order multiple risks and embryo transfers...

Higher order multiple risks and embryo transfers...

Anonymous for this one...
Anonymous for this one...

February 17th, 2011, 3:33 am #1

Hi, I've just been reading the thread about # of embies to transfer and one of the posters said they had a mantra 'only put in what you want to come out' or words to that effect. It's really got me thinking.... We are gearing up for a DE cycle, and hubby is insisting we transfer three embies. He is having a grief reaction and I'm not sure he is being rational. He keeps thinking of how many embies we have transferred without success in our OE IVF's and running with that. His dearest wish is for us to have twins, and I would love that too, but the risk of having all three implant scares me.

I'm hoping that this thread might bring some facts and anecdotes to the table to help me discuss this with DH. Did anyone put 3 embies back on a 5 day transfer without any known implantation/uterine issues and what was the result? Are there any women here who have ended up conceiving higher order multiples (or know anyone who has)? Anyone know the stats about the chances of a triplet conception or successful outcomes of a triplet pregnancy? Are there online resources that hubby and I can look at together so it's more a rational decision than an emotive one?

Thanks in advance...
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Anonymous
Anonymous

February 17th, 2011, 4:32 am #2

most clinics (in the US) just won't transfer 3 embryos anymore unless there are special circumstances. It might be a moot issue not worth arguing with DH about if the clinic is going to say no to 3 anyway

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Vianna
Vianna

February 17th, 2011, 4:49 am #3

Hi, I've just been reading the thread about # of embies to transfer and one of the posters said they had a mantra 'only put in what you want to come out' or words to that effect. It's really got me thinking.... We are gearing up for a DE cycle, and hubby is insisting we transfer three embies. He is having a grief reaction and I'm not sure he is being rational. He keeps thinking of how many embies we have transferred without success in our OE IVF's and running with that. His dearest wish is for us to have twins, and I would love that too, but the risk of having all three implant scares me.

I'm hoping that this thread might bring some facts and anecdotes to the table to help me discuss this with DH. Did anyone put 3 embies back on a 5 day transfer without any known implantation/uterine issues and what was the result? Are there any women here who have ended up conceiving higher order multiples (or know anyone who has)? Anyone know the stats about the chances of a triplet conception or successful outcomes of a triplet pregnancy? Are there online resources that hubby and I can look at together so it's more a rational decision than an emotive one?

Thanks in advance...
My dh and I only wanted to have one child due to the risks associated with twin births. We were told of the high odds of twins with the transfer of two embryos, so we did an eSET and were fortunate enough to have success on our first attempt (using a gestational carrier due to my damaged cervix).

Good luck!
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Anonymous
Anonymous

February 17th, 2011, 5:15 am #4

Hi, I've just been reading the thread about # of embies to transfer and one of the posters said they had a mantra 'only put in what you want to come out' or words to that effect. It's really got me thinking.... We are gearing up for a DE cycle, and hubby is insisting we transfer three embies. He is having a grief reaction and I'm not sure he is being rational. He keeps thinking of how many embies we have transferred without success in our OE IVF's and running with that. His dearest wish is for us to have twins, and I would love that too, but the risk of having all three implant scares me.

I'm hoping that this thread might bring some facts and anecdotes to the table to help me discuss this with DH. Did anyone put 3 embies back on a 5 day transfer without any known implantation/uterine issues and what was the result? Are there any women here who have ended up conceiving higher order multiples (or know anyone who has)? Anyone know the stats about the chances of a triplet conception or successful outcomes of a triplet pregnancy? Are there online resources that hubby and I can look at together so it's more a rational decision than an emotive one?

Thanks in advance...
... by transferring 3.
The risks associated with twin pregnancies are high enough.
What if all 3 implanted, or if 2 implanted and one split (which has happened)?
Would you do a reduction?

In the end I think the decision should be made with your RE, based on your history and the quality of the embrios. But I doubt any clinic in the US will transfer 3 DE embryos, unless maybe all 3 were of poor quality.
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Orchid
Orchid

February 17th, 2011, 5:55 am #5

Hi, I've just been reading the thread about # of embies to transfer and one of the posters said they had a mantra 'only put in what you want to come out' or words to that effect. It's really got me thinking.... We are gearing up for a DE cycle, and hubby is insisting we transfer three embies. He is having a grief reaction and I'm not sure he is being rational. He keeps thinking of how many embies we have transferred without success in our OE IVF's and running with that. His dearest wish is for us to have twins, and I would love that too, but the risk of having all three implant scares me.

I'm hoping that this thread might bring some facts and anecdotes to the table to help me discuss this with DH. Did anyone put 3 embies back on a 5 day transfer without any known implantation/uterine issues and what was the result? Are there any women here who have ended up conceiving higher order multiples (or know anyone who has)? Anyone know the stats about the chances of a triplet conception or successful outcomes of a triplet pregnancy? Are there online resources that hubby and I can look at together so it's more a rational decision than an emotive one?

Thanks in advance...
He's scared. Dang, I totally relate. I'd be the one wanting to do that and my H would be the one asking this question and getting info on line.

In the end, I wouldn't do it--but I sure do understand the feeling. Like 'dammit I'm not going through that again!' Anything to avoid the loss. A hail Mary pass.

People calculate risk differently. What are the REAL risks? If you find out, I'd be curious to know even though I wouldn't transfer 3.
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Kacee
Kacee

February 17th, 2011, 6:29 am #6

Hi, I've just been reading the thread about # of embies to transfer and one of the posters said they had a mantra 'only put in what you want to come out' or words to that effect. It's really got me thinking.... We are gearing up for a DE cycle, and hubby is insisting we transfer three embies. He is having a grief reaction and I'm not sure he is being rational. He keeps thinking of how many embies we have transferred without success in our OE IVF's and running with that. His dearest wish is for us to have twins, and I would love that too, but the risk of having all three implant scares me.

I'm hoping that this thread might bring some facts and anecdotes to the table to help me discuss this with DH. Did anyone put 3 embies back on a 5 day transfer without any known implantation/uterine issues and what was the result? Are there any women here who have ended up conceiving higher order multiples (or know anyone who has)? Anyone know the stats about the chances of a triplet conception or successful outcomes of a triplet pregnancy? Are there online resources that hubby and I can look at together so it's more a rational decision than an emotive one?

Thanks in advance...
All took and two of them split. She ended up being pg. with 5 babies, a singleton and two sets of identical twins. Three blasts are just too much.
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Hope2009
Hope2009

February 17th, 2011, 7:39 am #7

Hi, I've just been reading the thread about # of embies to transfer and one of the posters said they had a mantra 'only put in what you want to come out' or words to that effect. It's really got me thinking.... We are gearing up for a DE cycle, and hubby is insisting we transfer three embies. He is having a grief reaction and I'm not sure he is being rational. He keeps thinking of how many embies we have transferred without success in our OE IVF's and running with that. His dearest wish is for us to have twins, and I would love that too, but the risk of having all three implant scares me.

I'm hoping that this thread might bring some facts and anecdotes to the table to help me discuss this with DH. Did anyone put 3 embies back on a 5 day transfer without any known implantation/uterine issues and what was the result? Are there any women here who have ended up conceiving higher order multiples (or know anyone who has)? Anyone know the stats about the chances of a triplet conception or successful outcomes of a triplet pregnancy? Are there online resources that hubby and I can look at together so it's more a rational decision than an emotive one?

Thanks in advance...
you know in the end this is all a crap shoot...even with a DE cycle with lovely young eggs...those eggs still have a high degree of abnormalities in every cycle. You are wise to do some research ahead of time and ask other people's advise but in the end it comes down to a feeling in your heart regarding the number that seems right to you.

When we were doing our fresh cycle I was in touch with a dear friend who had done a DE cycle the year before and she was really pressuring us to consider a SET especially if the embie quality was good. We were on holidays...near our clinic at the time and everywhere I went while we were waiting for our donor to have her retrieval...the number 2 kept coming up...I found 2 perfect tiny shells lying side by side on the beach...I went into the pool and the only locker available was the number 2....I know this sounds crazy but when we found out that we had 13 blasts to work with..and one was hatching and one was about to hatch.....I still went with the number 2 at transfer time.

We were given an 80 percent chance of success...with a 50 percent chance of having twins. Our embryologist told us they seldom see embies this good. My lining was excellent..a 10 ts...we had had other children so my uterus was proven....my DH thought it was a slam dunk for twins...and I SHOULD say he was only wanting one...while walking on the beach I HAD had dreams of two little girls.

Two weeks later my first beta was 30, not good...2 days later it was 15 and that first perfect cycle ended in a chemical m/c. We had to travel to our clinic...took 2 weeks off from work, the expense was huge...and this is what we got to show for it...it just seemed like such a crap shoot. When we went forward with our FET a month later, there was no way I was going with anything less than 3 even though our clinic is very conservative with their numbers to reduce the risks of mulitples.

We thawed three blasts and all made the thaw...2 were very good and starting to take off..one not that great...and again we were warned about twins.....I just didn't want to hear...'I'm sorry' AGAIN....and thankfully we did get pg but with a singleton DS. Now how in the heck did our fresh not work with perfect embies...and this time with our FET we at least got pg...this just doesn't make sense and it sure isn't perfect science. all the research and talking to others just doesn't help in the long run...each situation is unique. Sometimes I think it's all about timing of the Universe.

We had to go through 5 almost perfect day 5 blast embryos to get one beautiful boy, what does that tell you about a 22 year old donor's eggs...so when we went back to do our FET it just seemed really rational to transfer 3 again....and our Dr. ahead of time agreed with my thoughts on the matter...that is until they thawed out and the embryologist said they look as good as the day she froze them....they warned us of triplets...talked about selective reduction...yeah, yeah....again I just didn't want to go to the effort of all the meds, the travel, etc and have to come back a few months later also...I couldn't bear to hear...I'm sorry...and so I was okay with the thoughts of even 3. and I wouldn't have reduced even though I told our Dr. we would think about it...no judgement here for those who would choose a different course....but that is just me.

Two weeks later our beta was really strong...and at our u/s we found we had twins....thrilled, excited....and my dream of those two little girls is coming true...but you know I still think about those other embryos that didn't make it...when they look so good...so perfect...what in the heck happened to them.

I have only been on the boards for 3 years and I know that there are women who have seen years of all sorts of transfers and end results..with multiples....but in the time that I have been a board bud I can think of only one time when there was a triplet conception...and it being a problem for my board bud. Yes there have been some triplet conceptions but they very early on reduced on their own.

I think you also have to look at your own health....I carried our first DE DS easily even though I was 49 when he was born...no complications during the pgcy, he was full term, almost 10 pounds and I had a quick, intense, no intervention labour and vag delivery with him....so when I went back for our FET...in excellent shape...I was able to reassure my clinic Dr. that I could do twins.

So here I am at 51 and things are going really well....no problems at all, knock on wood at 23 wks...13 wks to go to be term for twins...I may be rash in saying I could do triplets....but I think my body could handle it...this pgcy has been very similar to a singleton...absolutely delightful...except for the m/s in the 1st trimester but that is par for the course...normal stuff. I'VE gained a bit more weight but that is the norm...it's not been alot though.

I really like that mantra...only put in what you want to get out...and feel you can parent easily...but my mantra was, 'let go and let God'....I'm not overly religious...more spiritual if you will and after this long journey to our DE babies I have come to a place of trust and letting go. What will be will be...sure we do have some control but gee after all these years of ttc with my OE's to complete our family...and then doing 3 cycles...I SEE THAT it still isn't in my hands at all...so I just let go and let God..and trust that what is put in front of me is something that I can deal with and there are lessons in the journey.
,
We can do all the research in the world, have long discussions with our Dr. with our spouses, talk to the embryologist...but in the end we really have no control in whether it will work, we will have a healthy singleton...or be given two or more....if you only want two...and your quality on your fresh cycle is excellent my advise is to just put in two...the chances of one spliting is very rare.

If you put in three like your DH wants to do and you had triplets...would it be the end of the world...do you think you could carry them, would you or could you reduce?...you haven't said anything about your health, your age, etc....or if it;s a big deal to cycle with your clinic distance wise...or even how many embies you are going to have to work with...these are all unknown factors.

Some times we cycle and only have a couple to transfer anyway so again it's out of our control isn't it.

These are all things that you will have to consider when you come down to the final strokes and you won't know ahead of time.

good luck making your decision and blessings for building your family, Hope
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Original poster
Original poster

February 17th, 2011, 9:25 am #8

All took and two of them split. She ended up being pg. with 5 babies, a singleton and two sets of identical twins. Three blasts are just too much.
Wow Kacee, that's a scary thought. Do you know what happened to the pregnancy?
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Original poster
Original poster

February 17th, 2011, 9:37 am #9

you know in the end this is all a crap shoot...even with a DE cycle with lovely young eggs...those eggs still have a high degree of abnormalities in every cycle. You are wise to do some research ahead of time and ask other people's advise but in the end it comes down to a feeling in your heart regarding the number that seems right to you.

When we were doing our fresh cycle I was in touch with a dear friend who had done a DE cycle the year before and she was really pressuring us to consider a SET especially if the embie quality was good. We were on holidays...near our clinic at the time and everywhere I went while we were waiting for our donor to have her retrieval...the number 2 kept coming up...I found 2 perfect tiny shells lying side by side on the beach...I went into the pool and the only locker available was the number 2....I know this sounds crazy but when we found out that we had 13 blasts to work with..and one was hatching and one was about to hatch.....I still went with the number 2 at transfer time.

We were given an 80 percent chance of success...with a 50 percent chance of having twins. Our embryologist told us they seldom see embies this good. My lining was excellent..a 10 ts...we had had other children so my uterus was proven....my DH thought it was a slam dunk for twins...and I SHOULD say he was only wanting one...while walking on the beach I HAD had dreams of two little girls.

Two weeks later my first beta was 30, not good...2 days later it was 15 and that first perfect cycle ended in a chemical m/c. We had to travel to our clinic...took 2 weeks off from work, the expense was huge...and this is what we got to show for it...it just seemed like such a crap shoot. When we went forward with our FET a month later, there was no way I was going with anything less than 3 even though our clinic is very conservative with their numbers to reduce the risks of mulitples.

We thawed three blasts and all made the thaw...2 were very good and starting to take off..one not that great...and again we were warned about twins.....I just didn't want to hear...'I'm sorry' AGAIN....and thankfully we did get pg but with a singleton DS. Now how in the heck did our fresh not work with perfect embies...and this time with our FET we at least got pg...this just doesn't make sense and it sure isn't perfect science. all the research and talking to others just doesn't help in the long run...each situation is unique. Sometimes I think it's all about timing of the Universe.

We had to go through 5 almost perfect day 5 blast embryos to get one beautiful boy, what does that tell you about a 22 year old donor's eggs...so when we went back to do our FET it just seemed really rational to transfer 3 again....and our Dr. ahead of time agreed with my thoughts on the matter...that is until they thawed out and the embryologist said they look as good as the day she froze them....they warned us of triplets...talked about selective reduction...yeah, yeah....again I just didn't want to go to the effort of all the meds, the travel, etc and have to come back a few months later also...I couldn't bear to hear...I'm sorry...and so I was okay with the thoughts of even 3. and I wouldn't have reduced even though I told our Dr. we would think about it...no judgement here for those who would choose a different course....but that is just me.

Two weeks later our beta was really strong...and at our u/s we found we had twins....thrilled, excited....and my dream of those two little girls is coming true...but you know I still think about those other embryos that didn't make it...when they look so good...so perfect...what in the heck happened to them.

I have only been on the boards for 3 years and I know that there are women who have seen years of all sorts of transfers and end results..with multiples....but in the time that I have been a board bud I can think of only one time when there was a triplet conception...and it being a problem for my board bud. Yes there have been some triplet conceptions but they very early on reduced on their own.

I think you also have to look at your own health....I carried our first DE DS easily even though I was 49 when he was born...no complications during the pgcy, he was full term, almost 10 pounds and I had a quick, intense, no intervention labour and vag delivery with him....so when I went back for our FET...in excellent shape...I was able to reassure my clinic Dr. that I could do twins.

So here I am at 51 and things are going really well....no problems at all, knock on wood at 23 wks...13 wks to go to be term for twins...I may be rash in saying I could do triplets....but I think my body could handle it...this pgcy has been very similar to a singleton...absolutely delightful...except for the m/s in the 1st trimester but that is par for the course...normal stuff. I'VE gained a bit more weight but that is the norm...it's not been alot though.

I really like that mantra...only put in what you want to get out...and feel you can parent easily...but my mantra was, 'let go and let God'....I'm not overly religious...more spiritual if you will and after this long journey to our DE babies I have come to a place of trust and letting go. What will be will be...sure we do have some control but gee after all these years of ttc with my OE's to complete our family...and then doing 3 cycles...I SEE THAT it still isn't in my hands at all...so I just let go and let God..and trust that what is put in front of me is something that I can deal with and there are lessons in the journey.
,
We can do all the research in the world, have long discussions with our Dr. with our spouses, talk to the embryologist...but in the end we really have no control in whether it will work, we will have a healthy singleton...or be given two or more....if you only want two...and your quality on your fresh cycle is excellent my advise is to just put in two...the chances of one spliting is very rare.

If you put in three like your DH wants to do and you had triplets...would it be the end of the world...do you think you could carry them, would you or could you reduce?...you haven't said anything about your health, your age, etc....or if it;s a big deal to cycle with your clinic distance wise...or even how many embies you are going to have to work with...these are all unknown factors.

Some times we cycle and only have a couple to transfer anyway so again it's out of our control isn't it.

These are all things that you will have to consider when you come down to the final strokes and you won't know ahead of time.

good luck making your decision and blessings for building your family, Hope
Hope thank you for such a detailed response. I guess my circumstances are similar to yours - have carried a pregnancy, make a good lining, no known issues there. We are doing DE due to my age - 44. I'm in good health, have carried a 10lb baby, recovered well after CSection. No blood pressure issues etc during pregnancy.

We are travelling halfway around the world to do DE (we are not in the USA), and DH is very adamant it's a once only thing - I don't believe he would waver on that. My way around it would be to ask the clinic to put in two good embies, and one that they didn't think would make the freeze. But you can never tell, can you? In your case, perfect embies, yet no pregnancy and you fell with twins (congrats on all your bubbas by the way) with what must have been lesser quality embies than they originally transferred (I'm assuming that they transferred the very best two first, even though you mention all were good quality). Not an easy decison. Then I read stories like Kacee wrote above where a lady ended up with a quin pregnancy!!!
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Joined: July 19th, 2006, 6:58 pm

February 17th, 2011, 11:44 am #10

Hi, I've just been reading the thread about # of embies to transfer and one of the posters said they had a mantra 'only put in what you want to come out' or words to that effect. It's really got me thinking.... We are gearing up for a DE cycle, and hubby is insisting we transfer three embies. He is having a grief reaction and I'm not sure he is being rational. He keeps thinking of how many embies we have transferred without success in our OE IVF's and running with that. His dearest wish is for us to have twins, and I would love that too, but the risk of having all three implant scares me.

I'm hoping that this thread might bring some facts and anecdotes to the table to help me discuss this with DH. Did anyone put 3 embies back on a 5 day transfer without any known implantation/uterine issues and what was the result? Are there any women here who have ended up conceiving higher order multiples (or know anyone who has)? Anyone know the stats about the chances of a triplet conception or successful outcomes of a triplet pregnancy? Are there online resources that hubby and I can look at together so it's more a rational decision than an emotive one?

Thanks in advance...
Hi anon,

I understand where your DH is coming from and the fear that it will not work.  But, this is YOUR body and your risk (along with any risk to any potential babies).  If you do not feel comfortable transferring three (and I would not) stand up for yourself and tell him that it is really out of the question.  Follow your gut on this one.  What I have found with my DH is that he might make a pronouncement on something...only to change his mind later when it didn't work out as we hoped.  For example, I did an FET over the summer and he was basically like, this should be our last try.  It didn't work.  We sat a few weeks and I brought up the idea of trying "one more time" and he all for it as if he had never said that the one over the summer should be the last try.  So, even if your DH claims this is your one and only shot he may come around to the idea of one more try.  I wish you all the best. 

Pandora
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