Here we go - # to transfer, clinic says 2-3!

Here we go - # to transfer, clinic says 2-3!

Anon7
Anon7

June 16th, 2011, 2:30 am #1

Today I broached the subject of transferring 1 good embryo and the nurse was aghast. She asked my age (43) and said honey your uterus is not 25. You need to tranfser at LEAST 2 - she said Doc will be advising me of that. And that maybe I should even consider transferring 3 depending on how things go. I'm stressed out!

She said they don't see that many twins. BUT, I just checked the SART data, and for pg's under 35 at their clinic the % of twin live births was 40%!! Does it make a difference that my uterus is older and my hormones are different, even though they are manipulating them?

I'll know more tomorrow and even more Friday. Donor went in today, but I had a late appt. and they'll call me tomorrow w/my results (although u/s showed great triple whatever lining at "8") and will find out how she's progressing. They think retrievel will be Sunday.....

So, input? I know we have this conversation all the time, but if anyone doesn't mind having it again *and I'm sure it won't be the last time * I'd appreciate input.
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Anonymous
Anonymous

June 16th, 2011, 3:23 am #2

(toward the end it specifies to use the age of the donor to be used, and most donors are younger than 35)

http://www.asrm.org/uploadedFiles/ASRM_ ... of_embryos(1).pdf


These are guidelines only, can be changed of course if there are special circumstances (like failed DE cycles, crappy embryos, etc). Since this is your very first IVF and your very first DE cycle, the guidelines are pretty clear to transfer one or two max. If your clinic claims to be a member of ASRM, then your nurse is out of line IMHO according to this.
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Anonymous
Anonymous

June 16th, 2011, 3:29 am #3

If you want to try googling "ASRM number of embryos to transfer" and the paper should come up for you, it goes into detail how they came up with the # to tx depending on circumstances
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Joined: January 31st, 2011, 3:38 am

June 16th, 2011, 9:51 am #4

(toward the end it specifies to use the age of the donor to be used, and most donors are younger than 35)

http://www.asrm.org/uploadedFiles/ASRM_ ... of_embryos(1).pdf


These are guidelines only, can be changed of course if there are special circumstances (like failed DE cycles, crappy embryos, etc). Since this is your very first IVF and your very first DE cycle, the guidelines are pretty clear to transfer one or two max. If your clinic claims to be a member of ASRM, then your nurse is out of line IMHO according to this.
http://www.asrm.org/uploadedFiles/ASRM_ ... 281%29.pdf

Hi Anon 7. I struggled with this issue a few weeks. I posted the same question on this board as well as the pink board. Many ladies with twins responded. The ladies on both boards were enormously helpful. Those threads were started on May 27th, if you'd like to read them. I took a look at the guidelines, and they say that the age of the donor should govern the decision behind how many embryos to transfer. Not the age of your uterus.

As far as 43 year old uteri go, mine will be 43 on Sunday (funny, I initially typed 23 instead of 43...ha. THAT's a typo!)

DH and I were committed to a SET (single embryo transfer) from the start, but a GF (natural conceptions in her 30s, mother of two singletons) suggested we consider transfering more than one. Twins are cute, they play together, the entertain each other, we'd be done, they aren't THAT much more work, it gets easier after they turn 3 and most women have healthy twin pregnancies, etc. Many (not all) of the ladies who were blessed with twins really pressed me to reconsider those assumptions. I was so persuaded by my GF's arguments that I even floated the idea of transfering three and GOING for twins. RE said, um...no.

Ultimately, DH and I know we don't have the bandwidth to manage twins. We'd go from raising a child to managing a whole project. I'm a lawyer and project manager by trade and it seemed I'd be doing more project management at home than I already do! But the other major factor for us, well, for me, anyway, because it took a while for DH to really get the health risks involved, is that yes, my uterus is going on 43 - and twins are risky at any age, and even moreso at 43.

One of the many things I'm looking forward to (if I ever get out on the happy side of 2WWHell) is the statistical probability of a healthy pregnancy. One that I'm not absolutely terrified by (with good reason) every single step of the way. (Been there and done that three times over now, and miscarried each time.) I'm lookng forward to what will, in some respects, be a 28-year old pregnancy. I don't know that my body can handle carrying twins. I want a natural birth, if at all possible, I want to avoid a C-Section, if at all possible, I want to avoid pre-eclampsi, if at all possible, I want to avoind gestational diabetes, if at all possible, I want to go to term, if at all possible, and basically, I want to avoid complications - again, if at all possible.

Granted, I am losing my mind during this 2WW (and driving the very patient ladies on this board nuts in the process, I'm sure). And the people at CVS must think I'm starting a pregnancy test specialty store. But I don't, for a second, regret having transfered only one. We were lucky enough to be guided well by our RE in selecting a great donor, and we have 4 genetically tested embies on ice should this month's attempt not work. He uses vitrification to freeze (ie, quick freeze), so we shouldn't lose any in the thaw, should we have to go down that road next month.

Others feel differently, naturtally. And different things work for different people. But for us - I don't know that my body can handle carrying twins and I don't want to come out on the wrong side of that gamble, because the consequences could last a lifetime.

I hope this helps. Feel free to email me at elsee_g@yahoo.com. I know how difficult a decision this is.

Regardless - three seems like a nonstarter.

Last edited by elseeG on June 16th, 2011, 1:08 pm, edited 1 time in total.
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Piper
Piper

June 16th, 2011, 11:22 am #5

Today I broached the subject of transferring 1 good embryo and the nurse was aghast. She asked my age (43) and said honey your uterus is not 25. You need to tranfser at LEAST 2 - she said Doc will be advising me of that. And that maybe I should even consider transferring 3 depending on how things go. I'm stressed out!

She said they don't see that many twins. BUT, I just checked the SART data, and for pg's under 35 at their clinic the % of twin live births was 40%!! Does it make a difference that my uterus is older and my hormones are different, even though they are manipulating them?

I'll know more tomorrow and even more Friday. Donor went in today, but I had a late appt. and they'll call me tomorrow w/my results (although u/s showed great triple whatever lining at "8") and will find out how she's progressing. They think retrievel will be Sunday.....

So, input? I know we have this conversation all the time, but if anyone doesn't mind having it again *and I'm sure it won't be the last time * I'd appreciate input.
In fact, because you are older than 35 (and especially older than 40) makes an even more compelling reason to make every attempt possible to ensure that you will have a healthy full-term pregnancy- and the best way to do that is to have one baby.

An older uterus will not prevent an embryo from implanting if it is going to do so, but as you get older you are more likely to have pregnancy complications: pre-eclampsia and gestational diabetes. A twin pregnancy increases these risks and using donor eggs increases the risk for pre-eclampsia.

It sounds as if your nurse does not keep up with current research--and virtually no clinic transfers three embryos in a donor cycle these days without a very compelling reason.

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H40+
H40+

June 16th, 2011, 12:43 pm #6

Today I broached the subject of transferring 1 good embryo and the nurse was aghast. She asked my age (43) and said honey your uterus is not 25. You need to tranfser at LEAST 2 - she said Doc will be advising me of that. And that maybe I should even consider transferring 3 depending on how things go. I'm stressed out!

She said they don't see that many twins. BUT, I just checked the SART data, and for pg's under 35 at their clinic the % of twin live births was 40%!! Does it make a difference that my uterus is older and my hormones are different, even though they are manipulating them?

I'll know more tomorrow and even more Friday. Donor went in today, but I had a late appt. and they'll call me tomorrow w/my results (although u/s showed great triple whatever lining at "8") and will find out how she's progressing. They think retrievel will be Sunday.....

So, input? I know we have this conversation all the time, but if anyone doesn't mind having it again *and I'm sure it won't be the last time * I'd appreciate input.
They won't transfer 3
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Joined: November 20th, 2006, 6:03 pm

June 16th, 2011, 1:30 pm #7

Today I broached the subject of transferring 1 good embryo and the nurse was aghast. She asked my age (43) and said honey your uterus is not 25. You need to tranfser at LEAST 2 - she said Doc will be advising me of that. And that maybe I should even consider transferring 3 depending on how things go. I'm stressed out!

She said they don't see that many twins. BUT, I just checked the SART data, and for pg's under 35 at their clinic the % of twin live births was 40%!! Does it make a difference that my uterus is older and my hormones are different, even though they are manipulating them?

I'll know more tomorrow and even more Friday. Donor went in today, but I had a late appt. and they'll call me tomorrow w/my results (although u/s showed great triple whatever lining at "8") and will find out how she's progressing. They think retrievel will be Sunday.....

So, input? I know we have this conversation all the time, but if anyone doesn't mind having it again *and I'm sure it won't be the last time * I'd appreciate input.
She is not getting that input from the RE, I can assure you. As long as your clinic has decent stats, the decision they will likely have you make (especially if it's a day 5 transfer) is 1 or 2 - 3 will not be part of the discussion unless you've had prior failed cycles (plural) or other mitigating factors. Take a deep breath, she does NOT know what she's talking about! Be sure to mention her comments to the RE and let him/her reassure you next visit (and so he/she will have the nurse not opine to other patients). Piper is right on. The age of the uterus wont' affect pg rate, but it (along with DE aspect - higher risk of pre-e) may affect your ability to carry a healthy pg. Best,
Kenny
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BlessedThistle
BlessedThistle

June 16th, 2011, 2:42 pm #8

were that they were 13.4 years old, had been thawed and refrozen, and had not been chosen for three prior cycles. I did not expect twins even, but that is what I got. Despite my best efforts, they were born at barely 26 weeks and had 4 month NICU stays. It is an absolute miracle they are with me now and relatively healthy. Having been through watching my children suffer greatly, I would sure urge you not to consider a choice that is going to greatly up the odds you will have a similar experience - there's nothing quite like wondering if you will ever finally get to hold your child, watching your 1 lb 9 oz baby recovering from heart surgery, seeing your children struggling to learn to breathe months before they are ready to, or to watch them getting unsuccessfully poked repeatedly for yet another blood transfusion. Or that you find yourself in the unenviable position of considering selective reduction. Most twin mamas over on pink did make it well past 30 weeks but yuo are risking a lot courting a triplet pregnancy.
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Joined: December 2nd, 2005, 3:49 pm

June 16th, 2011, 3:33 pm #9

Today I broached the subject of transferring 1 good embryo and the nurse was aghast. She asked my age (43) and said honey your uterus is not 25. You need to tranfser at LEAST 2 - she said Doc will be advising me of that. And that maybe I should even consider transferring 3 depending on how things go. I'm stressed out!

She said they don't see that many twins. BUT, I just checked the SART data, and for pg's under 35 at their clinic the % of twin live births was 40%!! Does it make a difference that my uterus is older and my hormones are different, even though they are manipulating them?

I'll know more tomorrow and even more Friday. Donor went in today, but I had a late appt. and they'll call me tomorrow w/my results (although u/s showed great triple whatever lining at "8") and will find out how she's progressing. They think retrievel will be Sunday.....

So, input? I know we have this conversation all the time, but if anyone doesn't mind having it again *and I'm sure it won't be the last time * I'd appreciate input.
The twin rate for DE cycles is generally higher (sometimes quite a bit) than cycles using OE. Not sure if the "under 35" 40% is with DE or OE. Anyway...I was 43 when I cycled. Fresh cycle failed (1 embie) but we transferred two frosties the next time and those embryos are now 20 months old. Your age has nothing to do with it, and if there's an issue with a uterus, that will be an issue for any pregnancy (in other words, more is not better!).
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Joined: May 10th, 2011, 11:57 pm

June 16th, 2011, 4:38 pm #10

Today I broached the subject of transferring 1 good embryo and the nurse was aghast. She asked my age (43) and said honey your uterus is not 25. You need to tranfser at LEAST 2 - she said Doc will be advising me of that. And that maybe I should even consider transferring 3 depending on how things go. I'm stressed out!

She said they don't see that many twins. BUT, I just checked the SART data, and for pg's under 35 at their clinic the % of twin live births was 40%!! Does it make a difference that my uterus is older and my hormones are different, even though they are manipulating them?

I'll know more tomorrow and even more Friday. Donor went in today, but I had a late appt. and they'll call me tomorrow w/my results (although u/s showed great triple whatever lining at "8") and will find out how she's progressing. They think retrievel will be Sunday.....

So, input? I know we have this conversation all the time, but if anyone doesn't mind having it again *and I'm sure it won't be the last time * I'd appreciate input.
You've already gotten a lot of good advice here, but I was surprised to hear what your nurse said. I'm also 43, and my RE strongly recommended transferring only one embie unless there was a concern about the quality. We used frozen DE (not fresh) and transferred a single day 5 blast, grade A. I'm now 8 weeks.

Ultimately, it's your decision. Good luck!
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