Single or double embryo transfer?

[Chocolatemolehill]

Hello ladies,

I'm having ET on Tuesday and can't decide whether to have one or two day 5 embryos (blastocysts) put back in.

To give you a bit of background: it's my second fresh IMSI cycle. Previously I had one fresh 3-day embryo transfer followed by 3 FET. All single and all unsuccesful. Before that I had 4 unsuccessful IUIs and two early (week 6) miscarriages. I'm 34.5 years old.

After 3.5 years of trying I'm pretty desperate to gert pregnant and would like to maximise my chances. At the same time I'm really worried about possible health complications with twins. I know most of them are fine but some are not and there are a lot of possible complications.

What shall I do? What are your views on single vs. double transfers?

[StitchingMoss]

I had 3 cycles of IVF and wanted to go for double every time - I m/c twins on my 1st cycle and a singleton on my 2nd. Our 3rd cycle we sadly only produced a single embryo so had no choice but to go for SET - our single embryo is now 5 yrs old .

With your history I'd go for double but I understand your concerns.

[Viviennemary]

I don't have any experience of this but saw your post. I don't know all the details but I'd go for two if you feel you could cope with twins. Hope everything goes well.

[EllaMenOhPea]

I was in a v similar situation to you 3 years ago - multiple failed IUI's, m/c. One big difference, it was our first IVF round.

I ended up with 5 x5 day blastocysts. We agonised over whether we would have 1 or 2 transferred. In the end we went for 1. My rationale was heavily based on the fact that if I had had twins (or triplets or quads, which can happen) & something happened to those babies, I would have found it very difficult to reconcile that I had contributed to that by choosing 2. I thought I could live with a failed cycle more than that - so basically thought about the worse case scenario of each potential outcome & went with what I thought I could live with. BUT I knew I had another NHS cycle in the bag, and had my first cycle failed, I may have chosen differently the second time. As it was, my one blastocyst stuck, & I now have a wonderful 2 & a half year old.

I also spoke to the embryologist before transfer, and he was quite positive about the quality of our embryo, that there was a good chance it would be successful, so it would be worth doing this before you make your final choice.

Good luck with whatever you choose.

[HoopHopes]

NHS usually recommend 1 transfer and freeze the rest due to complications of multiple births. If you can freeze the remaining embies then you can use them later if needed.

Have you had any tests to see why not implanting? I had immune tests after failed ICSI which showed that however many embies out back they would have failed as I had raised NK cells, blood clotting issues etc.

[Chocolatemolehill]

Thank you all for your advice and sharing your stories!

EllaMenOhPea - I've had very similar thoughts. What if something goes wrong and I know is's partly because of my decision? On the other hand - we had good quality embryos in the past (3-day) and none of them stuck... Tough.

HoopHopes - it's not clear why its all not working. I've had some tests (all came back ok) but not super comprehensive. Everything seems to be ok (unexplained infertility). However, for each cycle/transfer I'm getting a lot of medication that's used when there are immunological problems (steroids and blood thinning injections), just in case. What tests did you have?

We still haven't made the final decision (my husband prefers single transfer) - it will probably happen tomorrow, after we've spoken to the embryologist.

[FreckledLeopard]

I haven't had IVF, but my best friend did. She opted to put back two embryos, both stuck and she now has 18 month old twins.

I would advocate taking a Sod's Law approach - if you put back two, knowing it would be more work, more risk etc, then Sod's Law, both will stick. My friend did a similar thing just before the embryo transfer - bought a car with a totally impractical boot, knowing it would be just her luck to need a double buggy. Lo and behold, she got pregnant and had to sell her beloved car!

Good luck!

[HoopHopes]

I had all the level 1 and level 2 immune tests. Have to do most of them privately and all of level 2.

[ringo65]

From my understanding a good quality blastocyst is less likely to give multiple pregnancy and more likely to be successful.
I had mt ET on Friday all along we had discussed a single blastocyst transfer, but when it came to it we had to transfer on day 2 at the recommendation of the embryologist we had 2 transferred that were grade 2 with 4 split and a 6 split, because how they were behaving they did not think they would make it to blastocyst. So I know we now run a higher risk of multiple if they implant at all.

Not sure this is any help.

[EllaMenOhPea]

Good luck tomorrow Chocolatemolehill.

[Mothersruin75]

I am currently feeding one of my 10 week old twins...

For our first icsi attempt we had SET, that failed & our subsequent FET never happened as all our embryos failed to thaw - from that point we weren't happy to have an SET.

My successful transfer was a Day 3 & Day 5 (I was at ARGC for my final attempt). Day 3 was a perfect embryo but by Day 5 all remaining were looking hopeless and they just put the best looking out of a sorry bunch back not expecting it to work - my twins are def non ID.

My pregnancy was very straight forward, I felt fine. I went on holiday at 33weeks & worked to 35 weeks. They were delivered by elective c section at 37 weeks. There are more chances of complications with a twin pregnancy & delivery but I made sure I knew what they were as much as I could.

What they don't tell you is how amazing having twins is! It's fantastic seeing the two of them together and knowing they have that special link. It is hard work but I don't find it double that of a singleton, (I have an older DC).

I would be guided by your embryologist as to how many to transfer as well as your gut instinct. I knew I'd be delighted if it was twins which helped our decision.

Like Hoophoops for this final cycle (3rd attempt) we had the full range of immunes tested, I was treated for my raised TNF levels before I cycled & my raised NK during.

On phone and it's hard to write but hope this makes sense.

Best of luck with the cycle whatever number you choose to transfer

[ringo65]

Hello Mothersruin75

Hope you do not mind me piggybacking on this message but I wanted to ask if your holiday at 33 weeks involved flying? I had my ET on Friday and we have a holiday booked in April, I don't want to get ahead of myself but felt I needed to ask the question.
Thank you so much x

[Mothersruin75]

Hi ringo, hope this cycle has worked for you.

It was Eurostar at 33weeks however flew to Tenerife at 25 weeks & back at 27 weeks. I drank lots of water and kept walking about and it was fine, feet slightly swollen on arrival but nothing that a few hours on a sunbed couldn't fix. I didn't need a doctors note at that point but I got one just in case as I was massive!

[ringo65]

Thank you so much Mothersruin.
I take my BFT on 13th Oct, fingers crossed, they transferred 2 x 2day embryos. Don't want to get ahead of myself with it all but I have been worried that if its successful would I be okay flying if it ends up being twins, I will be within the guidelines British Airways suggest, we already postponed the trip as was due to go the 26th of this month, but did not want to risk it so early on if all was successful.
Thank you for the tips about water and walking about x

[Mothersruin75]

I've got my fingers crossed for you ringo & for chocolate molehill too.

[Chocolatemolehill]

Thank you!
We went for single in the end. Good luck to everybody else!

[Chocolatemolehill]

Just to add - we still have 8 blastocysts on ice so hopefully one o this lot will soon become our baby!

[ElizabethCameron]

Hi,
I am at Lister. I am using DS, eggs taken this a.m., I think 8 but the embryologist is calling my tomorrow to see what can be used. Am 43 so not getting too excited. My main question was how many to put back if I have a choice so this thread helps. I will choose 2 if I get the chance. Thanks women!

[nutty123]

I had two transferred on day 3 and got my bfp today!!