A slightly odd IVF twins question

[Chocolatemolehill]

Hello ladies,
I'm just going through IVF and will have embryo transfer on Tuesday. I can't decide whether to have a single or double embryo put back in and thought I'll ask the experts - other mothers of twins - for advice :-)

To cut a long story short - I'm 34.5 years old and have a history of unsuccessful fertility treatment and miscarriages. I want a baby more than anything else in the world and having two embryos put back in would maximise my chances of getting pregnant. But I'm worried about possibility of having twins. Not so much that I won't be able to look after them (I used to work with twin babies as a nanny). I'm worried about possible pregnancy complications, miscarriage (I've already had two), health risks to the babies...

I've heard a lot of success twin stories but also a few difficult ones. How big are the risks? How difficult twin pregnancies are compared with singleton pregnancies? How about early childcare? Are my worries exaggerated? Is there anything else I should be thinking about?

What shall I do?

Sorry it's all a bit chaotic - I'm getting lost in all this. (And being high on fertility drugs doesn't help!) I'd appreciate any advice or information you could give me.

[chesticles]

Obviously every twin pregnancy is different, but I know three sets of twins in real life and all were straightforward trouble free pregnancies.
Good luck for Tuesday, whatever you decide

[ceeveebee]

I had IVF twins on our 2nd cycle. We only had one transferred in on 1st cycle and it didn't take. We were very lucky second time round.

I had a pretty much trouble-free pregnancy, although twin 2 (now my dd!) was very small as age stopped growing at 32 weeks so we were a few weeks early. Had a planned c section as twin 1 (now my DS!) breech. Much higher chance of a c section with twins. Also a lot of twins come early (some of my twin mum friends up to 3 months early - but none of them are affected long term)

Early days were difficult, dd spent 1 week in special care, was hard being separated. We had help from DM and MIL who took it in turns to stay for the first few weeks. We were blessed with good sleepers though and got full nights sleep after 12 weeks (now 22 mo and have to wake them at 8 most mornings!)

I won't lie, it was tough at first, and can be restricting in what you can do (eg going swimming etc) and feeding was a major challenge, but I would absolutely not change it for the world. They are best friends, they play with each other and are a delight.

My singleton friends are all now with (or already had) number 2 and I am so glad we had twins as I could not think about going through IVF again - even if we could afford it.

So if I was you I would go for two. But it's totally your decision.

[beachesandbuckets]

Hello Chocolate, good luck for Tuesday. My twin pregnancy was very straightforward and had no intervention (I was always expecting 'more' from my consultant appointments but there were no problems to discuss!), my birth likewise, and have managed ok with feeding. My dh works long hours so am doing all the childcare (he has changed 1 nappy in 8 wks!!) as well as with older dcs and am coping. This is not to sound smug (as fully recognise that each is down to the luck of the draw) but to reassure you that its possible and, gasp, enjoyable at times. When I was pregnant, everyone told me that twins would be really tough, awful, I would have no life etc etc. It is of course tough, especially the early days, but that is the case with any newborn (single or multiple) but not as awful as everyone had me imagine. I guess what I am trying to say is that I went into this expecting the very worse of experiences and have been pleasantly surprised so far, albeit lacking sleep!

[HighVoltage]

Our first pregnancy was IVF one embryo transferred - DS1 now 3. And our last pregnancy also IVF also but twins - two embryos transferred - as I was 40 this time, DS2 and DD now 3 months.

In my view as long as you stay healthy - eat well, mild exercise like yoga or Pilates, some walking, then the pregnancy is not that much more difficult than a singleton but is hard when you're 9 months big for about 3 months at the end (although not knowing any different I reckon it will be ok). It's uncomfortable for longer basically.

Birth wise you won't be able to have a birth centre/home birth with twins which we did for DS1 - twin birth was natural and pretty straightforward but it was helped by the fact I'd given birth before. It was in theatre in stirrups though and was given an epidural so all very different from the drug free water birth first time round.

Feeding is hard to establish with one for some of us and so can be very hard with two but with the right support can be fine (I am mixed feeding now with a bottle at night). Early days are an absolute blur of feeds, sore boobs, midwives weighing them ... But is over and it's a great feeling having two feeding at once when it's going well.

I chose to transfer one in the first place because the odds of us getting pregnant were pretty good (not that improved with a second embryo when I was 36) and I knew we had money for another cycle. This last time I was that much older the clinic advised us to transfer two as the stats drastically improved.

Very best of luck whatever you decide to do.

[Bombjack]

Hmm the dreaded decision of 1 or 2 embryos... It's a tricky one, with no "right" answer really.

We had IVF 4 years ago, and as we were 35 at the time, decided to go for 2 embryos to be transferred.

A few weeks later, we had 2 beans on board - identical twins according to the sonographer. Turns out they were ID, and were born by c-section at 35.2 weeks. They spent 4 days in SCBU, just to receive a bit of help, nothing serious.

As far as the twin pregnancy went, it was very straightforward. No complications, very minor morning sickness was all. Waters went at 35.2, otherwise I think they would have held on to full term.

It was hard at first, I won't lie. The twins were not good sleepers, and suffered badly from reflux. We decided to use savings and take on a nanny for a few months to give us a break. We used a night-nanny occasionally too, to give us both a decent nights sleep.

Now, they are two boistrous 3 year olds, who play together (and fight together) a lot . They are completely different personalities, with one being right-handed, and the other left. So, looks like there's some mirroring going on there.

We've just had DS3, who was a singleton. That pregnancy was much, much harder on my wife than the twin one. No major complications as such, but crippling morning sickness, and tiredness.

For what it's worth, in your situation, I'd advise putting 2 embryos back. Bear in mind though, that the odds of identical twins increases by virtue of undergoing IVF. In our case, if the second embryo had stuck, we'd be looking at triplets!

[Twicethehugs]

Definitely a difficult decision especially with all those hormones as you say. I was 38 but it was the first IVF attempt and had good quality embryos so had one embryo transferred and now have identical twins. A bit of a surprise at the time! For me the pregnancy was fine but I worried quite a lot, partly my nature and partly lots of extra scans & hospital appts and that in the IVF process they tell you a lt about the risks of twins as are trying to reduce the number of multiple pregnancies. There are definitely more risks with twin than single pregnancies e.g. More are born early but lots go smoothly TAMBA will have more statistics and info if you want this look at their website. I didn't get as big as I'd thought I would at the end and no swollen feet but horrible reflux and was knackered and doing very little towards the end. I did yoga and swimming throughout the pregnancy which personally I felt helped me. Mine were born just before 38 weeks, induced then emergency CSection, 5 days in SCBU as a bit little, low blood sugar and jaundice but nothing too bad. I guess twins are a more intense parenting experience but I feel vey lucky to have them and after the crazy first few months I think we've managed ok most of the time.

[Franchini]

Hi
I thought I would let you know what happened to us.
We have had four rounds of ICSI. On all four goes we had two embryos put back in. The first two tries were unsucessful and on the third we became pregnant with my beautiful DD (now two).
Our last attempt was in July just gone and we again had two embies put back in. I am now pregnant with identical twins (so only one of those two actually worked!).
You have to go with what you think is best, but remember that if you do have a twin pregnancy you will be closely monitored all the way through.
Myself and my husband both thought that we should maximise our chances of becoming pregnant (especially considering the price of the ICSI!) each time and have two put in.

I did consider freezing one of the embies that we had put back in last time as they were both freezable quality but our embryologist persuaded us that we would have the best chance of a sucess by putting two back in and it may not survive the thawing process if we did freeze it. I just could not stand the thought of our little embryo failing so we had them both put in.

I just want to wish you the best luck in the world and hope everything turns out well for you.

[Chocolatemolehill]

Thank you all so much for your advice and sharing your stories - its really helpful! I'm a bit less worried about twins now, although still haven't made the final decision. My husband prefers s single transfer.
I'll probably just speak with the embryologist tomorrow and try to make the best decision based on his recommendation.
Congratulations on your little ones - those already here and those still to be born. Enjoy it all and good luck!

[KnackeredCow]

I had a DET on our third fresh IVF cycle and now have b/g twins.

To put things in perspective, 60% of twin pregnancies deliver pre- term (ie before 37 weeks). But only 10% of twin pregnancies deliver very pre-term (before 32 weeks). And from the other twin mums I know, I've not yet met one who delivered before 32 weeks.

I was delivered by EMCS at 34+6 due to severe pre- eclampsia. Pre- eclampsia is a risk with a twin pregnancy, about 16% I read, but it's a spectrum. You are monitored very closely for it, however.

When I had my DET they told me that there was a 70- 80% chance of me getting pregnant as we had two top quality blasts, and if I did, a 40% chance of twins. This, however, all depends on the quality of the embryos on the day of transfer.

My main worry when we had the DET was triplets as identical twinning is increased from roughly 3/1000 pregnancies to 1/100 with IVF.

I found my pregnancy tough, and the first twelve weeks a blur, but my babies started sleeping through then so I get far more sleep than my friends with singletons! It is hard, but certainly not impossible, and you have the experience of nannying twins.

I delivered by c-section as my pre-eclampsia was rapidly escalating and my blood pressure unstable so they need to get my DTs out. That said, my recovery from section was very quick. I was in more pain after my laparoscopy and adhesiolysis when our fertility problems were investigated! Tbh, if we go for another (we have two frosties, although next time I'll only have one put back) I'd probably elect for a c-section rather than a VBAC so it can't have been that bad.

We did have a lot of support from DM and DMiL once we were home from hospital (I was with my babies on a transitional care ward until they were 37 weeks). We went solo when the twins were almost eight weeks.

[MerryMarigold]

Wow, great story Beetle . Made my day!

I think quite often twins are conceived but only one makes it, even when it's not IVF. It happened to my SIL and I don't think it's uncommon, so there is no guarantee of 2 babies making it.

In terms of the pregnancy, I'm not sure it's more high risk if there are 2 embryos, separate sacs etc. (so wouldn't be TTT risks). Certain things like diabetes are higher risks.

I've had a singleton pregnancy and a twin pregnancy and yes, the twin pregnancy was a lot harder, particularly as I was trying to take care of a toddler. I was massive! However, having the twins is brilliant. The baby years were not ridiculously difficult. The impact on ds1 was huge, but you don't need to consider that.

Personally, I would go for 2! Exciting whether you end up with 1 baby or 2.

[MerryMarigold]

The birth (c-section) with twins was an awful lot better than a natural birth. Ds1 had a traumatic birth and is still affected aged 7 by the consequences on his brain development .

[MerryMarigold]

Sorry to post lots. I had a C-section at 37 weeks and they weighed in 6lb 5 and 5lb 13. Ds2 had to go in SCBU as he had an infection, either when he came out or he already had it.

[neversleepagain]

My cousin had 6 cycles of IVF and eventually went abroad to get treatment. She had 4 embryos put back (despite her doctor advising her not to). An early scan showed 4 sacs but at 8 weeks there were only 3 heartbeats. Her triplets are nearly 8 months old, 2 boys and a girl.

My twins were not IVF and a big shock at the 12 week scan. They are now one and I love having twins. My pregnancy was trouble free but physically demanding. My girls were born by EMCS at 34 weeks and spent 2 weeks in SCBU. I found the first 12 weeks very hard but as the months went by it got easier.

Good luck!

[rattling]

I was dead set on a single embryo transfer. My "research" (google), suggested there was more chance of losing both if you started to lose one. (Subsequently I've also heard equally unscientific ideas that 2 are better at implantation).

My textbook IVF was heading for blastocyst transfer, when at the last moment all the embryos started to die/look pretty poor, so I had the last 2 dodgy ones put back. They have resulted in very beautiful, healthy boys.

My pregnancy was fairly easy (endless nausea, nothing much else), but came to an abrupt end at 32 weeks as I got pre-eclampsia (common in twin pregnancy). The boys were well, just small, they spent 4 weeks in SCBU which was a weird thing. DT2 was difficult to feed till he was much bigger. Generally I didn't enjoy their baby years as much as I would have a single baby. Since about 3, however, I love having twins and they do entertain each other despite being opposite personalities.

I know a lot of twins - only one has on-going health issues and he was born very early (24 weeks). And his brother, born at the same time, is just fine.

[bunnymother]

I have my twins running around right now, so can't read entire thread. However, my twins are identical, so sharing the 1 placenta means the risks are higher (TTT is the key one), and since yours would be fraternal, I understand its a lower risk pregnancy. My cousin is currently pregnant w IVF fraternal twins, and it seems like a more straight forward one than mine re risks and constant scanning etc. However, I have also had a single baby, and a single pregnancy is much easier re fatigue, how big you get etc. But I wouldn't let that put you off.

I would say that the first 2 years w twins is pretty hard work, but you get used to it, then suddenly becomes easier than having just 1, as its a built in play date. mine are never lonely, and play quite nicely together.

[Chocolatemolehill]

Thanks so much, again, for sharing your stories. We went for single transfer in the end (a bit of a last minute decision which I'm now slightly regretting). If it doesn't work the next one will be double!

[ceeveebee]

Best of luck chocolate, fingers crossed for you xx

[Bodeccia]

Hi chocolate, we've done two rounds of ivf and both times we've had two put back. The first round resulted in our dd (17 months) and the second round has resulted in us expecting twins next year. Different cycles though: round 1 - both embryos weren't great quality and ET happened on day three. Round 2 - both embryos reaches blastocyst stage, we did ICSI, and at the quality wasn't good enough for freezing. I was also 2 years older. It was a bit of a dilemma but the bottom line for me was I would rather have two than none :)

Best of luck with it!
(Hi beetle)

[Thiscoukdbeme]

Good luck chocolate! We went for one after similar deliberation. He's currently curled up next to me on the sofa.
Take it really easy over the next couple of weeks.

[Franchini]

I just want to say all the best and please let us all know how it goes. Did you have 3 or 5 day transfer?
Like thiscouldbeme said - take it very easy and make sure you get lots of pampering of your other half.
All my fingers and toes are crossed for you x x x x

[Balaboosta]

I think you've done the right thing. Try not to feel regretful. I think it's sensible. Good luck good luck good luck!