Double Trouble: options for elective single embryo transfer

Double trouble can only mean one thing – twins!  A couple of weeks ago our friend recently gave birth to two handsome little boys – fraternal twins.  I visited them after they were just a few days old, and as I held one of the boys I tried to imagine how it was possible to fit two of these little babies in anyone’s tummy!  I know they are curled up pretty tight in there, but seriously – it must be magic!  I am so amazed at how my friend carried these two boys to full term and not break her back!  I am also super impressed that she avoided a c-section, despite one of her boys being breach – what a super mum (mom).  And I am under no false impressions that it was easy!  So all this got me thinking about our first IVF cycle and the number of Embryos we will transfer…and our chances of twins.

Now…Chris and I have already discussed and agreed that we are OK with multiples…we had to make that decision when we had our IUIs, in fact for one of my IUIs I had three follicles, so there was always a chance for triplets! Yikes Treble Trouble.  But being OK with multiples is not the same as actively desiring multiples.  For IUI, it was kind of out of our hands how any eggs would fertilise and implant, it was still very natural.  But for IVF, we kind of have a choice.  Our clinic typically transfers 2 embryos for women <35 and first round of IVF, but of course, we can choose to just transfer 1.

I read somewhere that 29% of IVF patients said that twins were a desirable outcome.  Why?  Well it’s kind of like BOGOF (buy one get one free).  IVF treatment doesn’t come cheap, both financially and emotionally, so I can understand this logic.  But for me this is all about probability and gambling….not with money, but with needles and drugs.  Sure it costs $$$$s but fortunately we have it covered by insurance. It’s the emotional and physical cost that I am particularly nervous about.  I have no clue what it will be like, so I feel like for our first IVF round we can’t make a firm decision just yet how many embryos we will transfer. I want to wait and see what all these hormones are like first and what our doctor’s prognosis will be when the time comes.twins

However, that doesn’t stop me looking into it now.  Whilst I was surfing the web for more info on this subject I discovered an article that my RE had commented on regarding the a study that had shown single embryo beat double embryo transfer.  Her point of view on the study was very vanilla and cautious! Random. I also found that the CDC provide a good little list of things to consider for elective Single Embryo Transfer.

So for now this topic lays to rest until we get a bit closer to transfer day.  But until then, I’ll keep educating myself on what it might be like to be a mother of twins as well as help out our friend however we can with their teeny bundles of joy 🙂  So it’s not just double trouble – it’s also double the adorable 🙂

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3 thoughts on “Double Trouble: options for elective single embryo transfer

  1. ashleykyleanderson says:

    This is long, but I thought it might help to hear how someone else approached this decision.

    Our clinic (or at least our doctor) generally transfers one embryo for younger patients and we were told that the percentage of success with two wasn’t much greater than with one. They also feel that it is important to minimize the risk to the baby (ie avoiding preterm delivery) whenever possible, and therefore like to avoid multiples. However, my husband is a fraternal twin who was born premature by several weeks and he has no obvious health concerns (though he and his brother were both around 3 pounds at birth and spent a very long time in the hospital, which was hard on my in-laws), so I know that having multiples (even premies) does not always result in problems.

    Based on the very strong recommendation from the doctor to only transfer one, that is what we did (although I am only 27 so still on the young side for IVF). We were matched with our carrier so quickly partly because she also only wanted to only do a single embryo transfer when most couples chose to do two. One of the biggest questions we had for her when we first met was whether or not she would chose to “selectively reduce” a baby if the embryo had split (she said she would not thankfully, as that would have been a dealbreaker for us since we would be completely against it).

    There are other reasons beside my younger age for this decision, however. Our carrier is small at only 5’1″ and was worried about carrying two (understandably). Also, I have health problems and live with significant chronic fatigue and so it would be much easier for me to care for one child than two. Not to mention, I heard enough stories of my husband and his brother as children to scare me away from twins! 😉

    But, after everything we went through to get to this pregnancy and the likelihood that it will be our only pregnancy, I started to wish that we were able to transfer two, especially after the first failure. At that point it was not an option, but to me it felt like it could be the only chance of us having more than one child (and I have never wanted to just have one). Also, like you said, the cost of everything made it seem like a good way to save money if we were going to go back for a second in the future. Prior to our positive, we had even started talking about working with a gestational carrier who would be willing to do a two-embryo transfer if we were unable to continue with Elle.

    Now, I am about 90% glad we did a single embryo transfer. It is much easier in terms of caring for the baby once he/she is born and much less risky for the pregnancy. But, there is a small part of me that greedily wishes we had that other little baby growing in there!

    It is a tough decision in the IVF process. One of many. I always find it easier to mull over decisions like this for a little while and eventually find myself leaning a certain way. Whatever you chose though, I don’t think there is really a way to make the WRONG choice as long as you are okay with the possibility of twins (assuming you choose to transfer two). You will love those children and be grateful for the blessings no matter what. And if you have a singleton, you will love that child and be grateful for the blessing no matter what.

    Perhaps you might be able to wait and see what quality your embryos are prior to transferring? I don’t know if you would be able to make that choice the day before/ day of transfer, but if you have higher grade embryos you might be able to get away with just one and if you have lower grade it might be worth doing two. That’s probably how I would approach it if we were making this decision with what I know now and if we had the option. Just make sure you have a plan for if you get middle-grade embryos too! 🙂

    Liked by 1 person

  2. thegreatpuddingclubhunt says:

    Thank you for sharing your thought process, I really appreciate it. It’s also really interesting to hear what your hubby has reflected upon you regarding his twin life has been off-putting!! It’s a very good perspective to understand – what it’s like growing up as one of two :-s

    You have also made a good point, something I want to ask when I go in for my first day appointment is when we need to make that decision of how many we transfer, how much choice we will have – I have no clue how it happens. I hadn’t even really thought about the grade of embryos factor. I fear a little bit that maybe if we agree in advance it will be set in stone. Sometimes I’m quite impulsive and Chris finds it hard to figure out where my logic comes from, and could end in tears! Something I think we are going to have to really talk about more this weekend 🙂

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