Thursday, May 1, 2014

How many should we transfer?

I hate even thinking about this. It just feels like setting ourselves up for disappointment. At this point, we don't even know if we'll have more than one embryo to transfer. We don't even know if we'll have one! We don't even know if we want to do a transfer (though we're still leaning towards 'yes'). Still, after we show up at the clinic tomorrow morning there won't be a whole lot of time to make the big decisions. We feel like we need to have our plan of action ready for every scenario.

The American Society of Reproductive Medicine recommends that women under 35 with a favorable prognosis transfer only one blastocyst. That's what we did for our first cycle.


Now we don't fall into the favorable category. We're unfavorable. I'm still well under 35, but we have one failed IVF cycle under our belts and while we're hoping for a different outcome this time, we're not counting on having great quality embryos with plenty to freeze. Because we're unfavorable the recommendation is to transfer two blastocysts.

My biggest concern is the higher risks of complications (both the mother and babies). The other thing we have to consider is that if I were to get pregnant with more than one baby, I would be at an even higher risk of developing late onset OHSS. That is Dr. M's concern, though ultimately the decision is up to us.

I feel like George Michael at his eye exam.


I've never been good at making decisions. Usually Seth is much better, but I think he's afraid to make the call when a lot the burden of the decision could fall on me, depending on what happens.

Hopefully this is one of those situations where you just know/feel what the "right" thing to do is when the time to decide arrives.

4 comments:

  1. I have no advice, but wanted to say I have been thinking about you lots and hoping so much that this is it for you! I hope you find a decision you are both comfortable with. Sending you lots of love and ((hugs)) and positive vibes. <3 <3

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  2. I also wish I had some helpful advice to make this decision easier. I can tell you my story though in case it is helpful (warning: long):

    I feel I had a bit of an easier time deciding on 1 vs. 2 because I have chronic lower back pain and I wasn't sure my body could physically handle twins (plus, there's always the slight chance you could still end up with twins even with a SET). When we went into the hospital for a 3DT, the embryologist showed us the TWO embies they recommended for transfer and I told them we were only going to transfer one. That changed everything and they said that since I only wanted to transfer 1, it would be a better plan to come back for 5DT as there should be 1 blast that might "pull ahead of the rest and have a better chance of implantation". That was indeed the case, and it worked for us. My moderate OHSS did NOT get worse with the increased hCG. I only made it up to 20 weeks but I already had worsening back pain just from carrying Petey which "proved" to me that we ended up making a good decision for us, but who's to say how I would have felt if the IVF didn't work? Just another quick note that when I told the doc we had decided on only transferring one he seemed to approve and told us that was the "prudent choice". Again though, it is different for everyone though (and prob really depends on how good the blasts look on day 5). If I were you, I'd go in there with a slight preference but ask the embryologist(s) frankly for their suggestion and see what they have to say. I'm sorry this is so hard.

    Finally (then I'll shut up), I remember sometime in the last year on IDOB someone started a poll asking everyone if they transferred one or two and the majority seemed to go with two.

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    Replies
    1. Haha don't worry about saying too much Chickin! I really value your opinion. In fact, I went and re-read your blog after we talked yesterday :)

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  3. Ugh, I hate making IF decisions, I don't envy you here. I like Chickin's recommendation, have a slight preference and then ask their expert opinion. I know our cases aren't the same, but FWIW at my consult today my doc was clearly on team transfer two for us, and I think I remember the post Chickin mentioned and also thought more people said they transferred two. I'm sorry you're stuck with this difficult decision but I hope you and Seth can come to some agreement on what you think is best and feel good about. Thinking about you and sending lots of good vibes to your embies!!! <3

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