Why do the NHS fertility clinics in UK insist on only ONE embryo transfer? Please can you tell me your experiences and share your opinions.
Considering the emotional roller coaster that comes with IVF process, it feels like a horrible gamble to me if only one embryo is transfered. I am really scared for myself, I don't know why, maybe because I have 2 friends who just had a failed IVF. I am in panic mode now, wondering if this one embryo transfer business makes any sense at all. It's like setting one up for a fail at the outset. I mean, they can always remove the unwanted extras later on, right. Has anyone managed to convince the clinic to transfer more than one embryo?
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Aramadani
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According to my clinic, if you have a good embryo, transferring two will not increase your chances all that much (it certainly doesn't double your chances, despite what it might seem), and it does increase risk because having twins is much more risky to both mother and babies. I haven't corroborated this in the scientific literature myself. However, many of the risks that were thought to be related to IVF (e.g. birth defects) were found to be mostly from having twins—that I have read in the literature.
Thank you for your kind response, I probably should read more about this too.
It all depends on a load of different circumstances like age, chances of success etc. There have been a number of studies that have shown if you transfer two very different quality embryos a worse quality one can prevent a better quality one implanting etc. Also obviously there is a the risk of multiple pregnancies and the risk associated with that.
However as you get older they tend to let you transfer more than one as they feel the risk of success is lower, and in my 40's I have been able to transfer up to 3.
I am a bit confused with your 'remove the unwanted ones later on' comment. Are you suggesting if you had a multiple pregnancy the clinic would terminate any additional embryos!?
My one piece of advice is don't worry about what anyone else is doing. You need to trust your clinic who will decide as you go along and react to how you react and what your embryo quality is etc. Just because your two friends failed their first round doesn't mean you will, equally IVF isn't a perfect fix and some people go multiple rounds with and without success. Good luck x
Honestly I'm not one to worry about what others are doing but these days I don't know who I am anymore. Some days I think to forget about IVF altogether and pursue treatment for my health but im being told that treatment options will end my fertility potential. My health is hanging in balance and the doctors kept telling me I either try to have a child through IVF or forget about having children and save my health. It's driving me crazy. I am bed ridden 2 weeks every month practically. The last period which was 2 weeks ago, the ambulance had to take me to A&E which led to yet another emergency blood transfusions. They said I was a lucky woman, that any moment longer, my body would have started shutting down as I lost way too much blood. I have been feeling a different level of anxiety since then and in a serious panic as I dread the next period. Please forgive me if I came across as insensitive, I don't mean to hurt anyone with my words. I'm just a woman in severe pain, anxious and very scared. Maybe my desperation to maximise my chances in the IVF took over my mind. The doctors said the plan they have is after I give birth, they will be able to sort out treatment for the bleeding issues. So you see, I'm in a catch 22 situation and I'm so exhausted emotionally.
The NHS does it to try and reduce multiple pregnancies which are higher risk than singleton pregnancies. Lots of private clinics now advocate for single embryo transfers as well. Newer research also shows transferring two at once doesn’t increase your chances of a pregnancy.
I had three double transfers, they all failed. I’ve had two single transfers which have been successful. So having a single transfer is absolutely not setting up anyone to fail. The idea of ‘removing the unwanted extras’ is an incredibly insensitive comment to write on a forum full of women struggling to have a family. I can only hope you didn’t mean that in the way it’s come across.
Lots of places in the UK don’t have any funding for IVF at all (like where I live) so I would try and focus on the fact you are incredibly lucky to have that as an option and I’m sure if you talk to your embryologist when the time comes, they can explain why they recommend it in most cases. Good luck on your journey x
Thanks for throwing some light in this. Good to know that someone had a first hand experience with both single and multiple embryo transfer. Please forgive me if I came across as insensitive, I don't mean to hurt anyone with my words. So much has happened that I spend most days battling between hoping the IVF works for me so that the doctors can finally pursue treatment for the bleeding issues. They can't help me until I have had a baby as treatment options for the bleeding will mean I will no longer be able to conceive.
Most clinics prefer to transfer one, but as the others say it usually depends on your personal circumstance. I had two single transfers that were unsuccessful, then a third double transfer that resulted in a CP and then a fourth double which resulted in my current twin pregnancy.
I’m just 31, 30 at the time of starting when I had my single transfers and the reason we opted for two from my third transfer is to increase the chance of at least one embryo sticking - my consultant said there was an 8% increased chance of one sticking which felt like good odds to me. I was told to prepare for the risk of twins - which we were and I’m grateful I’ve now two beautiful babies growing healthy.
An embryo sticking depends on lots of other factors as well… trust your clinics advice. Plenty of women have a single transfer and go on to have successful outcomes.
My doctor told me that sometimes , even with all controlled medicated cycle to prepare the endometrial the implementation can fail , so for him it's a shame to lose two embryos at once , my transfer was last Saturday I wanted to have my two 3 day 8AA embryos transferred but he convinced me not to do so , so I transfered one and the other is still frozen.
I was only allowed a single transfer due to my health complications, my specialists would only agree to us trying if we agreed to a single embryo.
I was told by the ivf doctor that multiple implantation can actually have a detrimental effect if the embryos are of different qualities too, as our bodies would put more effort into the lesser quality embryo therfore reducing the chance of a successful outcome.
But I would like to give you hope.... I had a less than 3% chance of a successful pregnancy due to having SLE, Lupus Nephritis under active thyroid to name a few of my illnesses and now currently 7 weeks on our 2nd attempt so stay positive.
The main reason is to reduce the risk of multiple pregnancies. If you have one good embryo, the chance of implantation is better. If you have two lower quality embryos, they would consider transferring both to give a greater chance of pregnancy, but the main reason is to reduce multiples due to increased risks to mother and baby.
Hi, are you transferring 3 or 5 day embryos? I have the opposite issue. I'm in Ukraine and my clinic wants to transfer 3 PGS tested 5 day donor embryos. I'm terrified it will result in triplets. Twins I'm okay with, but triplets is dangerous for mother and babies. Also, IVF raises the chance of identical twins. So potentially I could end up with even more than 3. Hopefully you get what I'm saying. Multiples can be dangerous. You have a higher chance of losing all the embryos. I might also have to do selective reduction, which is a potion I didn't want to be in. Hope that sheds some light on it.
Remove the unwanted extra ones later???? As in an abortion of embryos? No they wouldn’t do that 😬😬 they are trying to create life not abort it? and it’s also risky to the remaining embryo. It would be incredibly irresponsible and immoral of the nhs or any clinic in the whole world to deliberately create life knowing it will be destroyed and how do you choose which baby lives or dies?
My experience is they can advise you not to transfer more than one as there are risks with twin pregnancies and they have targets in place to minimise the number of pregnancies that have 2 or more babies due to the known risks. They will likely advise one embryo if you are on your first or second go and are under 40 but on one occasion I went ahead with a double embryo transfer against their advise so it can be done (it didn’t work but my next single transfer did). The evidence showed there is a slight increased chance of pregnancy if 2 embryos are used but no more than if you did 2 single transfers. It’s the time e factor that you have to consider against the multiple pregnancy risks and potentially wasting an extra embryo on an unsuccessful round which is why age is a factor in their advise.
Hi… I think perhaps you should seek some counselling and a direct conversation with a fertility specialist. I assume from what you have said you have severe endo, and the doctors worry if they perform a hysterectomy you won’t be able to have children in the future which is obviously a scary thought If you want them. But based on your post, I can’t tell if you do, or if your rushing to have them, so you can have the treatment.
Both actions are big decisions for all of their associates reasons.
Please, This forum is great and has helped me so so much, but I think it would help to seek some professional help to discuss ALL of your options properly, rather than just jumping into IVF to have a child now so you can then have your health treatment.
The point on embryo transfer numbers, the other ladies have detailed the risk, but again it feels like it’s because your desperate for help on your illness (my best friend and sister in law have been through this so I have seen it very close how it impacts people) but there are options so please speak to a specialist x
I may be wrong, and you may be wanting a family now, but there are options… I hope you get sorted x
I was with a private clinic had two embryos transferred and miscarried at 6 weeks, had a single embryo transfer and have a beautiful 2yr old….. sometimes the gradings of the embryos make a difference in a double transfer so if you had one of good grade and one not so good if they both attach and the lower grading one miscarries it can affect the other one and make you miscarry both was the explanation I was given.I think all you need is one and a lot of hope!
Good luck I’ll keep my fingers crossed for a little miracle xx
Hi Aramadani, I agree with all the other replies here, it’s to cut down on risk & multiples. We’re doing nhs treatment but spoke to a recurrent miscarriage specialist via private after our last failed FET.
I was all for doing a double transfer this time but he advised against it saying that if one implants & 1 fails there is a very high chance of the failed one taking the implanted one with it, resulting in them both failing. I haven’t read up on this but it was enough 2 make stick 2 single transfers.
it's clear you're very new to this process. "Unwanted extras" don't really exist, because after years of negative pregnancy tests, and being aware of all sort of pregnancy complications, women don't want to "remove a growing baby"---what if that would be the one to be able to survive the whole pregnancy, whilst you kept the one that didn't make it? Wouldn't this be torture? Losing both, one on its own, and one of your making?
Reading one of your previous comments I understand where you come from, but still, in terms of IVF, implanting many embryos and then removing the "unwanted ones" doesn't make sense at all.
I did two double transfers, none of them worked. I also had 2 single transfers, one resulting in an ectopic pregnancy, and another giving me my wonderful little girl. So you see from my experience, single transfers work often better than double ones, possibly because clinics allow double transfers when they feel it's unlikely that both stuck, possibly because the embryos aren't as promising, or because they believe the body is somehow rejecting a pregnancy, as in the case of Emineasca who had 3 failed transfers.
It's a matter of balancing risks and gains. Also, given that you have some issues with bleeding, I'd be wary of putting too much pressure down there, if I were you.
You can try to convince your clinic to go for a double transfer, but if you're young enough, and if your embryos look good, I doubt anyone would agree on that for a first transfer.
Typically, they are only wanting to transfer one Embryo at a time. If the embryo is of good quality your chances of conceiving are greater than a low grade egg. If they were of a low grade they probably would've transferred me than one. There many other factors, as well. I had to sign a paper in my protocol of how many to transfer, but I'm in the states and that's their process. They are trying minimize multiple pregnancies that could end up putting the mother at risk. I'm sure this will not fail. Keep the faith and don't worry about your friends failed cycle, everybody is different.
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