clinic won’t allow double transfer - Fertility Network UK

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clinic won’t allow double transfer

19 Replies

Hi everyone, hoping for a little advice. Quick back story, I’ve had 3 egg collections, 2 x failed transfers of 1 x 5AB and 1 x 5AA and am 36 years old with endometriosis.

We are super lucky to have 5 frozen embryos from our 3rd cycle. 2 x top quality and 3 x good/borderline top. I’ve been told the only ones we can have pgta tested are our 2 x top quality, which they say is pointless as it’s just 2.

I’ve requested that we double transfer our 2 top, given that we have a 50/50 chance of euploid embryos and they’re saying absolutely no chance. Is this normal for a clinic to say no? I would not classify us a ‘high risk twin pregnancy’. Anyone experienced similar? Did you push it? I just cannot face potentially having 5 transfers, from a cost and mental health perspective. Thoughts? X

19 Replies
HedgehogMad profile image
HedgehogMad

Hey lovely, as you know we have had a fair few transfers, two of ours were double. Our clinic offered us a double after we had 3 failed transfers of top quality embryos - we then transferred two lower quality ones together. I think generally after failing X3 good quality embryos means your chances are then reduced - I would say you have a good chance still with single transfer of your next embryo and that's probably why they want you to do a single transfer first. That being said, I'm not sure if the clinic can refuse to do a double if you sign a waiver to say you understand the risks. Perhaps they might let you transfer a higher and lower quality embryo together..? X

in reply toHedgehogMad

Thank you so much. Maybe we go with our top quality ones individually first and then transfer the lower quality together. It’s such a minefield. I just want to do everything to increase our chances. Thank you. Hope you’re doing ok as can be ♥️♥️ xx

HollyT7 profile image
HollyT7

Our nhs cycle wouldn’t allow single of top quality, but a relative was going to do an nhs double with two lower quality (didn’t in the end as one skipped up a grade). With private I would have thought you could opt for this, your paying for it. Maybe it’s in your clinics terms not to allow regardless if private? Have the justified why? I know our clinic classified all multiple pregnancies as high risk which is why the nhs wouldn’t allow it.

in reply toHollyT7

They said I am classed as high risk twin pregnancy, which I disagree with. Funnily enough my previous clinic which was nhs weren’t so against double transfer but I never actually made more than one blast 😞 I can’t help but think it’s a money making exercise, as it’s 2.5k per FET. I don’t know, maybe I am being too negative. Guess I need to listen to the experts x

Linny12 profile image
Linny12

Hi, My clinic's policy statement said they'd transfer 1 if the patient was 39 and under, 2 if 40 and 3 if above 40, but at the consultation they said they normally only transferred 1 because of possibilities of twins. They're really against it.

Fruitandflowers profile image
Fruitandflowers

I asked before my last FET about transferring two as tbh I wanted this whole part of my life over with and also the mounting costs of each transfer was becoming daunting. But my consultant basically said no he wouldn't, which I took as meaning the clinic wouldn't. He said the risk of a twin pregnancy is too great and/or the possibility of one failing and risking the other embryo or meaning more complications for the mum and baby. But he said this was also because we'd had one successful pregnancy and three early losses, whereas if they'd transferred a few (I think he said 3) singles, and we'd not had success (or any implantation/progression) only then would he consider it. So at least having the choice taken away stopped me agonising over it, but equally when you're paying it's a difficult one to swallow and there's a niggling thought it's about money for them, but hopefully it's really about your best interests.

in reply toFruitandflowers

Thank you for sharing ♥️ I’ve never seen a positive pregnancy test in the last 4 years and I just feel like I’m becoming desperate and will try anything to increase our chances. But I need to trust that they do have our best interests at heart. Maybe if we transfer these 2 singletons and if we do have to go down the route of using our lower grade embryos then it’s then we push harder for double x

Avocado111 profile image
Avocado111

hi, my consultant from NHS hospital opposed the double transfer, I have other health problems like diabetes, so been identified as high risk due to age and health conditions, I’m 40, first cycle, but I didn’t choose their service, went for private instead, the private clinic doctor suggest double transfer straight even though I didn’t request it, I mentioned the NHS doctor’s concern but he said doesn’t matter, so I think it really depends, just like different doctor use different protocols and med

try to find out your clinic’s policy, and ask for the details how they identify you as high risk, what rules/criteria, if your clinic’s plan is for your best interest then go for it, if God want to give you baby, it doesn’t matter which way, you will get it, calm down and find out details and sort out the cons and pros and make decisions and make yourself comfortable with final plan, good luck you can do it!

Lamagarden profile image
Lamagarden

I thought that under 40 most clinics only transferred one embryo at a time but I’ve no idea where I’ve got that info. Best of luck x

LSandJ profile image
LSandJ

Hi Elsidee! I think any twin pregnancy is classed as high risk! So don't worry there. And most clinics do have the 3 x failed transfers before they will consider doubles (and then they will look at age factors too). I think you said it earlier, maybe go for single transfers for your top two, and then consider doubles after that. I've done a combination of single, doubles, singles again and then doubles again. The first time I was doing doubles and they failed I really felt like I wasted precious embryos because in the end we were sure it was the environment that was wrong, not the embryos. Obviously we don't know for sure, but I did regret using two. Stats show you have more chance usukbg them individually. (Yes a slight increase per transfer if there are two, but not much!) Does that make sense. HOWEVER...after we'd had 7 transfers we were for a double snd ate now pregnant with twins! I'm happy about that after going through lots of fails, but there are also risks and problematic challenges to overcome (how do I take them swimming on mag leave without a friend or family with me? What about the climbing frame? Sooo much more money for two car seats etc..!) I know it sounds frivolous, and overall we are happy! (We'd been doing it a long time, so am glad we don't have to potentially do another 7 transfers to get our second baby!) But... also, I can kinda understand the 3 fail rule. Expecially if you don't know the embryo genetics! Do they have any clue why the transfers haven't taken? I guess not.. but do they have any reasons to believe its wither environment or genetics?

in reply toLSandJ

Huge congratulations ♥️ such a wonderful blessing after such a long and hard road to get there.

The thing is they believe I don’t have any environmental factors impacting implantation and that I’ve just been unlucky. Which I can’t understand as I have stage 4 endo. Everything I propose is a ‘you don’t need that’ response; NK cell testing, pgta testing, endometrial scratch, etc etc. So I felt with a double I could control things a bit more but that was a no 😅 so basically nothing is changing this FET. Other than taking some antibiotics.

I totally understand how devastating it would be to lose our only 2 top embryos, so actually without the extra tests maybe it’s wise to do singles and then if we are unfortunate and need to use our 3 lower graded ones we can double there. And also having twins would definitely be tough - we have sets within our family, but equally I’d love to know I wouldn’t have to go through this all again 🫠

Thanks for replying and wishing you lots of well wishes throughout your pregnancy and for when twinnies arrive xxx

Wishinandahopin profile image
Wishinandahopin

Clinics don’t like to transfer two as the chances of twins is high. And being pregnant with twins makes you much higher risk of miscarriage and just about every other complication.

The clinics that will transfer two is often lower quality or people that have a much lower chance of PGTA Normal.

If you’ve had failed transfers so far then I really wouldn’t recommend doing a double transfer as it doesn’t really increase your chance of it working it just increases your chance of having twins.

I would look at doing more testing as to why your transfers have failed specially with top embryos. We had two separate FETs with PGT-A embryos fail and did loads of tests and found out some immune issues- which incidentally meant if I had transferred two they would have been less likely to stick around. So my third we transferred one and I was on some immune drugs. And this one worked. Had I not done the testing and I had transferred two then I would have lost both which would have been heartbreaking 😔

That said you may have just been really unlucky and the next one hopefully will work anyway! Xx

in reply toWishinandahopin

Huge congratulations ♥️ amazing to hear success stories. Thank you for sharing.

I know what you’re saying about chances, it’s probably just another aspect I’m trying to control. Which ultimately I can’t.

I asked about further tests and they don’t believe I need anything and have put my failures down to chance - again which is why they think I’m a high risk of twin pregnancy. They don’t want to give me any steroids etc (I did ask about immune testing) as they don’t think there’s enough evidence to support it, but I disagree.

With a bit of pushing they said I could have an endometrial biopsy if I felt the need, and having endometriosis I believe I should. So maybe I push for that and at least I might feel like something is changing.

Thanks again xxx

Doodlebug23 profile image
Doodlebug23

NHS double transfer OE aged 42 BFN IVF in Spain aged 46/47 double donor: 1st single fresh BFN, 2nd single FET BFN, 3rd single FET BFN, 3rd single FET BFN, 4th single fresh chemical, 5th double FET tbc

Due to my age NHS were ok for double.

Clinic in were Spain reluctant for double due to age and hypertension. 1st 3 transfers they didn’t want to consider it. 4th they said we don’t like to do on fresh transfer (new donors). 5th they were still not keen but I pushed a little and they agreed without issue, I just had to sign to say I understood the risks.

I would think that there may be something in the small print of any contract that you signed with the clinic that should clarify.

I didn’t like to think I was going against the advice of my doctor but I weighed up all the pros and cons and I’m pleased I pushed for what I wanted. If your clinic are really putting their foot down it could be awkward to really push against them?

I have read that a poorer quality or abnormal embryo can affect a better quality normal embryo if transferred together.

I feel like you do though. The thought of several more transfers (I now have 4 frosties left) really makes me want to do double transfer x

in reply toDoodlebug23

Hey @doodlebug23 - hope you’re doing ok in the wait 🫶🏻 I think you’re right about pushing, I wouldn’t want to go to strongly against their advice as I really like my consultant and clinic.

When they say I’m high risk they mean high risk of having a twin pregnancy, not high risk to my health - which is what I don’t agree with, I’ve struggled to get one pregnancy 😅😬🫠 ah well, maybe it just means they’re confident I might get my miracle one day. Wishing you lots of luck x

Doodlebug23 profile image
Doodlebug23 in reply to

I’m on day 5 today. So I’m not stressed about testing yet and I think I’ve almost gotten past the panicking about bleeding. Whatever will be will be now I guess…

I wouldn’t have gone strongly against either but a little pushing and they agreed so it’s maybe worth a little push! Despite already having made my decision I did think about all the pros and cons so I was armed with info but all I had to say was that I had thought about the consequences. My Dr has a paragraph on his bio about not liking double transfer so I was surprised he agreed!

Saying you’re high risk of twin pregnancy does sound a bit weird! But I guess it does mean they are confident! X

Lornell23 profile image
Lornell23

I think it's just down to risk. After reading other people comments I agree I wanted this part of my life to be over but I was made to do like a little 'test' to understand the risks and factors but I was never given a choice either.

Habibi87 profile image
Habibi87

Hi Elsidee11, we had two single transfers of euploid embryos and one was a chemical pregnancy and the other a BFN. The embryos were made when I was 34 and the transfers at 35. I had also experienced a miscarriage of naturally conceived identical twins. I did so so many tests and they couldn’t find the reasons for failure so I requested that the third transfer be a double transfer of two euploid embryos. My consultant and the clinic were really against it particularly as the embryos were all tested but I insisted as they could not suggest anything that would increase my chances. At the end I had to speak with the clinical director to explain why I wanted a double transfer and to have my case presented to the clinical commission and eventually they agreed to it (I had to sign a doc on the risks of twin pregnancies). From the double transfer one of the embryo stuck and is now my beautiful 7 month old daughter. You really need to be convinced and be prepared to undertake the risks which is not easy. Now that we have our daughter, I think we’d only do single transfers if trying for a sibling. Sending you lots of love and luck with this tough journey x

thank you Habibi87 🫶🏻 sorry to hear about your losses but delighted you have a beautiful daughter.

I am not sure I have it in my to fight so hard, just felt like it was another disappointment when they said it. I guess for now I need to trust our consultant and have the double as a back up for our lower quality blasts.

Thanks for sharing your journey xx

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