Trying to decide if single or double FET? Any advice?

hello friends.

we’ve just had our 9th failed FET. We’ll, it was a chemical for 24 hrs; I got a very faint positive & when I tested the following day it was negative.

Historically I hyperstimulated & ended up with 7 freezable day 5’s. We had 3 failed single FET, then I had Alice/Emma/era (all normal) & then our BFP- our miracle daughter! Since then we had 3 more failed FET, a new egg collection- hyperstimulated again & got 11 freezable day 5’s, we’ve since transferred 2 of these (as singles)- both failed, then I had a scratch test (thinking it was the Alice/Emma biopsy that helped our little one implant) and then our chemical just yesterday.

Our embryos are all untested- it was just way to expensive given our numbers.

our consultant said that if our last single transfer didn’t work then we should consider a double transfer.

Im a midwife & know all too well what twin pregnancies can be like. I have a bicornuate uterus (heart shaped) which means potentially a bit less space & higher risk of prem labour. I honestly don’t think we could afford to put twins in nursery. We have no family support close by- basically twins would be extremely difficult for us!

Any advice whether to try a double transfer or wait it out doing singles? I’m 40 & feel like we’ve been doing back to back treatment for a long time now, so if I’m not pregnant by Christmas I think we’ll call it a day- for mental health survival.

I so want a sibling for our daughter but scared of twins with a double transfer, but equally the chances of both taking given our history are so slim?!?!

Any advice/support gratefully received. Thank you so much xx

[Allotmenteer16]

Hey, I don't have an answer to your specific question but just want to say I feel for you. I am in the 2WW hoping for a sibling for our 4 year old daughter. Our first ICSI in 2019 only gave us one day 3 embryo -BFN, then second cycle a couple of months later gave us two day 5s, one of which ended up being our daughter. The other was frozen and I finally had it transferred in January after several hiccups and hurdles for about 18 months previous, unfortunately BFN.It took me a few months to lose some weight and start a new cycle of ICSI, got 21 eggs, but only one blastocyst, so nothing in the freezer as a back up. It was a 5AA so I'm keeping everything crossed but trying not to get my hopes up as not really feeling anything, although I know that doesn't mean anything much.

I turned 41 last month and we said if we didn't get there this year we would call it a day as it's just getting so expensive and my mental health has taken such a hit with it all. The thought of giving up is still heartbreaking though, but I'm trying to keep hopeful for OTD on Friday 🤞

Do your clinic have any stats about how likely it is that a double transfer would result in twins? I guess you need to think about whether you'd find it harder having twins or not trying again?

It's so hard when you have to make these decisions, not like fate can take it out of our hands. Good luck with whatever decision you make in the end.

[Millbanks]

Hello lovely,

We're in a weirdly similar situation - I have a little boy from my 6th transfer and just had an mmc after getting a positive on our 9th transfer.

I wouldn't transfer 2 either because I am well aware of how hard twins are, physically, emotionally and financially - it's just not something I would be able to cope with I think, so every transfer was a single. We decided to call it a day after our last transfer (even though we were lucky enough to have 2 frosties left) but emotionally I didn't want to carry on. But now the familiar niggle is back and I'm starting to think maybe we should just try these last 2, then it really is over. I'm 41 now and want to finish this by Christmas too.

Hope you are able to make a decision soon xx

[Hidden in reply to Millbanks]

Ah it’s so hard- so much harder for the woman than the man too. I think we’ll transfer a single & then call it quits (though it’s horrible the idea of leaving some behind in the freezer 😢, but emotional health is important too). Wish money wasn’t an issue & we could have tested the embryos. Sucks to be infertile! Good luck with your decision xx

[Millbanks in reply to Hidden]

Yes indeed - we have to go through it all don't we! Thank you - good luck with yours too - fingers crossed it works out for you xx

[Endofitall]

have you considered testing at this point and then doing SETs with tested embryos? I saw Prof. Brosens at the Warwick research clinic re implantation failure and he was strongly against DETs on basis that the abnormal embryo can impact the implantation of the normal embryo - because the endometrium can often detect issues and then potentially shut down to implantation. So that’s really changed my mind on them. I already had concerns about twins from a pregnancy risk POV being from medical background myself.

Hope you can make a decision that feels right for you x

[Hidden]

I’d love to test- but we have 8 embryos in storage still- £500 per embryo plus £1300 ‘lab fee’ - I’m pretty sure that’s what I was quoted…it’s just out of reach financially. Really really interesting what your prof said about the endometrium though, I’ll absolutely take that on board, it makes sense! X

[Endofitall in reply to Hidden]

Many clinics have a set fee up to a certain number eg 5 then it’s per embryo on top. Could make it more financially viable than going through many transfers to find the one and the heartache. But I get it’s not a sure thing or easy decision esp with the cost x

[Kerry1487]

sorry I don’t have any advise but if you were to opt for single transfers, are your clinic recommending any protocol changes that may help such as steroids for potential auto immune conditions or intralipids?

Due to me not wanting to go through lots of transfers I’ve considered wether we suggest a double. It’s such a tough decision to put upon you. I’ve read a lot of double transfers don’t automatically result in twins but it’s a big risk to take.

[gianna83]

I've always done double fets except for the last one where there was only one embryo left. Twins never worried me, i've always wished for them actually but it never happened.

[Londonlady2024]

Hi, all my transfers were double transfers except the first NHS funded one where I only got one early blastocyst. I had 4 fresh transfers (3 were double) and 1 frozen day 3 double transfer which resulted in my little boy who is now 6 weeks old.

I secretly wanted twins but none ever implanted other than my frozen transfer; only one stuck.

I would stick to whatever you feel is best for you given your heart shaped uterus. The chances of twins is slim however it can happen. With twins they wouldn't let go full-term anyway. I hope you get your sibling for your daughter. Please keep us updated x

[Londonlady2024 in reply to Londonlady2024]

I turned 44 last month and my baby was born 4 weeks early to prevent another stillbirth.

[Lucyhannah1]

I did a double transfer with my first frozen cycle which resulted in my near 4 year old. I then like you had 3 failed transfers. 2 were single and 1 double. I carried on with another single transfer, the only difference with this one is that they were monitoring my progesterone levels. On the previous double that failed my progesterone levels were way to low, annoying they didn’t do the bloods till the day of the transfer and I think by that timr it was too late! I was quite sure that I didn’t want twins though so actually grateful now that one wasn’t meant to be! I now have a 2 week old from my last single transfer. Good luck! X

[Twins2022]

Hi, I personally would go for a double FET and make it your last. This way you have thrown everything at your fertility journey so why not just go for it if you have the embryos. I had my eldest (6 yrs old) at 42 and like you my partner and I wanted a sibling for our daughter but we only had 2 frozen embryos left. We had no intention of doing anything beyond these two embryos, simply down to cost, my age but also the emotional toll is just too much sometimes. So this was our final attempt and if that didn’t work for our last go then we would have adopted for sure. They weren’t particularly great quality embryo’s either. Anyway to cut a long story short our twins are 2 years old this week! Yes there is always a higher risk but the care I received was absolutely amazing. I found my twin pregnancy much much easier than with my singleton. I had an elective c-section and for me it was a magical experience. Don’t get me wrong we’ve had our sleep deprived moments and ‘ahhhh can I do this, am I good enough’ etc. But the bond the three of them have is amazing. Our twins go to nursery 3 full days a week. Yes it costs a lot but it’s not forever. Also, from next year any child over 9 months of age is automatically entitled to 30 hrs childcare a month, so infact now is a good time to be pregnant! Best of luck with your decision x

[Hidden in reply to Twins2022]

Thank you for replying. We’ve decided to just do a single transfer. I would have done double but my husband was/is adamant not to risk twins. We live in wales so that childcare funding doesn’t apply to us. I’ve made peace with that decision & am now back on drugs for 1 last try.

Thank you so much for taking the time to write to me xx

[Twins2022 in reply to Hidden]

It’s great that you have made a decision and I wish you and your husband all the luck in the world x