Frozen Embryo Transfer Dilemma

[cd497Q]

Hi people,

I will be going for a frozen embryo transfer in a couple of months and would be keen to hear your thoughts and advice. We have 5 embryos in the freezer and I will be turning 40 in March, so I am feeling that if none of these work we will be looking at fostering/adoption instead.

On my last visit the nurses were very sympathetic and floated the possibility of having two embryos transferred. I was under the impression that they would only do this if the embryos were of poorer quality, but also that they would only freeze high quality embryos. I would be over the moon to have twins but also understand that there are lots of risks, and additional ones due to my age and a few medical issues on top of the infertility.

So my question ladies (and gents, if reading!) is would you try for two embryos on the next go, or play it cautious and go for one?

[Orla9298]

For me always two. Even if I was told mine were top quality I would still go with two. I think because i would want the best possible chance of pregnancy and twins is a risk I feel ok about taking, that’s the part you have to think about xx

[MissSaoPaulo]

I've just turned 39, had my first IVF in Sept and also got 5 blastocysts to freeze.

We got 2 'good' and 3 'intermediate' quality and so decided with the doctor to transfer one of each on our first transfer earlier this month. Given my age, we put in 2 in the hope 1 would stick.

I have yet to have a scan (next week, yay!!) but very high hcg levels in the blood test last week suggest that both of them have stuck. We were really shocked, as we really didn't expect that to happen.

I'm a twin myself and I don't know if I have a biased view that it's no big deal? I hadn't really given much thought to health implications before, maybe because my health has always been very good - and I'm trying not to worry about it now. My brother and I were practically full term but my mam was aged 22 when she had us so I guess things won't be that simple!!

What really freaked us out were the financial implications. My husband is Brazilian and we live there and he just kept saying "flights to the UK for 4 people!!!". And space - where are we going to put them?!?! If it is twins we'll need to move to a bigger flat.

Nothing confirmed as yet for me but if you put in 2, be prepared to get 2 out.

Best of luck whichever you decide on, I hope it all goes well for you!!

[AmbK]

Hi there, I have been doing a hell lot of online digging lately as I'm scheduled for starting my IVF in January as well. There's no real experience here though, I can share whatever I found useful online... just in case it helps you sort the dilemma you're having. Firstly, twin transfer is mostly referred to based on the age of the expectant mother and not the embryo really. Usually, the clinics are reluctant to do twin transfer before 35 years of age unless there's sufficient clinical reason and failed attempts at IVF to make them try it as an alternative. Also, frozen transfers are way better than fresh transfers for a number of reasons. At 40 the acceptability of the whole process is somewhat doubtful, however, nowadays it's very much possible. It's best to get on with a clinic with a good success rate not only in general IVF but with older women and hopefully you'll make it. Considering all the points you shared I'll definitely advise you to go for a twin transfer unless it poses any threat to full-term or your health... which the docs shall definitely make sure of before going on with the twin transfer.

[2-shades-of-hope]

I’m going to be having two put back on my third transfer. Not a decision I’ve taken lightly but on balance I think it’s best. It’s within the nice guidelines which I find reassuring. Good luck with your transfer x

[AJJ123]

Go for two, if I had two left I would be xx

[Kloulou83]

Hi there

We always asked for two embryos to be transferred. My thought process was always I would prefer two babies than no babies. I had two back on both of my full rounds of IVF. First round BFN and second round we were lucky enough that both implanted. I now have 8 month old twin girls and although my pregnancy was quite tough, I wouldn’t have changed anything and they were incredible weights and only born at 36+3. They are healthy and happy and apart from some serious tummy muscle separation, I’m absolutely fine.

Good luck 🤞🏼 xx

[Dunla]

Hi there. Due to both my age and in most of my cycles embryo number and quality, I’ve always had two transferred in the hope of increasing the odds for us. There are of course risks involved in terms of multiple pregnancy but it was a risk that we were willing to take xx

[Saya85]

Hi

As others have said above, it’s usually the age and health of mother that’s taken in account rather than embryo quality when deciding number of embryos.

Women below 35 have a much higher risk of twin/multiple pregnancy and so clinics generally will transfer one.

Usually 35 and over they would put two in as routine- to increase the chances of one sticking (with a lesser risk of multiple pregnancy) but of course it can and often does happen.

There is a slight theory that putting two in could be worse than one (in that if one doesn’t stick it can send hormone signals that may prevent other one from sticking too) but that seems to be the less popular opinion.

I would suggest at your age and given how many embryos you have that you put two in (but depends on your health overall) as time is also a factor for you and you have a healthy number of spare embryos.

Frozen transfers generally do seem better and if you can have it within your natural cycle even better. Definitely make sure they consider all the extras to help you - blood thinners and higher progesterone /injections due to age etc also

Although I am 33 with two failed Ivfs we have decided to put two in this time.

My cousins wife had 2 put in at age 37 and she’s now expecting twin girls !

Everyone’s journey is their own but don’t want you to feel as if transferring two embryos is unusual in your case. If anything it’s the norm across most clinics

Good luck 🙂

[Tugsgirl]

Once you’re over a certain age they’re more likely to transfer two embryos that’s all xx

[runsoncuddles]

Hey! I'm 38 and waiting to start my treatment end of Dec. Given an option I'll have 2 embryos implanted. I appreciate that there are risks involved the older we are, howver there are risks even when a woman conceives naturally. For someone like me who's fast running out of time and sanity I'll have two implanted then take it from there. Good luck on your journey x

[MofM]

Hello, I am younger than you (35 1/2) and my clinic suggested to put back two (if we will have two blastos after my semi-disastrous cycle).

However, I am scared to death of the implication of a twin pregnancy not much on me (which I think I can do fine, due to my general health) but mostly on the babies.

Therefore, we decided that we would invest more economically and emotionally on the "implantation" side, trying them one by one, rather than worry or regret this later, on the "pregnancy" side. I think I will cope better with a negative pregnancy test, rather than a later miscarriage or early deliver or some other complications.

Yet, this is a very personal decision, and you should discuss this with your doctor, also considering your age and the few medical issues you are mentioning in your post.

[Bexta6060]

Im 36 and heading in for my transfer tomorrow, my clinic said we can discuss the option of 2 being transferred in the morning once they have a look at the embryos. I was all for it as this is our last try but they did say there is limited evidence that if you lose one your uterus lining can block off implantation of the other. As a poster said above, its not a popular opinion but that did scare me into only doing 1.

[Lizzielizzielizzie]

I would only have one transferred unless they gave me a really good set of research to suggest having two transferred would be more likely to result in a child. Having twins carries too much risk for me- and having just been in an NCT group with a girl who has just had ivf twins I can also see how much work it is even when there are no medical problems (although she did have to have a c section pretty early on).

[Lizzielizzielizzie in reply to Lizzielizzielizzie]

Ps I had my successful FET of my only embryo at 39 and am now 40 and 38 weeks pregnant- I do worry about age for having a sibling but that’s because I don’t have any frozen embryos. With any luck you’ll get a baby and still have embryos in the freezer for a sibling later x

[Olivia1980xxx]

Hi cd497q I had my fresh cycle two years ago . On a transfer day embryologist ask me if I want to be transfer one or two ...my intuition told me one and when I ask her what she think she told me she will go with one and the other freeze....so that what I did. My little baby girl is 18 months old😍 We got one frozen but I turn 38 and my AMH level is 5.7 so the doc in clinic recommend for us to go through fresh cycle . So we done all tests they need and we ready to start fresh cycle.... They say this time they gonna increase the dose...and I hope for good outcome...but if we end up with only two good quality embryos I will take for consideration to be transferring two .... Just trust your intuition..fallow your heart and what ever u decided will be the right decision 🤞xx

[Anya80]

Very difficult decision for myself too. After failures with two earliest FET attempts with single embryo transfer where one was ended with mmc and next was just bfn both myself and my hubby taken hard decision on transferring two embryos this time. We have considered the risk there but with our situation we needed to go for it and now in tww.

[Hidden]

I have had two transfeŕred in the past however last time I actually looked into the medical implications. So many things can go wrong, and as an older lady (I just turned 42) these increase. When I read that there is a higher chance of premature birth which leads to a higher chance of problems for the children throughout life, higher chance of birth problems which can ultimately not end well for baby or mother, potential study showing that if the body rejects one the other could be impacted too, and many other reasons - I decided to opt for one. Give my little embryo the best chance of full term, all the nutrients from me going to one - no competition, at 42 I thought also about trying to cope with two after they are born. There was also the fact that I had had 2 transferred in March - got my very first ever BFP after 4 previous attempts, but it ended in a long drawn out 4 week final diagnosis of anembryonic ( two empty sacs) which had to be medically managed.

So I vote one xxx

[Hidden in reply to Hidden]

P.s. I am now 8wks7days pregnant with my most recent attempt with one xxx

[sandra81]

I transfered three that’s what my doctors recommended. Two took and I now have 5 month old twin girls. The pregnancy was tough but I also have a friend who is preg with a singleton now having same complains as I had. I ended up with preenclampsia and girls being born at 35 weeks but they did not stay in NICU. I left hospital on 4th day with the girls. But then again other people with singletons also get preenclampsia and some singletons end up needing NICU. Was it hard yes. Would I do anything differently. NO.

[cd497Q]

Replying to myself... The consultant has decided for me so we are having double embryo transfer. She said my ova and embryos were all great quality so I am optimistic (again). Starting Supercur on 31st January. Let's go!

[AJJ123]

It depends, if ur embryo is good quality I’d focus on one - but that’s just me.

I had two embryos transferred because they were only 3 and 2dt and although I got pregnant they were amnionic and I mc at 8 weeks.

If time is not on ur side - then I would consider differently and have two implanted - prob a higher chance of success xx