FET - how many to transfer after twin loss?

[leorira11]

I did my first IVF/ICSI in August 2009. We transfered two 3-day embryos and I got pregnant with b/g twins! We were so excited. On December 25, 2009, Baby Girl A's water broke. I was almost exactly 22 weeks pregnant. There was nothing we could do, and our daughter and son were born and died on December 26.

For most people, having a second set of twins is statistically astronomical. Not so for me.

We finished our first IVF with 4 leftover embryos. We froze them in pairs, since we were expecting to transfer two at any future FET.

Now that I have had severe complication with a twin pregnancy that let to infant death, I'm terrified to have twins again. But I hate the idea of discarding embryos and/or decreasing my chances of getting pregnant.

We did our first FET in March. At our doctor's recommendation (both my high-risk OB and our RE), we defrosted one pair, waiting until they grew to blastocysts and transfered the better of the two. The cycle resulted in a BFN.

We have an appt to meet with the RE again on Thursday to discuss our next FET. My DH is in favor of doing the same things again (defrosting a pair, growing to blasts and transfering one). I really want to transfer both on the day they defrost... I don't really have a logical reason, just emotional ones. Also, our national health insurance covers all IVF expenses, so my DH would rather do more cycles with a single embryo than fewer cycles with multiple embryos.

My RE gives us a 45% pregnancy rate for a single blast transfer and a 55% rate with a double 3-day transfer. With the double transfer, our odds of twins are around 30%, with a single blast, twins are only 3% chance (identicals).

I don't know what to do. I know that there are no answers. I'm just looking for support and advice....

Thanks

[Ghost]

I did my first IVF/ICSI in August 2009. We transfered two 3-day embryos and I got pregnant with b/g twins! We were so excited. On December 25, 2009, Baby Girl A's water broke. I was almost exactly 22 weeks pregnant. There was nothing we could do, and our daughter and son were born and died on December 26.

For most people, having a second set of twins is statistically astronomical. Not so for me.

We finished our first IVF with 4 leftover embryos. We froze them in pairs, since we were expecting to transfer two at any future FET.

Now that I have had severe complication with a twin pregnancy that let to infant death, I'm terrified to have twins again. But I hate the idea of discarding embryos and/or decreasing my chances of getting pregnant.

We did our first FET in March. At our doctor's recommendation (both my high-risk OB and our RE), we defrosted one pair, waiting until they grew to blastocysts and transfered the better of the two. The cycle resulted in a BFN.

We have an appt to meet with the RE again on Thursday to discuss our next FET. My DH is in favor of doing the same things again (defrosting a pair, growing to blasts and transfering one). I really want to transfer both on the day they defrost... I don't really have a logical reason, just emotional ones. Also, our national health insurance covers all IVF expenses, so my DH would rather do more cycles with a single embryo than fewer cycles with multiple embryos.

My RE gives us a 45% pregnancy rate for a single blast transfer and a 55% rate with a double 3-day transfer. With the double transfer, our odds of twins are around 30%, with a single blast, twins are only 3% chance (identicals).

I don't know what to do. I know that there are no answers. I'm just looking for support and advice....

Thanks

If I was in your position, I would have the doctor do exactly what he did with your previous frozen embryos. If both look good on transfer day, I might transfer both...maybe. Twins are an extra financial strain, they put extra stress on a marriage, and they are associated with increased medical risks. These factors are not huge, but they are real.

[natakia1108]

I agree with the new protocal of your doctor and your husband. You cannot ignore his wishes. If finances/coverage is not an issue you can do this until you get pregnant with the 1 embryo transfer. Don't base your decision on emotions. I'm getting ready to leave to do my 1st transfer it's an FET, but I'm scared to death of having twins....primarily for the risk associated with it. And we don't have unlimited benefits..as a matter of fact, we pay for everything except the monitoring portion. our policy will only cover IUI's & we're past that. Good luck, but be patient and have faith. Go with the less traumatic option, do one at a time.

[angelaezra]

Leorira – I had a similar experience as you did with my first fresh IVF cycle in 2008. I transferred two embryos and became pregnant w/ twins. I had a vanishing twin about 5 ½ weeks and continued to spot and bleed for the next two to three weeks. I then lost my remaining daughter (Ashley) at 21 weeks. My RE thinks some of my problems started from the fact that I became pregnant w/ twins in the beginning, so he refused and strongly recommended that I only transfer 1 embryo at a time. I consulted a high risk OB also and he agreed saying that the majority of his patients who are pregnant w/ twins have severe complications and sometimes results in permanent injury to the children.

So after our loss of Ashley in Feb. 2009, we had a FET w/ 1 embryo in May 2009, which resulted in a BFN. And, I just had to get away from the fertility rollercoaster for awhile and we decided that we would try again in March 2010. So I felt that I would have the best luck w/ a fresh transfer and my RE has higher rates w/ fresh transfers vs. frozen transfer that we would do a fresh transfer w/ 1 embryo again. But, I tell you even though I know the medical complications of carrying twins as I am a RN and my past pregnancy losses, I still contemplated transferring two embryos all the way up to the ET date. It was so very hard to put our faith in just 1 embryo. But, my RE has high rates for single transfers vs. 2 embryos. But, so far it has worked out and I got a BFP. I just pray that this pregnancy progresses uneventfully and I have a healthy baby!

I know the decision is hard but you have to continue to think of the health of your baby and most importantly your health. I wish you good luck in your decision!

Angela

[rikirees]

Do you know why your water broke at 22 weeks? This is a really important question. if your cervix was opening, then in any pregnancy, twins or not, you maybe need to consider a cerclage at about 10-12 weeks. My water broke at with my first pregnancy at 24 weeks exactly and my DD was born at 25 weeks 6 days (after 114 days in the NICU she came home, now 2.5 years old), we now know that an amnio might ave been the reason, as well as a new diagnosed of a blood clotting disorder. This time around I did not have an anmio and I am on injection blood thinners, and progesterone to prevent preterm labor.
Also, notice in my signature....I DID NOT WANT TWINS, since my last pregnancy was so complicated....i transfered 1 early stage blast on day 5 (FET cycle)....Beta 10dpt was 414...i knew instantly something was fishy....but Thank God the twins are doing well so far.
Good luck in whatever you decide to do. it will be the right decision:)

[Franca]

This has actually frightened me, we transfered 2 but i wont know until the 14th may if im carrying twins or not. If twins are highly dangerous why would they put us in stress and high risk?

Franca
xx

[Ghost]

This has actually frightened me, we transfered 2 but i wont know until the 14th may if im carrying twins or not. If twins are highly dangerous why would they put us in stress and high risk?

Franca
xx

Twins are not really high risk, but the risks are higher than with singletons. Most twin pregnancies work out just fine. They are much more likely to be born premature, but modern medicine usually handles that just fine. There is a modest increase in the risk of losing the pregnancy or having fetal anomalies. These are not really high risks, IMO, but they are increased.

The risks jump dramatically with triplets, and continue increasing as the number of fetuses increases. My understanding is that pregnancies with 3 or more are routinely referred to a perinatologist.

[Franca]

Thankyou ghost xx