Choosing how many to implant

I’ve been pretty consistent with the opinion that we do not want twins / the health risks that accompany them, and for that reason we’ve done EIGHT single embryo transfers.

http://3yearwait.blogspot.com/2014/04/the-age-old-question-to-implant-two.html

http://3yearwait.blogspot.com/2015/02/yeswere-still-talking-about-this-how.html

Studies suggest that, obviously, putting in more embryos increases the chance of success in any single cycle, but it also dramatically increases the risk of twins.  On the other hand, if you are willing to serially implant embryos (ie. two single embryo transfers back-to-back), you end up with the same overall pregnancy rates, albeit with more cycles:

http://humrep.oxfordjournals.org/content/20/10/2681.full

So that’s what we’ve been doing.  I’m not going to lie, embryo transfers are a major, major drag, emotionally and physically.  (And for people who don’t enjoy burning money like we obviously do, they’re expensive too!)  So doubling the number of transfers one has to do… well, it’s not for the faint of heart.  But, and I still believe this, it would be my biggest regret if we put two embryos in and then ended up with twins and something terrible happened to either me or the babies.  Which is why, as much as I HATE this process, we continue down the SET road. 

Everyone (my doc, the docs we talked to at CCRM, and my acupuncturist) agreed that twin pregnancies are not desirable, and too risky with chromosomally normal embryos.  But, after six failed single embryo transfers in the past two years (or five, if we do not want to count the anencephaly one against us), it can be tempting just to say “fuck it, put two in!”  I told my husband, I am CERTAIN that we are the only people in the world who would have six (or five, depending on how we want to count) failed SETs in a row and choose another SET for our seventh cycle.  His response: “we don’t want twins.”  I like his optimism!

So we stayed the course and implanted only one embryo—a bedraggled looking one, which looked particularly rough when I compared it to pictures of its smooth and hatching (or hatched!) failed siblings.  I don’t think it was the ugliest embryo we ever used (there was a rough untested one in 2014…) but it’s definitely less cute than the other seven we’ve used. 

If this one makes it, it will be like the ugly duckling turning into a swan.  

I’ll admit that less than 12 hours after our transfer I started having regrets about choosing another SET.  (Hell, when I looked at how rough the embryo looked before our transfer I started having regrets!)  But if this one does not work, we’re going to thaw our last two embryos together.  Chances are the chromosomally untested one—which we were told was a very early and rough looking blastocyst when it was frozen—will probably not survive the thaw or work.  Even if it does, after as many failed cycles as we’ve had, many with chromosomally normal embryos, I think our chances of twins are approaching zero.  (Famous last words?)

So, let’s hope this one works.  Otherwise, for our last cycle we’re doing what most people would have done long ago… rolling the dice on two embryos.