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One vs. Two – the debate returns

04/10/2012

Belle

Sorry for the complete void of activity since my last post. I have been working on a response to all of your great comments and was hoping to finish it today until I was slapped in the face by reality.

Today is CD14. This morning Fred (my new name for the dildo cam) revealed a rock star lining weighing in at 7.8 and two shockingly cyst-free ovaries. That was the good news.

Dr. A then asked how many embryos I wanted to transfer and I said a firm ONE. He quickly said my rates of success would be half that of two embryos. I explained that according to all my research the success rates are the same for one vs. two embryos. He was very hasty to say that his success rates are not that good. He only has a 30% success rate when transferring one embryo and a 60% success rate with two. When two are transferred his rate of twinning is 10%.

After our appointment we again looked up his statistics online and dammit if they are not very helpful. Why on earth does FET reporting have to be so much more vague than fresh reporting? This seems incredibly unfair.

Mr. Husband and I have been reading statistics from across the globe today, frantically looking for the magic stat that will make it all okay. Unfortunately there is very little on one vs. two embryos when it comes to FETs. We are scientific people and not the types to make decisions on a whim. With less than 24 hours to make a choice, it looks like we are going to have to go on faith more than fact, something that leaves us both uneasy.

First, let’s summarize where Mr. Husband and I are in our lives, both personally and professionally in case you are new here:

  • I am at a job a dislike and plan to return to school when Mr. Husband is done and employed.
  • Mr. Husband is done in July (he pushed graduation back from May to buy some more time) and currently has no good job offers.
  • I make very little money in my current position.
  • He makes even less.
  • We have four cats who are loud and demanding and smelly.
  • We are not happy in Lexington and do not intend to stay here.
  • I have funky autoimmune issues that could be lupus, but no one is really sure. Clock. Is. Ticking.
  • He is normal – or as normal as a math Ph.D. can be!
  • Our relationship is not at its strongest thanks to the above “challenges.”
  • We are both terrified of the possibility of two dirty diapers and two screaming faces.
  • I’m scared to death of two mouths heading for my boobies every few hours.
  • My boobies are small. I doubt their ability to feed one, let alone two.  My torso is small and I doubt it’s ability to carry one, let alone two babies. I have a usually small cervix and have no idea what that means but am pretty sure it does not bode well for a twin pregnancy.

Now let’s summarize our embryos:  We have 6 blastocysts, three at day five and three at day six. Of those six, three are perfect AA’s and three are near perfect AB’s. (I can’t help but grin when I type those stats. I’m a proud mama already!)

So with all this in mind, we have come to the following tentative decision:

We will thaw two embryos. We’ll transfer the best and refreeze the second. In the event the second is too crappy to refreeze, we’ll either let it go, or pop it in with the good one. If this cycle is a bust, we’ll have to do another month of birth control pills and then another month of ute prep putting our next transfer in mid June. By then, we’ll hopefully know what our future holds. Does Mr. Husband have a job? Is it somewhere that I can go to school? Are we moving somewhere closer to family? How is our financial situation?  How is my mystery lupus? How is our marriage?   Have the cats magically relaxed and stopped being so damn loud? Ok, that last one is sort of a joke!

In June we’ll be at a better place to face the real possibility of twins. If FET 1.1 fails, then we’ll transfer two for FET 1.2. If that fails we will change doctors. Hopefully by then we’ll be in a new city with better choices.

So that is where we stand at this moment. Terrified and uncertain, but ready to jump. Sweet little embryo, please be strong and stick around, Mommy and Daddy suck at these kind of decisions and would like to stop having to make them. xoxo.

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24 Comments

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  1. April 10, 2012

    We constantly debate this issue. Your plan sounds totally reasonable. Good luck!

  2. April 10, 2012

    I am not sure what to say except CONGRATS on:
    1. All those fine embryos!
    2. Getting to this point!

    Trust your gut. Seriously. Trust it.

    Please remember that most traditional fertility clinics want to maintain their sucess rates so thats why they they transfer multiple embryos. I go to a clinic that gets really squirmy when you want to transfer more than one. The clinic I go to says that 1 is just as good as 2 and defintely prefers 1.

    But you need to know if the RE is worth his salt and if the lab dealing with your embroys is any good.

    I know its stressful, but you will make the right decision for you which is really all that matters!
    I will keep you in my thoughts and wish you the vvery best!

  3. April 10, 2012

    We have this debate too. After our last IVF fail our doctor suggested transferring 2, but we still said no. Well, we said no as long as we have at least 1 to freeze.

    I think everything you’ve expressed sounds completely reasonable. Having twins does take more work, more money and is harder on your body. I completely understand not being certain you want to take that on (and admire couples who do). Oh, and congrats on your superfabulous lining!

  4. April 10, 2012

    Crossing everything for you. Tough choice to make, but an exciting one!

  5. April 10, 2012

    I think your reasoning for transferring just one embryo is sound. Ultimately you have to do what you feel comfortable with. Go with your heart.

  6. April 10, 2012

    I have no words of wisdom to offer you but hope you know I’m wishing you lots of good luck! I do have to agree, it sounds like your plan is very well thought out and I’d go with it!

  7. April 10, 2012

    I don’t like your doc’s stats ! That’s odd. Glad you’ll consider looking elsewhere after the move. Speaking as someone having all of the one percent risks in pregnancy , ONE :-). My body has done it tough. It’s been hard. I cannot imagine what we would have faced with two. I honestly think i would have lost both. I know FETs are different, but I also personally know three little boys from single FET transfers. Do what is right for you both, go with your gut, and good good luck.

  8. April 10, 2012

    Huh. I’m kind of surprised by your doctor’s response: I feel like all of the news in the media lately has been very pro- one embryo, claiming the same rates of pregnancy.

    A weird theory I’ve developed lately: I wonder if having really wide hips for a person of my size (they are seriously totally not in that sexy waist to hip ratio) is what allowed me to carry my twins pregnancy so far. I wonder if there is research on the whole torso ratio/height/hip thing and twin pregnancies? I think that would be good stuff to know. Maybe. Maybe not.

    • April 10, 2012

      Also, good luck!!!

    • robin #
      April 11, 2012

      OH! I hope there is validity to that. I have nice wide hips and am carrying twins. My personal goal is to make it to 37 weeks. I hope my hips help me get that far!!

      • April 11, 2012

        I made it to almost 36 weeks 😉 Pear-shaped, FTW!!

  9. faith #
    April 10, 2012

    Congratulate yourselves, my dear. When faced with a super tough decision you joined together for research and major life decision making that:
    A. has proven your marriage bond is still strong and that when reality hits you two work exceptionally well together
    B. will help you make the sometimes unbelievably crazy life decisions required of pregnancy, childbirth and parenting

    Have you ever noticed the people that have six kids that walk around in an obcene sense of peace? I believe they are so numb from the decisions of life that they have become masters of it, in a sense. They don’t sweat the small stuff and know what to do when dealt with all kinds of issues. With age and experience, hopefully we will all come to that place. I feel like the experience of IF will make you a more prepared parent…if even more prepared to make major decisions in informed and graceful ways. That is an skill that you seem to be perfecting. Give yourself a hug..and even one to Mr. Husband.
    Someone told me long ago..your children will grow to be who they are meant to be..have their own lives, etc. Marriage is something that outlasts child rearing, college, grandkids…it is the rock, the commitment..the delicate garden of life that we must nourish and care for like we would our baby. I don’t always do this..trust me…but I have seen that garden bloom time and time again and it is worth the weeding, digging up and redoing if need be. You two will get through this…:)

  10. April 10, 2012

    Wow! So much to think about…so close to transfer time! Exciting and nerve wracking all at the same time! We are a few months out from IVF and think about these things constantly. So tough! I would have been very nervous after that conversation with the RE. I’m proud of you for standing your ground! Good luck with your decision!!!

  11. April 10, 2012

    I’m with the majority on trust your gut. Our RE, too, told us that he will transfer two but depending on the quality of embryos also often recommends one. However, that is for fresh transfers.
    Fingers crossed!

  12. April 10, 2012

    If this feels right to you then it must be a good decision. I am a HUGE believer in gut instinct so I think everything you are saying sounds like it is the right decision for you. Logic is awesome.

  13. alexicographer #
    April 10, 2012

    I came over for the first time from SQ and now am back … what I’m going to say is somewhat inconsistent (maybe) with your plans but FWIW I’ll throw out a few things that guided my decision-making through this process (for the record I was considered absurdly conservative by the REs I was working with at the time, though that was awhile ago — 2003-2006, mostly — and I was older than you are — 34-37. I always insisted we transfer just 2, and for me that led to a total of 1 singleton pregnancy across 5 IVFs and 2 FETs. But, note, totally different situation (my issue was high FSH plus age) so don’t extrapolate from that to you).

    All that said, I was totally clear that for me, there were worse outcomes than never getting pregnant. Like, I’d rather the cycle not work than, heaven forbid, face preterm loss. So anything approximating a modest risk of twins (again, remember, different diagnosis, different era) seemed to me unacceptable. I also often found the question “If I try this and it doesn’t work, will I regret having tried it?” question a huge help to my thinking process. Again, for me, referring back to the first (worse outcomes) issue helped me frame that in terms of what outcomes I would and wouldn’t really regret (contributing to) causing.

    Last but not least I admit I’m puzzled by the thought that a FET makes transferring 2 a good strategy, unless it’s what you definitely want (e.g. if you desired twins). Given that the embryos are frozen, why not keep them that way until/unless they are needed, and just thaw and transfer what appears to be the best one? I do know there are good arguments against that approach (cost, financial and emotional), but, again, unless you want twins it’s far from obvious to me that in your shoes, those arguments would outweigh the advantages of single transfer.

    But mostly — best wishes for your success, whatever you decide.

  14. April 11, 2012

    I agree, trust your gut, go with one! If this isn’t successful maybe next time try two embryos but for now I agree with your logic. I also had “only” a 10% chance of twins with my set-up and guess what!!!

  15. April 11, 2012

    Like others have said, you should go with your gut. You have weighed the pros and cons for you and you know what you want. Good luck!

  16. April 11, 2012

    I would also say like many already have – stick with what you feel is right!! Especially since you have very good embryos! For me it was one of those things, that I just could not do two whatever the doctors or the statistics said. I just found it impossible to deal with the conflicting feelings I think I would have had if we had transferred two.

    I wish you all the best of luck with the transfer!!

  17. April 11, 2012

    Good luck with whatever you decide, not a easy one but I agree with the others, trust your gut and we will pray with you for a good outcome

  18. April 11, 2012

    Do what feels right for you. If two would add to the stress in a more negative way it might not be worth it. But only you know that!

  19. April 11, 2012

    Good luck on your decision:) BTW:

    I tagged you in a Q&A!

    http://itsgonnahappen.wordpress.com/2012/04/11/q-a/

  20. April 11, 2012

    This is so exciting. I think you all have made a good decision. I would go with two, though, but I have more fears of it not working with my crappy stats than worries about it working too (TWO) well.

  21. April 11, 2012

    It’s easy to drive yourself crazy with overthinking and researching and second-guessing decisions this big. You are smart (and it sounds like Mr. Husband is too:). Give yourselves a break and go with what feels right for you, then try not to second guess it. My husband and I are going back and forth between 1 and 2 fresh embies. I’m so terrible at making decisions anyway… I know I’m going to have to try to follow my own advice and just go with the one we’re most comfortable with and then leave it alone.
    Here’s hoping the universe sends you a sign tonight …and some peace of mind!

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