Our Journey

2002 Uterine Fibroid Surgery #1

2003 1st consult with an RE, you know, just in case

2003 Got Married (at 37 (me) & 34 (DH) years old)

2003/2004 Naturally conceived pregnancies BFPs #1, #2, & #3 and miscarriages #1, #2, #3

2005 Uterine Fibroid Surgery #2

2005 IVF #1, BFN #1

2005 IUIs #1 and #2, just because, BFN #2 & #3

2005 FET from IVF #1, BFN #4

2006 Exploratory surgery to remove scar tissue from fibroid sugery #2

2006 IVF #2 (w PGD), BFP #4

2006 Emergency cerclage for IC @ 16w6d (5 months + 1 week of complete bed rest at home ensues)

2007 Our son is born @ 38w by scheduled c-section

2007 IVF #3 for baby #2, BFN #5

2007 IVF #4, BFP #5, miscarriage #4

2008 IVF #5, BFP #6, miscarriage #5

2008 IVF #6, BFP #7, miscarriage #6

2008 DE IVF #7, BFN #6

2009 DEFET #8, cancelled, embryos don't thaw

2010 Decide to adopt domestically

12.17.10 Profile is live with our agency

November 2011 Consult with RE re: donated embryo cycle

Early January 2012 Cleared to proceed with deFET

January 2012 Freeze our profile

1.20.12 deFET begins
2.12.12 eSET of one compacted morula
2.22.12 BFN

3.23.12 deFET #2 begins
4.14.12 transfer 3 embryos (1-8 cell, 1-5 cell, 1-4 cell)
4.22.12 + HPT
4.24.12 Beta #1 = 48.4
4.26.12 Beta #2 = 125.7
4.30.12 Beta #3 = 777.8
5.11.12 1st U/S - Singleton!
7.12.12 It's a Boy!
12.26.12 C-section: Baby G is born, 9#5oz, 20.5"

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Elective Single Embryo Transfer

I cannot be pregnant with twins. It is not even a matter of desire (although I have never wanted to have twins). It is far too risky a proposition to even consider. My kind of incompetent cervix (rapid shortening with funneling) is not conducive to supporting a twin pregnancy. Therefore, I cannot knowingly put myself in a position to become pregnant with twins and must act responsibly and prudently when it comes to transferring embryos. (I am talking about becoming pregnant.  Me.  Wow.)

The six donated embryos were vitrified on Day 3 and frozen in two straws of three. Why any clinic would freeze donor/donor embryos three to a straw is beyond me. In fact, I posed that question directly to my RE and I can’t say that he had a good answer. He seemed to believe that it was, perhaps, the quality of the embryos that drove the decision to freeze them that way. And, by quality, I mean their cell count on Day 3. Since we now know that two fresh embryos (a 6 and a 5 cell) from the cycle produced twins, in hindsight I doubt they would have made the same decision. Nevertheless, that is the reality. And, I found out today that each straw contains one five cell and two four cell embryos. I am glad that I do not have to thaw both the five cell at the same time.

My RE is well aware of my physical limitations to being pregnant with twins. Still, he is a proponent of transferring two embryos. His own experience (and that of some researchers) shows that transferring two embryos increases the odds that one will take. But it also increases the odd that both will. And, therein lies the rub.

That these embryos are from young donors and that they are frozen three to a straw creates challenges to only transferring one. If all three thaw and live, my RE doesn’t feel that they will refreeze well just based on their slower initial growth rates. That means, possibly, that we pick the one that looks the ‘best’ and discard the other two. I see no harm, then, in growing the other two out and seeing what happens (no harm, right, if we were going to discard them anyway?), but I do see his point that even if they grow out and even if they are re-frozen, once thawed again they may not actually have the ability to produce a pregnancy (and why pay storage fees in that case?). So, something to consider should all three thaw well.

Another consideration if all three thaw well would be to grow them out beyond the requisite few hours to see that they are alive and viable and actually allow them to continue to grow for 24 – 48 hours. I already know that my RE is not a proponent of this. He ascribes to the ‘uterus is best’ school of thought and doesn’t want to risk an otherwise viable, thawed embryo to arrest just because it is in a culture medium. Point taken.

The situation that will be more difficult for me would be to have two survive the thaw. Even if one had a slight advantage over the other in appearance, if they were both alive, it would be far more difficult for me to not want to transfer them both. I won’t, but it is going to be much harder to say no.  Or, worse, if two survive but neither looks that great.  Ugh.

All of this, of course, it outside of my control and is nothing to obsess over. However, I do believe in having a well thought out plan in place so as to remove from the realm of possibility the discussion surrounding transferring two. We all have to be on the same page. And, I’m not saying that my RE won’t be supportive, he will, but I can see him making a sound argument for transferring two, especially if they both look so-so.

I am not a cart before horse kind of person, so at this point, I’m not thinking too far ahead.  I have been taking my meds as prescribed and have a lining check on Friday.  Let’s see if things are progressing nicely in there.  Most of the time, I can’t even imagine making it to transfer, so much of this mental acrobatics seems a bit premature.

“Worrying is like a rocking chair, it gives you something to do, but it gets you nowhere.”
~Glenn Turner

2 comments to Elective Single Embryo Transfer

  • Lut C.

    Tough, tough decisions to make and all sensible things to take into account.

    But first, good luck with the check on Friday.

  • You have been such a prolific blogger lately; I have been reading but hardly have time to catch up on commenting. Your post about being back in ART and knowing it was the end of the line stirred up some old feelings for me. And this one, these decisions you have to make about the tiniest of little lives balanced against your own limitations…it is just so nervewracking (and I just don’t get the three to a straw decision either – are straws really that expensive?). Anyway, such a change of emotional pace for you to wait for months, years in the adoption mindframe and then suddenly to the life altering (literally) decisions of ART. Will be thinking of you.

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