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  1. #1
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    Default Guidance on multiple embryos needed

    Afternoon everyone, just looking for some help from a newbie.

    DH & I are both 36, turning 37 early next year, 3 previous cycles in 2008 (1st cycle BFP, stopped growing at 7w, 2nd & 3rd BFN) but had to take extended break for multiple other family and business related reasons. Now changed from MIVF to Monash (Clayton) to start fresh.

    DH has absent vasa (CF carrier) so ICSI is our only option, I have had total thyroidectomy (Graves disease), also carrying a bit too much weight which I'm having trouble losing. We had discussed and agreed to give 2 embryos a go if we had two good quality after EC. IVF specialist and nurse have both advised against it, but we're desperate to get a successful BFP, was hoping doing 2 would give us more chance of that. I'm now starting to get worried that we shouldn't be trying multiple due to the risks they talked about.

    My paternal grandfather was one of a set of twins, does this have any bearing on our chances of ending up with more than 1 fertilising or splitting?

    Mixed responses from other medical professionals in my life so curious to see what people think that have been through similar situations? In an ideal situation I would have loved to have had twins and then we could be done with the IVF journey but now am getting worried about what risk I could be giving any potential viable embryos and also myself. But then scared about hopefully having successful PG now then going back to IVF again in a few years when I'll be older.

  2. #2
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    Hello, I've also had ivf so understand somewhat what you're going through. My clinic would only do 1 embryo unless advanced age/multiple failures/other significant factors. I don't think they would do it in your situation yet.
    We finally got our BFP and take home baby and she's now 12 weeks old. Personally knowing what I know now I would definitely not take the risk. There is always a chance that both could fertilize and one split = triplets. Small chance but it's a chance nonetheless. Even a twin pregnancy carries greater risks for mother and babies. I have a good friend who had 1 embryo transferred which split and she had a very risky pregnancy (look up twin to twin transfusion syndrome). My singleton pregnancy started off fine but I ended up very very sick and bub was in neonatal care for 2 weeks which was not a nice experience, can't imagine how bad it would have been if there were 2 in there. Early motherhood has been so much harder than I could ever have imagined and I'm traumatized whenever I think of what I would do if I had 2 babies right now instead of 1. Before we got our BFP a little part of me kind of hoped for twins but I'm so glad we have just one baby. She's had some difficulties and I wouldn't cope if we had 2. It might be ok if you have a smooth pregnancy, easy babies but of course there are no guarantees.
    Sorry to be so negative but for me I wouldn't risk it at this stage. I know how badly you want it and it's easy to romanticize twins but it is risky for you and them and bloody hard work once they're born. If the clinic is willing to do it then you need to do some serious thinking about what way to go and listen to people who have multiples to hear the positive (there are many also!) and negative. All the best with your decision making, it is so hard and I wish you every chance in getting your BFP and take home baby soon.

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    Hi. There is research that says that transferring multiple embryos does not increase the rate of live births. I can try to dig up a link if you like.

    As for whether there's a hereditary chance of twins, I'm no expert, but I think that if the twins are non-identical, there may be a hereditary link, but if they're identical, there's not? Could be wrong there. I think if they're non-identical, it's because of two eggs being released at once (which could be hereditary), but one egg splitting (identical twins) is just random luck of the draw.

    I would second PP about how hard twins would be - one's been hard enough!

    Good luck!

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    This might be off topic. Since DH has generic related disease, perhaps it is worth looking into PGD? If the embryos have chromosome problem, it doesn't matter whether you transfer one or two. It might be a wasted cycle. Also, graves is an immune disorder. Was it treated during your previous cycle and after transfer? This will affect your implantation success rate. Just a thought about things to discuss with FS for a better success rate.

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    Quote Originally Posted by JustJaq View Post
    Hi. There is research that says that transferring multiple embryos does not increase the rate of live births.
    This is what our specialist told us too. Ultimately it is more likely to just waste embryos than increase your chance of pregnancy. I would transfer one at a time and focus on perfecting your treatment protocol so that your embryo has the best possible chance.

    We did PICSI and used the Polscope technology for our 3rd (and successful) cycle. It helps the scientist to avoid damaging the embryo during fertilization.

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    Thanks for the responses.

    In relation to PGD, my specialist deemed it wasn't necessary to check the embryos for abnormalities because I'm not a carrier of the CF gene. She said if I had of been a carrier, PGD would be necessary but because I had got PG with very first cycle and I'm not a carrier she didn't think we needed to do it. I accepted that advice, now wondering if I should have pushed for more info.

    Technically I no longer have Graves as they took my thyroid in full. I'm managed with daily thyroxine but it wasn't under control when I was PG so they think that could have been main reason for the stopped growth. On a side note, my thyroid specialist rang tonight to say she wants me to have another blood test, wasn't happy with my results from yesterday's test. Bit worried now that IVF specialist might put a hold to IVF until thyroid under control.

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    Quote Originally Posted by babybeanie View Post
    Thanks for the responses.

    In relation to PGD, my specialist deemed it wasn't necessary to check the embryos for abnormalities because I'm not a carrier of the CF gene. She said if I had of been a carrier, PGD would be necessary but because I had got PG with very first cycle and I'm not a carrier she didn't think we needed to do it. I accepted that advice, now wondering if I should have pushed for more info.

    Technically I no longer have Graves as they took my thyroid in full. I'm managed with daily thyroxine but it wasn't under control when I was PG so they think that could have been main reason for the stopped growth. On a side note, my thyroid specialist rang tonight to say she wants me to have another blood test, wasn't happy with my results from yesterday's test. Bit worried now that IVF specialist might put a hold to IVF until thyroid under control.
    I've done single and double transfers... no take home baby yet... for us the cost of transfers was a factor... especially with my last FET we had 2 left... they were from an old clinic (we had moved to a new FS new protocol) both grade C so rather than doing separate FET with double the cost, we decided to transfer both so we could move forward with new clinic and egg collection if we needed to (which we did) ... the risks are there... but i think its balancing whats right for you individually to make the choice xx

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    Note that the evidence is low quality and a couple of years old:

    http://www.cochrane.org/CD003416/MEN...technology-art

    Cochrane reviews are meta analyses - they don't get their own data, they re-analyse all available information that meets Cochrane's quality criteria. The problem with almost all IVF data is that they lack adequate power - sample sizes and the number of influencing factors make it hard to tell if the results are biologically meaningful or if they happen by chance. Collecting data from multiple studies together is a good way to get around this lack of power.

    Buffy
    Last edited by buffalo speedway; 23-09-2015 at 22:43.

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    I'm not an expert on CF but I do know another couple whose DH is CF carrier (missing the van deferen as well). The child has the CF gene. Obviously, passing down from the father because she doesn't have it. Luckily, the baby doesn't have the severe type and health wise is OK. Some people can be very sick with CF. I guess it is up to you if you want to take the risk or be safe to get all embryos tested. I would do some reading. Sometime you just need to be a bit pushy and proactive in the entire IVF process because not FS are proactive.

    It is absolutely important to get thyroid monitored during the entire pregnancy. The medication needs to be adjusted accordingly for sure.

    All the best. xx

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    Double post
    Last edited by JustJaq; 24-09-2015 at 04:47.


 

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