it’s more important to be pregnant

I am leaving this post public as I feel like women in my position are often looking for a clear answer about the number of embryos to transfer.  I don’t think there’s a clear answer at all, but I want to share my thought process.

I began this cycle thinking that if we made it to a Day 5 transfer, that we’d seriously consider transferring a single embryo.  At my last three monitoring appointments, I raised the issue with my doctor in different ways.  I was looking for the argument that would convince me, and really convince Mr. Hope, that one was the way to go.

I don’t think it worked out that way.

Let me be clear – twins are not and have never been my goal.  I am scared of a twin pregnancy and the increased complications that it would mean.  I am scared of sick babies.  I am terrified of the NICU.  These are the reasons I would do a single embryo transfer.

There are things on paper that make me a good candidate for an eSET.  I am young.  I am a good responder to the medications.  It seems we will have good quality embryos to choose from.  We have a child already.

But it’s not as simple as transfer an embryo and ~poof~ I’m pregnant.  This isn’t my first cycle; this isn’t even my first transfer since having a baby.  And it’s not like I got pregnant on my first cycle before, either.

It took several surgeries, two canceled cycles, a miscarriage, and another failed FET to get here.

If we transfer one Day 5 embryo, and the cycle fails, I know my doctor will probably say that they probably chose the wrong embryo.  I don’t think I can bear to hear that as a valid argument.

This is what I picture if that scenario were to come true: a month off because of cysts, another HSG with more polyps or scar tissue, which means another hysteroscopy, another attempt at a frozen cycle where maybe my lining grows and maybe it doesn’t, leading to potentially another cancellation.  Another debate with Mr. Hope about whether or not to continue.  And he might just win this time.  And I will regret making the decision to transfer one.

If we transfer two Day 5 embryos and get a negative, it could still be argued that we had really bad luck and they chose two wrong embryos, but it will be much harder to do so.  And I will feel clearer that perhaps my uterus was more the problem than our embryos.  Don’t get me wrong, that will be difficult to deal with, but it impacts our future decision-making.

On Saturday, my doctor asked this nearly impossible to answer question, “Is it more important to be pregnant or more important to not be pregnant with twins?”

I couldn’t answer at the time, but I have been mulling over the question since.

I think, after another year of fertility treatments, surgeries, and endless waiting, it’s more important to be pregnant.

~ by Larisa on January 29, 2010.

15 Responses to “it’s more important to be pregnant”

  1. Yep, I agree. It took 21 transferred embryos, 18 of which were blasts, to get Adam. Like you, I see the risks in a twin pregnancy, and it’s not something I would choose. But given our history you can bet that we’ll be transferring more than one this cycle if we have them.

    Good luck with ET!

  2. How I wish there was an easy answer to this question for you. As with most questions when you’re dealing with infertility, there’s not a clear cut “yes” or “no”. Which I know is so incredibly frustrating. I say maximize your chances as much as possible. You have a wonderful doctor and his resource of experts at your disposal if you end up pregnant with twins. His question is an interesting one and I would say at this stage of the game, it’s more important to be pregnant. But that’s just me. Whatever you decide, it will be the right choice for you and your family, and one that was made with the utmost thought and consideration.

  3. You know I’ve never been in this position, to really have much choice being that we always had to transfer everything that looked remotely good on day 3, but I would definitely transfer two. I think you’ll get this without offense (none meant of course!) but I don’t think of you as the ‘typical’ eSET gal. I think two blasts is a good plan, but that’s just my opinion for what it’s worth!

    So glad you have a choice, even if it is a hard one to make.

  4. I think what will happen is what needs to happen for you. You have come so far. It sounds like he believes that you have a higher chance of pregnancy with 2 embryos. I believe, with nothing more to go on than what I know of you online, that closing your eyes and jumping in with both feet is an okay choice. The zen saying goes: “Leap and the next will appear.” Especially when you’re jumping off with Dr. S nearby, and your husband, and your daughter. Your net will be there.

  5. That really is a great, yet incredibly difficult, question to ask. Especially since twins, while scary, are manageable. I think everyone understands that you feel it is more important to be pregnant. If it weren’t, you wouldn’t have gone through all the pain and heartache you have to get there. You are a strong woman, have a great dr, live in a area full of top notch care. And maybe just maybe luck will be on your side this time! Good luck with the transfer! I hope and pray it is perfect!

  6. I agree with you that it’s more important to be pregnant. I think you would regret transferring only one if the cycle failed and that would be a huge thing to carry this being your last fresh cycle. I know your scared of twins ( I was too ) but if it does happen you would be okay. Maybe even better then just okay with 3 beautiful little kids. Outside of the fertility stuff, would you be more at risk then any other woman carrying twins? Healthy twins are born all the time. And this might sound weird but I still remember the NICU with Erik as being one of the most peaceful places I can think of. Even if you have to go the NICU route it isn’t always so bad. Anyways, good luck with your choice, but it already sounds like you know what you want to do.

  7. Go with 2!!!! You are making the right decision! And I totally understand your reservations about twin pregnancy with our education and background! But you of all people can handle twins or anything that comes your way! And the upside is so worth it!!!! Good luck on your decision!

  8. I agree, but I transferred way more when I get pregnant with my second daughter. I transferred 4, mostly because of my AMA (41) at the time, although 2 were not of the greatest quality. Two started, one made it past 6 weeks. I feel so lucky and blessed. I was also terrified of twins, I’m very small but it worked out OK, and both my husband and I agreed it was more important to be pregnant.

  9. Sounds like you have really thought it out… and will be comfortable with what you decide is best, at this moment, for this cycle. Will be thinking of you- Good luck!!!

  10. After last years failures the scales have tipped for me too. If, next time, there are two to transfer, I will.

  11. The infertile mother knows too much about so many things that might go wrong, and because we can’t undo all the knowledge and bask in the “bliss of ignorance” every decision sucks. It’s a moot point for me to wish we could have the innocence of women who can easily breed.

    A twin pregnancy is scary, but it’s also within the realm of normal. Your doctor is really smart. He so often has known what to say to you, and he has proven that he cares about you as an individual and not just as his patient. I completely understand that you trust his judgment.

    If you do end up with a scary twin pregnancy there is no guarantee that it will go smoothly, but there is no guarantee that it will be a nightmare either.

    I hope I’m not coming across preachy or pollyanna. I know there is nothing I can say to comfort you, but I do hope you go with two.

  12. It’s so funny to find your blog today on LFCA. Yesterday, I transferred two not-so-great blasts after saying for MONTHS that I would only do eSET due to the risk of twins. But when I’m facing the doctor and she’s telling me the odds aren’t great for pregnancy with one or two, and we may not have any to freeze…I made the same decision you did. I couldn’t transfer just one and then live with the regrets if it failed. I do no want a twin pregnancy. But I want a pregnancy more.

  13. Here from the round-up. What an eloquent way to share your thought process on likely one of the hardest decisions you’ll have to make. I appreciate the openness and honesty of this post.

  14. Here from the Roundup. I also didn’t want twins at all, but agreed to transfer two for both IVFs because it upped the chance of a singleton from 30% to 50%. Then I ended up with twins from IUI.

    The pregnancy was full of complications, it was quite dicey with threats of preterm labor and a month-long prenatal hospitalization, and my babies spent over 2 weeks in the NICU, but I couldn’t be happier with how everything turned out. There was a lot of worry that they wouldn’t arrive safely (or at all), but now that they’re here and doing great, it’s so fantastic to have twins.

    Hoping that whatever you decide and whatever happens from there turns out well for you.

  15. I have twins. IVF twins, from IVF #5. I made it clear I didn’t want twins. I made it clear that twins were not the goal. While pregnant with twins I was sick as a dog and all three of us were hospitalized repeatedly. They were born early and born sick. We’ve been behind. They are the great loves of my life and I cannot imagine living a single minute of life without them. And yet every time I hear an IF mom saying she wants twins, or saying “to hell with the odds, I just want a baby!” I want to punch them, because those moments in the hospital with your high-risk pregnancy and the huge uncertainty if you’ll all make it out – those are the ones that still make me cry.

    Kudos to you for thinking things through carefully and calmly. I honestly, truly wish you the best of luck.

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