FET after twin pregnancy issues

HI!  I haven't been on TS in forever, but I thought this might be the best place to potentially find ladies who have had similar situations.  My name is Amanda, I am 31 and DH and I have 5 year old B/G twins born as a result of our 2nd IVF cycle. 
 
Our 1st IVF cycle also resulted in pregnancy but immediately miscarried shortly thereafter.  We had 3 frozen embryos from that cycle but opted not to use them bc they messed up my medication during the egg-growing phase (can't remember all these terms, it's been too long!) and I ended up only on the stim meds for 7 days.  They got a bunch of eggs but all of them seemed to be immature and I think that's why I miscarried.  Possibly not, but that's always the belief I had in my heart and in a topic surrounded with pain and loss, it was hard to be objective!
 
So our 2nd IVF went very well and we became pregnant with our twins.  Everything was fine, super healthy pregnancy (I am very healthy as well) until 20 weeks when I went into pre-term labor.  They were able to place an emergency cerclage and stop labor.  After 3 months of hospital bedrest, my twins were born at 31 weeks.  We were very fortunate that they both made it with essentially no health issues. 
 
From that 2nd IVF we had 5 day 3 embroys frozen and one day 6 blastocyst.  We have just been putting off making a decision all this time, but finally decided we need to wade through all the emotional crap and make a decision.  So at this point we are looking at going ahead and doing a transfer.  It seems like with every question I answer, five more pop-up. 
 
One of the biggest issues I am trying to decide is how many to transfer.  I think my fertility doctor will suggest 2, but I know my perinatologist would throw a fit at the idea.  It seems foolish to risk twins again after what we went through, but it also is so costly for each transfer.  Everything about this is hard! 
 
If you made it this far, thanks for listening to my rambling.  Any advice welcome.

 

How many embryos did you put back the first time?

Remember your age now doesn't really affect the quality of the embryos, right? Wouldn't they be 5 years younger?

I think there are a lot of clinics that are going towards single embryo transfer, I would probably lean towards that. How much is the fet? Think about the cost of a second child if you were to get twins again... if you are worried about the cost I think it would be cheaper to try for just a single... and if that doesn't work, maybe think about a second fet with 2 embryos...

Ugh for all the emotional feelings again! The good news is a singleton after twins is easy peasy! Especially with older siblings. We had our bonus baby when our twins were 4 years old. So much fun to see them loving on her and being helpers!

 

First: it is so nice to see you here Amanda! :hug: and exciting news that you're considering another LO! So special. I am so happy for you!

I don't have personal experience with FET or trying for a second (or third one such as your case) but I know there has been a few ladies on here with a similar question. Most recent example i can think of is Rachael. She ended up transferring two embryos and it resulted in a single pregnancy. (Her little girl was born about two months ago)

My fertility specialist is also very pro single embryo transfer especially with fresh cycles. With FET and special circumstances he will transfer two but almost never will he transfer three. The only reason I had two transferred is because it was the only embryos to survive after 4 IVF attempts. I think it is a very difficult decision to make. Both financially and emotionally. However considering the complications with your first pregnancy I might consider trying one at a time, maybe the day 6 blastocyst first? Whatever you decide: Good Luck! And come post if you need some support through the process. Will be rooting for you and keeping you in my thoughts!

 

I actually wrote a whole post when I was feeding #3 at 5:00 am and lost it somehow. Let's try again!

So we decided last year to do a second IVF to try for #3. First IVF cycle, I was 31. We got 2 good embryos, transferred both, had twins. Second IVF cycle, I was 36. I went in adamant that I wanted a single embryo transfer. I felt I had good odds. Our issue is male factor. Fertility rated for women in my family are good, even at "advanced" age in late 30s and into 40s. I was sure I'd end up with twins again, and I didn't want that even though I love my twins. Plus, there is a lot of research over the last few years that single embryo transfer is as successful. It's more about the quality of the embryos. For me, at that point, not getting pregnant at all was preferable to having twins (deciding to have #3 was a hard decision for me and definitely something my husband wanted more), and I made that very clear every time I saw my RE.

Fast forward to transfer. When I was on the table for the transfer, my RE did a kind of emotional push for me to transfer two. I ended up caving. I spent weeks regretting it and being afraid. Then the u/s at 6 weeks showed two sacs, one with a definite baby and one that we couldn't tell. Long story short, two follow up u/s at the hospital perinatal unit later, and it was concluded that there was only one baby. Second sac was empty. My RE was practically gloating that he was right, two was the right decision, and he gave us exactly what we wanted--one baby.

It's all a little emotionally charged for me. I transferred two, and I do, in fact, have one beautiful baby girl that I wouldn't trade for the world. We don't know which embryo she was. Was she the A+ 10 cell that we were going to transfer if we only did one? Or was she the A+ 8 cell we decided to transfer at the last minute. It's impossible for me to say that I regret my decision given the outcome. But it was a very stressful few weeks. I wanted one, but you can't root against an embryo, particularly one that may be growing in your own body.

What I will say is that your RE wants numbers. He wants a successful pregnancy because that makes his stats look good and that's his job. His motivations aren't bad. But they are his motivations. Not yours. He would rather you have a twin pregnancy than no pregnancy, so in aiming for one he's going to err on the side of two above zero (I'm assuming--a lot of REs are starting to push single embryo transfer. Mine is very good but obviously not pushing single embryo.). For me, I wanted to err on the side of zero instead of two.

I can't say I regret my decision because everything worked out perfectly for me. I'm in love with my baby and I wouldn't change a thing. But I can also say that for me personally, at this point in my life, I would have been at peace with no pregnancy. I think that's the question you really need to ask yourself. If the choice was between two or none, what would you choose?

 

Thank you ladies.  Rachael, you are exactly right.  I would be more at peace with no pregnancy than with twins again.  Not because I don't love my twins, I do.  (I always feel like I have to justify my "I don't want more twin statements!")  Anyhow, I love my family the way it is right now and could very much be fine with it being complete.  However, I want another just bad enough that the thought of donating embryos to another couple breaks my heart.  Everything about fertility is hard! 
 
One thing I found since posting this is that studies have been done showing that FET cycles are more likely to have positive perinatal results, specifically higher birth weight and less instances of pre-term labor.  That makes me happy and gives me some hope.  My pregnancy was just so incredibly challenging and we were so fortunate to have the outcome we did.  My husband always says that it would be like asking for too much to hope for as good of an outcome. 
 
Anyhow, this gives me some good things to think about.  We have our initial consultation with our RE on Friday (phone consultation).  One of the other complicating factors of this is that our embryos live in Portland, Oregon and we now live in Westminster, Colorado (Denver basically).  We looked into transferring them here but the clinic here told us it was better to leave them there so we're looking at me needing to fly up there for each transfer which just adds another financial burden on top of the whole thing.
 
Also my health is a factor for me.  I feel like when I talk about this I sound super selfish, but it is what it is.  I spent years after fertility treatments and pregnancy getting my health back and I am not really wanting to turn my body back over to an RE who cares little about my long-term health and a great deal about their success rates.  I am going to ask about doing a transfer within a natural cycle to minimize the impact and I imagine FET is much less destructive than fresh cycles anyway.  
 
Ok well I am rambling at this point.  I will keep you all posted if you're interested.  Thanks for the replies
 
PS Maybell I transferred two the first time as well.  I wanted to transfer three the second time but my wonderful RE (who is retired now, sad) heroically talked me out of it which is a really good thing! 

 

I tried posting yesterday, but hit a random key and lost it. 
 
I had similar difficulties as you did. I had an emergency rescue cerclage at 22wks and then spent 13 weeks on hospital bedrest. It was so stressful and scary. For a long time I was terrified to even try again. 
 
Skip to this past summer when DH and I decided to try for baby #3. We did IVF #2 and both struggled a lot with how many embryos to put back. When it came down to the day, we went with 2. One was slightly lower grade. I was terrified and spent the next few days until my blood test hoping it was only one and feeling like a horrible person for thinking that. But Chris and I discussed it at length and while we both were hoping for 1, we had to be ok if it was 2. And our fears were based mostly on my history. We knew carrying one would be a lot easier on my body. 
 
Thankfully, we are now 20wks with one baby! I was very relieved when there was one little heartbeat. 
 
We do have one embryo left that we are very conflicted on. As of now, I'm done. But I changed my mind before, so we'll see. When our prepaid storage if over, if we haven't used it, we will probably donate it. But that is such a hard decision! 
 
Good luck and keep us posted!

 

Gina, I remember your story, thanks for posting!  Congrats on your pregnancy.  Did you end up having a cerclage with this pregnancy bc of your previous complications?  I know that after we meet with the RE we will also need to find a peri and set up an appointment with them.  My peri was never sure if I had IC or if it was just PTL that led to the dilation. 

 

Although it didn't feel like it at the time or while I was going through a second fresh cycle, in a way we are lucky that we didn't have any frozen embryos with either cycle. We had decided on donating to science or destroying if that wasn't possible. I may have considered putting them back off cycle or something. But I would not have donated to another couple. Call me a bad person, but I would not have done it. So I get how you feel.

 

I totally forgot to finish that thought! LOL
 
Yes, I did get a preventative cerclage at 12 weeks and started seeing a maternal-fetal specialist a few weeks after that. At my last MFM appt (last week) my cervix was 4.7 and stayed stable even with pressure applied. I couldn't believe it! I asked the doctor if he was sure about 3 times before Chris was finally like, "He's not going to lie to you!!" Hahaha! But it was never that long with the twins. It was a very encouraging appointment to say the least. (I don't know what it's been before that because I was too chicken to ask or find out.)
 
I did ask if it was the cerclage that made it that long and he said no that the cerclage is at the bottom and the length is all above the stitch. He says he's hopeful that my complications were the because of the added stress of carrying twins. Time will tell, but we are hopeful this go 'round. 

 

I will chime in as well.
 
We had twins born at 31 weeks as well on our first IVF-ICSI of two transferred. We froze two 6 day blasts.
 
When the twins were 3, we attempted a FET. We talked and talked about how many to put back....and decided to wait and see depending on how the thaw went, etc. My high risk Dr wanted ONE if both looked healthy, as did the RE. My twin pregnancy was very high risk, but I felt our family was not complete.
 
A compromise to all the FET meds & physical stress was to do a 'natural' FET with  no meds but progesterone support post transfer.
 
We had three frozen. Two good looking ones and one not so good one.We  attempted to thaw them all to determine the best one and as we drove to transfer--- we got a call that  none survived the thaw. It was devastating. Statistically it was very unlikely, but someone has to be that little percentile.
 
I have been hoping for a *bonus* pregnancy ever since, but so far no luck.
 
I wish you luck and that everything goes smoothly. Majority of the FET stories I hear are positive and many transferred two that resulted in one baby. Almost everyone that I know that did a FET post IVF said it was less stressful and a smoother pregnancy (if they had one prior).
 
BEST WISHES!!! I totally understand all the stress that swirls around infertility :grouphug:

 

KCMichigan, thanks for chiming in.  It helps to hear all the perspectives.
 
Gina, have you done any kind of bedrest during this pregnancy so far?
 
We had the appointment with the RE today and she recommended growing out the day 3 embryos, choosing the best blastocyst, and transferring only one.  I have to say I wholeheartedly agree with that.  I know that embroys can look beautiful and linings can be perfect and all the stars can align and it can still not result in pregnancy, but as Rachael pointed out earlier, I honestly would rather have no pregnancy at this point than run the risk of twins and having the outcome not be as good this time.  We won't do anything for sure until after the first of the year and honestly with our penchant for procastination, it will probably be closer to next summer but I will let you all know when we start.  I am going to do the estrace/progesterone protocol only instead of adding in the BCP and lupron.  So it'll be fast when we do go ahead!  Hopefully we don't end up with a bunch of blastocysts because that would just take us back to square one and be pretty depressing.

 

That sounds like a great plan Amanda. I am excited for you guys. Good luck! :hug:

 

The only bed rest I've done is the standard day or so after transfer and then 3 days after my cerclage.
(Confession: after the cerclage my doctor said 48hrs was fine and to take it easy, etc. But no one was there when she said that, so I stretched the truth to Chris and my MIL just a tiny bit....)

I'm not working this time around, so while I'm not on bed rest, I am able to take things easier than last time. I still do all the normal household chores, walk the dog 2-3 times a day, and all that. But on days I'm tired, I rest more. That's been a nice thing about the twins being in school now.

 

I also had a personal experience with IVF when we got our baby Sammy the first time. We had already tried a lot of methods for TTC but unfortunately we'renot lucky to have one until one of my friends told me about the company named Placidway who can help me about this matter. So, I gave it a try and ask for their help and they intrduced me this IVF process. About your issue, if I were you, I would prefer to have just a sinlge embryo because it is not easy to bear a child most specially if it's a twins. You already have a healthy twins and so why not try to choose to have a sinlge child after that. Practically speaking, it is better to take care only one baby rather than having two babies to be taking care of at the same time, right? Also, if you want to have a lesser expenses with this then a single embryo will do.