Transfer 2 vs. 3 embryos?

[allgood427]

Hi,
DH and I are on our second IVF attempt due to his low sperm motility.  Our first cycle we transferred 2 embryos and did get a BFP, but miscarried at 8 weeks.  We later found out that I have MTHFR, which we hope was the reason for the miscarriage and feel very positive about it working this next cycle.  I have increased my folic acid intake and of course, take my baby aspirin every day.  We will also start Lovenex shots the day of the transfer.

We just got the call from our RE that we have 7 embryos, 3 look really good, 3 look ok, and 1 not so great.  They want us to do the transfer tomorrow (day 4).  They also encouraged us to transfer 3, which really took us by surprise b/c they have always been really against more than 2 so it kind of scared me when she said 3, b/c I started thinking that our embryos must not be very good.  Our nurse just told me that was what the embryologist recommends and she wouldn't have done that if we hadn't already had a failed cycle.  She said the odds of us having triplets is still less than 10% but twins does go up to about 30%.  DH and I are ok with twins, but triplets is a little scary.

What would y'all do??  I'm worried that we won't have any embryos to freeze (again) and have to do this all over again if this doesn't work or for the next child (unless we had triplets...then we are definitely done!)  

I am 28, in good health, but haven't really produced many eggs, or had any to freeze, which disappoints me, especially since our "issue" is more DH's sperm motility.  Frustrating!

Please give me some advice!
Thanks,
Sara

[allgood427]

MTHFR is a genetic mutation that causes small blood clots, which prevent the baby from getting the nutrients that it needs.  It also keeps your body from converting folic acid.  From what I understand, there are 2 strands of DNA and then 2 genes of this particular mutation on it.  So, you can have multiple kinds of mutations, some are worse than the other.  Heterogeneous is when the mutation is just on one strand of DNA and homoegenious is when it's on both.  I have a homogeneous version, but it's just 1 of the two genes mutated on each so not as bad as as it could be.  Basically, the treatment is a daily baby aspirin and extra folic acid and then, after the transfer (or if you find out you are pregnant and you know you have MTHFR), daily shots of Lovenex, which is another type of blood thinner.  I've been told that staying on the baby aspirin regimine for the rest of my life is wise as well, since it is a blood clotting disorder and to maybe see a doctor about it later.  I don't think they are too worried about it though.  Again, depends on how bad your mutation is.

Thanks for the well wishes everyone!

[foxylady62903]

I transferred 3.  I also have MTHFR, 1 copy though, and on the same med protocol as you with the Lovenox and baby aspirin and Neevo (a special prenatal that has all that extra vitamins and whatnot that we need since we don't absorb everything that we need during pregnancy).  My RE actually waited until day 6 to transfer since during my 1st attempt at IVF we had 1 embie left over by day 6 that looked so much better than the 3 that were transferred on day 5.  I am not 11 days out from my transfer and took a HPT this morning with a totally positive result.

I miscarried 6 and a half weeks after my 1st IVF. My RE also thinks that I may have miscarried and haven't acheived a pregnancy with all our IUI attempts and also naturally because of the blood clotting disorder, but he can't say for sure.  Nothing in medicine is black and white, it's all gray.

Lots of sticky baby dust to you and your 2 embies!

[nshapland]

What is MTHFR? Thanks

[allgood427]

Thanks for all of the advice!  After all of that, we didn't even have to make that decision.  When we went in for our transfer, our embryologist said that the embryos were looking much better, so her recommendation would only be 2, which we were happy about.  So, I have two new babies in my belly now!  They looked really good and she was very pleased.  She also did assisted hatching to help them out since I had such a delayed implantation last time.  I feel so much better this time around because we transfered on day 4 instead of day 3 so the embryos were much further along and easier to determine quality.

Now, on to the dreaded 2ww!  thanks again for all the advice, support and prayers!

[feather2e]

I would recommend going for 2 especially if they are good quality.I would ask specifically why they are pushing 3 after you got pregnant before with 2. If 3 did happen to take you might not like the option of selective reduction and triplet pregnancies carry alot of risks.

[kris71]

i just had my day 5 transfer yesterday and I also had 3 i could have put in. The dr said he recommended 2 but with my age of 38 and inhibin B borderline (this determines egg quality), it was up to me if i wanted to do 3. I opted for 2 because i got scared of the possibility of of triplets but 2 was also the dr's recommendation.i wound up freezing that 3rd and got a call this morning that i had an addiitional 3 they they froze as well (they were monitoring them yesterday to see if they would make it to day 6) I think you need to do what feels right but i would go with the dr's recommendation as they have experience with this thing but also you have to feel comfortable with the decision and not worry about what you have left to freeze.  My dr said usually 1 out of 4 doesn't make it through the thawing. anyway good luck and keep us posted!

[Kristyingeorgia]

Cant wait for your update!! :-)

[dorti]

I had to go through four ivf to get positive results. I did three fresh cycle - all failed. First one trf 1 embryo (that's all I had), second ivf trf 3 embryos, third ivf trf 3 embryos. After the third one I had four embryos left frozen. I did my fourth cycle (frozen one, did not really think I had a chance), from four frozen embryos only two survived the thawing. But it worked! Now I am 20 weeks pregnant with twins! Yesterday I found out it is a boy and a girl (certain for 90%)! Additionally I am not a youngest chick any more I am 39 YO :). I am still taking baby aspirin (I was told to take it until week 36).  

[usuk]

my DH wants to believe it too. i lost one at 14 weeks. stopped growing at 12. but they tested the baby and it was not chromosomally abnormal. then again at 9 weeks when it had a heartbeat at 8. the third never even made it. so it would be nice to know the folic acid an the baby aspirin will help. let us know how it goes tomorrow... :)

[allgood427]

Thanks for the advice, i hadn't thought about asking about doing some good and some ok embryos.  then, we might have a better chance of freezing some as well.  i will call and ask this afternoon.

usuk, my RE hasn't said he can't guarantee that the MTHFR is what caused my miscarriage, but it helps put my mind to ease that that's what it was.  we were such a random case (long story, but very delayed growth with everything being a week behind, but we did IVF, finally seeing a heartbeat at 8 weeks, but then it stopped the next week).  It would make sense that we had a good baby, it just wasn't getting the right nutrients b/c of my MTHFR so it tried and tried and even had a heartbeat, but just couldn't survive. I have to believe that that's what caused the miscarriage or else I will drive myself crazy wondering about the "what if's"

I just don't know what to do!  But, your advice is always appreciated!

[usuk]

do the 3. they are always against triplets so they are not suggesting this "willy-nilly."

btw...i have mthfr and had 3 mc but no one will say that was the cause. has your RE said it is???

good luck :)

[mhv]

Sara,

I would go ahead and do 3.  We actually did 3 on 2 of our transfers... Do you know if they are going to transfer all 3 of the "really good" ones... or 2 of the really good ones and an "ok" one?  If it's the latter.... I would definitely do 3.

Good Luck and I am praying you get a BFP!!!!

Melissa

[Ready_2_be]

Sara: Don't worry about how many embryos you are left with for freezing. My hubby and I ended up with only 4 embryos by the time of the transfer so the RE transfered 2 and only had two to freeze. Just like you this really worried me, but now I am 18 weeks pregnant with twins and wonder when I would be even able to use the other two embryos. Which makes me sad for those other two.I probably won't be able to go back for them for 2 years.

So go to your transfer tomorrow relaxed!!!

xo
Renee

[kele1129]

We did 2 embryos the first try and got a BFN. For our second and last try we did 3 embryos and have one healthy 14 month old son now. We too were a bit nervous about triplets but were willing to take that chance.