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eSET vs multiple pregnancy


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#1 a-baby-inshallah

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Posted 22 October 2010 - 03:23 PM

I was wondering what everyone's thoughts/experiences are with the elective single embryo transfer. my husband and i would love to have twins, but we are scared of the risks during pregnancy plus, the health of the baby. i know that when you transfer two embryos, there is a chance that it will result in a singleton pregnancy, but the thought of a 2-embryo transfer working and resulting in a twin pregnancy scares me. i am just being honest and dont mean to be disrespectful to any mother out there who want/have twins. i am just very, very scared. any ideas/thoughts/experiences? sending baby dust to everyone!

#2 tmariederm

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Posted 22 October 2010 - 05:17 PM

There are many factors (age, response to stims, health factors etc.) that go into the decisions but I think most of us here would say that your RE's (doc) opinion should be heavily considered.
"To accomplish great things, we must not only act but also dream, not only plan but also believe." Anatole France

#3 bal

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Posted 22 October 2010 - 05:28 PM

Hi,
I guess it would depend on your age and situation. I transferred 2 embies on my fresh, 2 on FET1 and 2 on FET2. I have one DD from those 6. I now transferred 3 and am on 2WW. Twins are scary, but no baby is even scarier...
Me 41, DH 41
TTC - since Nov '04
2005 - TTC Naturally
2006 - IUI w/clomid x 4 - all BFN
2007
Feb - 1st appointment with RE
Lap to remove ovarian cysts
IVF #1 July - Cancelled / only 2 follicles
IVF #2 Sept - ICSI 13 / 2 transfered, 4 frosties BFP m/c 5 wks
2008
FET #1 Jan - AH 2 blasts BFP DD born Oct 2008
God, Thank You for our miracle baby!
2010
FET #2 Feb - AH 2 blasts BFP m/c twins 8wks D&C
Lap to remove ovarian cysts
Histeroscopy to remove polyp in uterus
IVF #3 Oct - ICSI 3 blasts BFN
2011
IVF #4 Jan - ICSI 4 blasts BFN
IVF #5 May - LAST!
ER May 19 - 19 eggs retrieved, 13 fertilized ICSI
ET May 24 - 3 blasts transferred - 5AA, 5AA, 4AB No frosties
HPTs since 5dp5dt -> 7dp5dt all negative
June 1st (8dp5dt / 13dpo)- HPT very faint BFP
HCG 6/2-61.33, 6/4-217, 6/5-328, 6/7-836, 6/10-2,493(22dpo)
U/S 6/20 - HR 116bpm EDD Feb 8, 2012
June 30 - SCH diagnosed - bedrest
July 25 - SCH gone! NT - 0.18cms
Aug 10 - 14 wks - Complete Placenta Previa Dx - bedrest
Aug 19 - 15 wks - No measurable amniotic fluid - bedrest
Sept 16 - DD delivered stillborn at 19w1d. RIP my angel.
Done TTC

#4 a-baby-inshallah

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Posted 22 October 2010 - 06:09 PM

Thanks for the response. I am 37, responded excellently to the stims, got a lot of eggs at ER and have my ET on Monday, inshallah, as we say. My doctor is not in favor of a multiple pregnancy, but it is such a gamble to transfer just one. and such a gamble to transfer two- i would hate to see it all ending in tears if god forbid something happened to the babies. we are playing the lottery! Thanks, girls, for replying. +EMBRACE+

#5 bal

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Posted 22 October 2010 - 06:24 PM

Everything will be clear on Monday, God willing.
Let us know what you ended up deciding, ok?
Me 41, DH 41
TTC - since Nov '04
2005 - TTC Naturally
2006 - IUI w/clomid x 4 - all BFN
2007
Feb - 1st appointment with RE
Lap to remove ovarian cysts
IVF #1 July - Cancelled / only 2 follicles
IVF #2 Sept - ICSI 13 / 2 transfered, 4 frosties BFP m/c 5 wks
2008
FET #1 Jan - AH 2 blasts BFP DD born Oct 2008
God, Thank You for our miracle baby!
2010
FET #2 Feb - AH 2 blasts BFP m/c twins 8wks D&C
Lap to remove ovarian cysts
Histeroscopy to remove polyp in uterus
IVF #3 Oct - ICSI 3 blasts BFN
2011
IVF #4 Jan - ICSI 4 blasts BFN
IVF #5 May - LAST!
ER May 19 - 19 eggs retrieved, 13 fertilized ICSI
ET May 24 - 3 blasts transferred - 5AA, 5AA, 4AB No frosties
HPTs since 5dp5dt -> 7dp5dt all negative
June 1st (8dp5dt / 13dpo)- HPT very faint BFP
HCG 6/2-61.33, 6/4-217, 6/5-328, 6/7-836, 6/10-2,493(22dpo)
U/S 6/20 - HR 116bpm EDD Feb 8, 2012
June 30 - SCH diagnosed - bedrest
July 25 - SCH gone! NT - 0.18cms
Aug 10 - 14 wks - Complete Placenta Previa Dx - bedrest
Aug 19 - 15 wks - No measurable amniotic fluid - bedrest
Sept 16 - DD delivered stillborn at 19w1d. RIP my angel.
Done TTC

#6 a-baby-inshallah

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Posted 22 October 2010 - 06:28 PM

Everything will be clear on Monday, God willing.
Let us know what you ended up deciding, ok?

and best wishes to you- for tomorrow, right?

#7 bal

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Posted 22 October 2010 - 06:44 PM


Everything will be clear on Monday, God willing.
Let us know what you ended up deciding, ok?

and best wishes to you- for tomorrow, right?



THANKS!!!
Me 41, DH 41
TTC - since Nov '04
2005 - TTC Naturally
2006 - IUI w/clomid x 4 - all BFN
2007
Feb - 1st appointment with RE
Lap to remove ovarian cysts
IVF #1 July - Cancelled / only 2 follicles
IVF #2 Sept - ICSI 13 / 2 transfered, 4 frosties BFP m/c 5 wks
2008
FET #1 Jan - AH 2 blasts BFP DD born Oct 2008
God, Thank You for our miracle baby!
2010
FET #2 Feb - AH 2 blasts BFP m/c twins 8wks D&C
Lap to remove ovarian cysts
Histeroscopy to remove polyp in uterus
IVF #3 Oct - ICSI 3 blasts BFN
2011
IVF #4 Jan - ICSI 4 blasts BFN
IVF #5 May - LAST!
ER May 19 - 19 eggs retrieved, 13 fertilized ICSI
ET May 24 - 3 blasts transferred - 5AA, 5AA, 4AB No frosties
HPTs since 5dp5dt -> 7dp5dt all negative
June 1st (8dp5dt / 13dpo)- HPT very faint BFP
HCG 6/2-61.33, 6/4-217, 6/5-328, 6/7-836, 6/10-2,493(22dpo)
U/S 6/20 - HR 116bpm EDD Feb 8, 2012
June 30 - SCH diagnosed - bedrest
July 25 - SCH gone! NT - 0.18cms
Aug 10 - 14 wks - Complete Placenta Previa Dx - bedrest
Aug 19 - 15 wks - No measurable amniotic fluid - bedrest
Sept 16 - DD delivered stillborn at 19w1d. RIP my angel.
Done TTC

#8 nervus optmist

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Posted 22 October 2010 - 07:58 PM

I did a lot of research on the subject - in europe and in australia they are really pushing for single embryo transfer (in some countries it is the law) and so they have a very large sample size to look at across ages, Dx and other factors. at the end of the day - you are equally likely to get PG with SET - it just might take a tiny bit longer - there are almost no risks to freezing and huge risks to multiples (that being said there are lots of healthy multiples out there, but no one can argue that the potential risks are very serious).

last year there was a group that evaluated the idea of publicly funded IVF in ontario and they made strong recommendations for covering IVF on the condition that it be mandated to do SET as the default, and multiple transfers in specific situations only. the research showed this would lead to increased health for moms and babies and save the province a lot of money (that's right - the province should pay for IVF to SAVE money, just by doing SET)

at the end of the day you and your doctor will decide what's best for you - however the default answer for doctors here is to put in 2 and the default answer for docs in europe is to put in one.

we said right off the get-go that we were only prepared to do a SET - our doctor wanted us to do multiple and we just didn't feel comfortable with it for us. at the end of the day it was irrelevant as we only ever had 1 embryo from each cycle, but it was something we decided anyways.

on a side note - if you have lots of embryos to freeze and you want to do SET with your FETs, you need to ask your clinic to freeze each embryo in it's own straw - they typically freeze 2-3/straw and then each time you do an FET they thaw a straw (does that make sense). It is their default so if you want something different with your frozen embryos you should make sure they are aware.

best of luck whatever you decide!
wishing you lots of luck in your cycle
:flowers:

I am 33, DH - 35
Genetic - IVF&PGD to prevent Genetic Disorder
IVF #1 - Nov/08 - MC @ 6 weeks, no embryos frozen
IVF #2 - Aug/09 - bfn
IUI #1 - Feb/10 - ectopic
PRIDE - Apr/10
Homestudy - July/10
Given the gift of donor embryos - Jan/12
Donor FET Jun/12 - 9 weeks - no heartbeat... MC
Donor FET Oct/12 - we're PG biggrin.png

===> Beautiful baby boy born June 2013 babyboy.gif


#9 foxburybaby

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Posted 22 October 2010 - 08:32 PM

My first IVF we transferred 2 embies..and as my Doc had all but promised, we got pg with twins. We lost that very healthy pregnancy at 21 weeks..something I NEVER want to go through again (it was due to an incompetent cervix, which of course you don't know you have till it's too late..). 2nd time around, we did eSET and got pregnant. My pregnancy was excellent and with the help of a circlage I gave birth to a healthy baby boy. Everyone is different, my story is probably not the "norm". Everyone's body and pregnancies are different. For me though, eSET is the way to go, because I don't want to risk putting myself through another twin pregnancy. Now my Dr.'s clinic is focused on singleton pregnancy when the situation is right.

Good luck with whatever you choose and may it lead to a happy and healthy pregnancy either way!

PS. I don't mean to offend any twin momma's or hopeful twin mommas..I'm just sharing my thoughts and experience.
Me 31 Hubby 32
PCOS Dx'd at 16
TTC naturally for a year. Then started clomid x 6 months..not even close to O'ing!
Referred to Dr. Virro/MFC
July 2006
IVF # 1 5 Eggs Retrieved
1 died..4 fertilized
Transfered 2 "Perfect" Embies
Froze 2 "Perfect" Embies
BFP!!! Twins!! B/G
Preterm Labour at 21 wks due to IC
My Angels were born and returned to Heaven January 3rd, 2007
June 2007 FET--Chemical
August 2007-Adoption opportunity presents itself!!
Our Son is born March 2008..the best day of my life.
December 2008--IUI # 1--Chemical
March 2009--IUI #2 -- Cancelled after 3 weeks of Stims..0 response to meds!
May/June 2009--IVF # 2
After 12 days of stims...25 follies measuring 1-2 cm's..retrieval booked for June 4th
Retrieval day...23 follicles retrieved...20 fertilizied!! HOLY COW!!!
Day 3--17 "Oustanding" 8 cell or more and 3 average
Transfer booked for June 9th
One "Spectacular" Embie transfered June 9th
2ww :(
faint bfp 5dp5dt..not getting excited until my beta comes back
darker on 7dp5dt..still holding back the exctitment till the 22nd...
8dp5dt's pee stick..test line is just a shade lighter than the control line..I'm happy and can now stop daily POAS. Still waiting for beta on the 22nd......
Beta # 1-June 22nd : BFP..898!!!
July 6th--First u/s...1 little one..good heartbeat and measuring exactly right for Feb. 24, 2010 Due Date :)
July 13th--2nd U/s..hb is 150bpm and adjusted due date of Feb. 25, 2010
July 27th--3rd u/s due to cramping...hb of 173 and measuring 2 days ahead at 10weeks. Everything looks good!
Aug. 19th--4th u/s. Baby looks/measures perfect. Was moving, kicking and mooning lol. Very happy :)
Next u/s will be at 18wks....
18wk 6day u/s shows we are having a BOY Baby measures exactly right..except for long legs measuring at 20 wks! Showing partial Placenta Previa..so back in a week for another u/s!!!
Brodey Jonas born Feb. 18th, 2010 weighting 9lb 8oz's! 21 inches long and healthy!
Getting ready to make our family bigger!! FET in November
eSET FET November 25th--1 excellent blast transferred. 2ww...ugh
SUPER faint-hold-it-in-only-natural-light-and-wiggle-the-stick-around-now-do-you-see-it BFP 4dp5dFET
5dp5dFET--Line is there and although super faint does not need to be manipulated to be seen!
12dp5dFET--BETA is 584!!! Woo Hoo!!
First u/s! All looks perfectly on track. HB is 112!
Jan 4th 2011-2nd u/s. Saw baby moving..hb of 173. Blood sacs around the baby..to be followed up next week with another u/s.
March 21st u/s shows everything looking exactly as it should and shows that we are expecting another BOY!!



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#10 a-baby-inshallah

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Posted 22 October 2010 - 08:47 PM

Nervus Optimist and Foxburybaby Thanks for your amazing and wonderful responses. My doctor is not in favor of multiple pregnancies. I have so many friends with twin babies that I just thought it was the norm when you have IVF. When I went to see him he said he is in favor of the eSET. DH says that "we want a healthy pregnancy, not A Pregnancy" so he is in favor of the eSET. I am so happy the eSET worked out for you, and NervusOptimist, I am sending positive vibes and prayers your way!

Foxburybaby Were your embryos of superior quality if you dont mind my asking- if you do, feel free to ignore my question. Reason being, I am told that an eSET is best suited for those with high quality embryos (unless you dont have the best, and dont have a choice ie in my case, I dont know anything yet...). Thank you.

#11 Ope

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Posted 22 October 2010 - 09:25 PM

Embryos do much better in the womb , where they belong. Some embryo may survive in utero, but won't in the lab. If you have lots of good quality embryos, you can afford to do 5 day blast transfer and eSET. However, many IVF patients doesn't have this luxury.
This is something that you only will know once after ER and fertilization. When we did IVF I was 32 had great FSH , and no problem with me, we did IVF because of dh's sperm had low morphology. Well, despite my age, great FSH , I wasn't responded that well to stimulation, we got 11 eggs, but only 6 were mature, 5 fertilized. On day 3, we only had 2 quasi good, and 3 not good embryos.
We transferred the 2 acceptable quality , the others were not good for freezing. I got pg with a singleton, and had a great healthy pregnancy and a wonderful baby boy.
If we had been pushed toward eSET and 5 day transfer, probably none of our embryos would survived until day 5, and we won't be parents now.

Also i want to comment on the notion that many EU countries push eSET or even only allow eSET. This may be true, but in those countries , the government pays 100% for IVF and heavily subsidize the medications as well. Most couples in Canada do not have the financial ability to afford 4-5 IVF cycles to get pg with one baby, then again 4-5 cycle to get pg with a sibling.
I know that we had money for 3 fresh IVF at the most, so we are going to have as many kids as will result in 3 cycles.

Again decision is greatly depend on the # and the quality of the embryos and previous history. We do not want to have twins either, we even discussed selective reduction if I get pg with 3 or more. (there are always a chance for identical twins/triplets etc) . Still based on the chances eSET was not for us in the previous cycle.
If you are not transferring 2 perfect blast , the chance of twins low anyway.
right now me : 37 Dh:40

TTC #1: natural TTC 1.5 yrs
Dh: 35, Severe Male factor infertility, morphology is 1-2%
Me: 32 , tubes open, no endo, regular ovulation, all hormones are good, 3rd day FSH 5.3 , antral follicle count is 12, only problem is my weight BMI: 30

IVF/ ICSI #1: 2008 February -McGill, Montreal
Long protocol: BCP for 1 month, burselin from CD21, 300 Gonal F and 150 Luveris for 10 days
ER: 11 egg , 6 mature , 5 fertilized, 3rd day transfer:a 7 cell & an 8 cell embyos, no frosties.
1st beta : 13dp3dt: 77, BFP
2008,November 19th: Adam has arrived 7 lb 4 oz, 21"

TTC #2: natural TTC 1.5 yr
Dh :39 morphology went up to 4%, we meet the IUI cutoff! count are fluctuating from 30 to 105 million, motility is great. Caryotyping is normal
Me: 36 FSH is slightly elevated and keep rising 8.5, 8.8, 8.9, 9.8 , AFC is still 12, everything else looks good.

IUI #1: Edmonton, 2011 January ,Clomid 50mg (x5), 106 mil ,68% motile, grade 4 :BFN
IUI #2: Edmonton, 2011 February, Clomid 50mg (x5), 30 mil, 57% motile, grade 3: BFN
IUI #3: Edmonton, 2011 March, Clomid 50mg (x5), 88 mil , 49% motile, grade 4: BFN
IVF#2: 2011 May, Edmonton: long protocol , nasal suprefact : CANCELLED due to high progresteron & cyst
IVF#3: 2011 August, Edmonton: short protocol/natural start: CANCELLED due to high progesterone
IVF#4: 2001 September, Edmonton: short protocol with BCP: CANCELLED due to high progresteron & cyst
Change clinic

IVF #5: 2012 March-April Hungary: stimulation starts march 28, 300 Menopur
mixed protocol: BCP for months, CD3: Menopur 300& lupron for 8 days
ER : April 8th , 4 eggs retrieved, all were mature and fertilized with ICSI and AH
ET : April 11th, 1 A quality 8 cell, and 1 A quality 4 cell embryo transferred, no frosties.
BFP on the HPT at 7dp3dt: happy 37th birthday to me :D
Beta: , 12dp3dt: 150, 2nd Beta, 15dp3dt: 550
Anna has arrived on 21st December after being induced at 39 week. She is 6 lb 9 oz, 20" , and has blue eyes, and long dark brown hair and just perfect !

#12 SunnyS

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Posted 22 October 2010 - 09:38 PM

My clinic has a big SET program, and in fact, there are only rare circumstances were they will transfer more than 1 blast. I personally was asked to only transfer one blast due to having Lupus, and pregnancy is going to be hard on me enough as it is, never mind a multiple pregnancy. I would listen to your doctor. In the end, they really do know what is best, even if you can't see it right now.

Me: 33 DH: 35
Me: Lupus, low AFC during Lupus flare-ups, Hypothyroid
DH: mod. MFI

5 monitored Clomid cycles, 1 BFP (m/c 6w), 4 BFN's
4 Puregon IUI's, BFN

IVF#1
8/25 - start BCP's
9/8 - start Suprefact injections
9/16 - start Puregon and Micro-dose HCG
9/21 - first monitoring appt
9/29 - ER - 10 eggs, 9 mature
10/4 - 5dt of 1 4AA Blast
10/11 - BFP!!!
6/11 - Beautiful Baby Girl is born!!

FET#1
Hoping to start 9/12!!!
Sept 19 - CD 1 - Start Estrace
Sept 29 - Start Progesterone
Oct 4 - Trans 1 4BA Blast
Oct 10 - BFP on HPT!
Oct 11 - BFP on HPT digital!!

Oct 16 - 1st Beta - 1,020
Oct 18 - 2nd Beta - 2,372
Jan 28/13 - IT'S A GIRL! EDD 6/22/13