Wednesday, May 22, 2013

Single Embryo transfer

Well after I wrote out all of my reasons why we wanted to transfer both of our remaining embryos I found out today that Dr. D only wants to transfer one. He said that he doesn't think I qualify for transfering 2 since the first transfer was "succesful" in that I did get pregnant. He gave his reasons for wanting to transfer 1 and I gave my reasons for wanting to transfer 2.

He is fairly confident that I will get pregnant again with a single embryo transfer and doesn't want to expose me or my potential babies to the increase risk of twins. I understand these risks and understand that a singleton pregnancy is perferred. I am scared of the potential adverse outcomes of twins; no one wants to increase their potential children's risks of cerebral palsy, necrotizing enterocolitis, and periventricular leukomalacia, or have a NICU stay and the potential of taking home only 1 or neither baby, or 2 sick babies.  K changed his mind about transferring 2 when Dr. D mentioned the risks to me with twins. K doesn't want anything bad to happen to me. He would rather take the potentially longer but safer route. I understand what he is saying, but at the same time I worry about the damage that happens to me the longer I go in this journey. Yes, I am not physically injured, but this process has taken a huge emotional tole on me. I feel like I am living a life of waiting. I can't enjoy the present. Likely this has made me more willing to take risks in the hope of achieving a baby quicker. Dr. D says he thinks I am too caught up in the process to look at things objectively. He thinks I want to adress this too agressively, which may cause unecessary harm. I understand what he is saying, and I agreed to only transfer 1, but I am still not happy about it. I can't predict the future. I know that if I did get pregnant with twins and something went wrong I would feel horrible about it.

We did also discuss my reasons for wanting to transfer 2, and I did get fairly upset because our priorities aren't the same. Dr. D thinks the chances of transfering 2 and ending up with twins is greater than the chances of transferring 1 and have another nonviable pregnancy (however, he isn't the one who has to go through the potential loss, and he did say that there is a possibility that 1 or both of our remaining embryos could be chromosomally abnormal). He agreed that they do not like having only a single blast left for a future transfer because thaw rate is not 100%, but he says if that happens the worst thing that happens is that the cycle is cancelled (which would be a big deal to me!) and I would be set back 3 months (but that is a long time when you have been waiting so long and want a baby so badly!).

I did agree to only transfering 1 by the end of the appointment, although I did so begrudgingly. He did say if I still realy wanted to transfer 2 he could bring it up at the next patient plan meeting, where all the REs discuss the how to treat a patient, but I declined. I could still change my mind if I want to, but I believe the other REs would agree with his plan to only transfer 1.

The timeline for the FET is a bit longer than I would have liked. Since I never had regular periods in the past, I likely will need provera to induce my next period, after which I would start estrace for the FET. However, Dr. D wants me to wait to start my 10 days course of provera till June 23, which would mean I wouldn't get my period till July 5th or so. Then I would need to take at least 19 days of estrace, so tentative transfer July 23. I am a bit worried because the last day of embryos transfers for this entire up-time is July 26, so if we had any set backs (i.e. period takes longer than the usual 3 days after provera to start, or my lining doesn't thicken and I need extra days of estrace) then the whole FET may be cancelled until August. I wish that they would let me start the provera at least a few days earlier.  My miscarriage started May 10th, so June 20 will be 5 weeks from then, and July 5th would be 8 weeks after the miscairrage. The only hope I have of starting earlier is that they said if I got my period on my own in June, we could discuss beginning the FET at that time. I hope that my body recovers and even though I don't normally ovulate or cycle, maybe the pregnancy will have reset my hormones and I may cycle on my own.


  1. Sounds like an extremely difficult appointment! Honestly, I think you are right to have tried to stand your ground. Your doctor is the specialist in his field of study; but you are the specialist in YOU. Don't let the "experts" talk you out of the course of treatment you want. Twins do have a higher risk - true. But, it's not like EVERY twin pregnancy results in these complications and health issues. It is really expensive to do this process, and having only one transfer done would be difficult for me knowing the future had a good chance of involving more drugs, more money, more stress, more money, more appointments/probing/cycling, more money, etc. Remember that your very best advocate is YOU! I encourage you to stand your ground and be strong in what you want for this cycle! Best of luck to you!

  2. Wow. I agree...this sounds really stressful, especially after you had just made your decision. I'm sorry it didn't work out as you wanted, but at least there is a plan and it sounds like the doctor is trying to think things through as best as possible. Keep us posted!