Ask the girl doing in-vitro fertilization (IVF)

[Tibby or Not Tibby]

I have two daughters, 9 and 11, resulting from IVF with donor egg (chosen because of wife’s advanced age…and because she’s nuts). It's an odd concept: mom gives birth, but dad’s the biological parent. Anyway, they are the lights of my life: gifted, sweet and considerate (<crosses fingers/>not the type to ever put dad into a nursing home <crosses fingers/>). I wish you all the luck in the world with your IVF…it can be frustrating and time consuming, but when it works, it’s worth the effort.

[EmAnJ]

And it starts! Derek had his semen analysis last Thursday, and I had my baseline ultrasound and blood work first thing this morning. All looks good. I will be starting with 150 UI of Gonal-F and 75 UI of Luveris, and continuing the Suprefact to prevent ovulation, but dropping from five sprays a day to three.

The Gonal-F is a pen looks like this. My pens are 350 UI each (with a bit of extra, just in case), so I will use one pen in three days at this point. I change needles each day, obviously, and just dial in the dose.

The Luveris is a bit more complicated. It's two vials, one with saline, one with powder. Using the syringe and some tool of which I can't remember the name of, I mix them up myself.

Both injections go in the stomach. I asked to take them at 6 pm so I can be home from work and also so my husband can help me if he's home as well.

Both of us also start antibiotics today as well. Since they will be pushing the collector tube through the walls of my vagina, and going right in to my ovaries, I take it to prevent infection. Derek takes it just in case he has an infection that will present in his sperm.

I should be on injects for 10 - 13 days. I go in for more blood work on Wednesday, and then blood work and another ultrasound on Saturday to check progress.

Now, if you saw my other post, I seriously injured my knee on Friday. I am pretty sure it's an MCL injury, though the ER thought it was a knee dislocation. We are worried that I may have to have surgery, and want to talk to the doctor about that possibility. I feel like at this point, if we have to cancel this cycle for a surgery, I'm done, and won't attempt this again. So, fingers crossed all is well on that front.

[Girl From Mars]

Originally Posted by EmAnJ

The Luveris is a bit more complicated. It's two vials, one with saline, one with powder. Using the syringe and some tool of which I can't remember the name of, I mix them up myself.

Both injections go in the stomach. I asked to take them at 6 pm so I can be home from work and also so my husband can help me if he's home as well.

Both of us also start antibiotics today as well. Since they will be pushing the collector tube through the walls of my vagina, and going right in to my ovaries, I take it to prevent infection. Derek takes it just in case he has an infection that will present in his sperm.

Oh man, I remember having to mix my first trigger dose (which needs to be done at an exact time) with a set of glass ampoules and powder, freaking out that I would break one and stuff up the whole cycle. So much better the next time around that my trigger shot was a preprepared syringe.

I never heard about antibiotics though - that's a new one for me.

Good luck! Hint for the stomach injections is to place an icepack on your tummy for a minute or so while you dial up your dose and load the needle - you'll pretty much feel nothing (and it's a really thin needle, so nothing to worry about). Are you going to stick yourself? I found the only time I ever bruised was the one time I let Boy From Mars have a go...

[EmAnJ]

Yes, I've been told about icing, especially for the Luveris because it apparently stings! It depends what time Derek is home this evening - I'm planning to inject at 6, and he works until 5:30. He might *just* make it. I figure I've been giving him allergy shots for years, may as well let him get me back! But I'm not worried if I have to do it myself. I've been poked and prodded so much the last couple of years that I have no problem with it any more!

I spoke to the nurse about the possibility of knee surgery and she gave us some good advice. We are going to proceed with the cycle and see what the doctor says on Tuesday. If I do need surgery, there are two options - continue and freeze all, or look in to surgery with an epidural rather then general. Epidurals are fine in pregnancy, and will work for lower body surgery, if I need it. Looking around online is making me feel better, however, because it seems like MCL tears (which is what I think I have) very rarely need surgery to fix. I am fine with intensive physical therapy. I will do what I can to not delay this any longer!

[Finally]

Best of luck to you!

[EmAnJ]

Just an update, if anyone is reading!

I had my appointment with the physical therapist yesterday and he's certain I do not need surgery! What a huge relief! I will need some pretty intensive physical therapy, but he's sure I can rehabilitiate and will be able to support pregnancy weight (one of my primary concerns). I'm still swollen, but he thinks it's a partial tear of both the ACL and MCL. I'll be going in for a private MRI next week once I see my GP.

Also had my first appointment at the fertility clinic since I started injects on Sunday. It was just a blood test to check my estrogen levels (indicative of follicle growth) and they were lower then they'd like them at 130 (they like to see 250 - 500 at this point). So, they've increased my dose of Gonal-F from 150 to 225 UI, starting last night. I'm now starting to get some side effects, most especially headaches and tiredness. I am exhausted, even though I'm getting 7 to 8 hours a night.

Next check is on Saturday and it'll be both blood work and ultrasound.

[Sarabellum1976]

Glad to hear that you won't need surgery! Hope things continue to go well.

[EmAnJ]

Another update: I had another monitoring appointment on Saturday and they saw seven follies on the left, all around 10mm, and four on the right, of which two were at 10mm (the other two were closer to 6mm). My estridol levels were at only 501 (in Canadian terms) so they've upped my Gonal-F to 375 UI.

The nurse said I may be triggering on Wednesday, for retrieveal on Friday, but we'll know more at my next appointment tomorrow morning.

On Saturday, I had to do my first non-home injections, and it was...nerve wracking! We travelled to another city (Red Deer) for a cousin's birthday party and I had to run into the bathroom as soon as we arrived to do my injects (they are very time sensitive - I have to do them at 6 pm, or within about 15 minutes of). Using a small bathroom counter in an unfamiliar house to give myself injections was not my idea of fun! I have heard of other women having to do them in the car while stuck in traffic, or on airplanes if travelling, and I couldn't imagine!

My primary symptoms so far are headaches in the morning, cramping and a heavy feeling in my ovaries - tender to the touch, even - and gas. Horrible gas! I don't know if it's from the meds or what, but it's horrible even to me!

[ENugent]

Man, that sounds awful. I hope that you have nine more months of uncomfortable symptoms, though!

[EmAnJ]

Originally Posted by ENugent

Man, that sounds awful. I hope that you have nine more months of uncomfortable symptoms, though!

Haha, me too! Thanks!

Another monitoring appointment this morning. Lining is at 8.3 (this is good), and they found two more follicles total today. On the left I now have eight follies, the leads are are 16, 13, 13, and on the right I have five, the leads are 13 and 11.

Two more nights of Gonal-F and Luveris, and another monitoring appointment on Thursday morning. I should be triggering Thursday evening.

Those of you who have done the HCG injection - it seems like a LOT of liquid (compared to everything else I've been injecting). Does it hurt more? Did you do it in two spots, or all in one?

I had a horrible headache this morning, but it seems to have gone now. I actually feel pretty good at the moment!

[Sarabellum1976]

Glad to hear you're feeling good, EmAnJ.

Since this IS an "Ask the" thread, maybe you could fight some ignorance and explain a little bit about linings and follicles.

Is it simply, "the more the better"?

[iftheresaway]

Hey EmAnJ, just wanted to let you know that I'm over here on the sidelines, wishing you well!

[EmAnJ]

Originally Posted by Sarabellum1976

Glad to hear you're feeling good, EmAnJ.

Since this IS an "Ask the" thread, maybe you could fight some ignorance and explain a little bit about linings and follicles.

Is it simply, "the more the better"?

Sure!

Your lining is created through the secretion of estrogen from your developing follicles. Ideal lining for IVF at the time of embryo transfer is over 9mm (but less then about 16mm) and triple stripe (trilaminar). A trilaminar lining is the pattern of the endometrium, and is ideal for implantation. After ovulation (and after they take my eggs), the ruptrued follicles create progesterone, which helps to support a pregnancy until the umbilical cord takes over. I will be on progesterone supplements (suppositories).

Every woman responds differently to the stims, so you can never really tell if she'll produce a high amount of follicles or not, unless she has some other indicators of diminished ovarian reserve (such as high Day 3 FSH and low antral follicle count). I was expected to be a high responder, which is why they started me on a lower dose of Gonal-F. Turns out I'm a bit of a slow responder (but am starting to respond well now), so they increased my dose quite a bit.

You don't want too many follicles or you are at increased risk for ovarian hyperstimulation syndrome (OHSS). OHSS can be life threatening, and presents with large amounts of fluid in the abdomen - some women gain up to 30 lbs. in a couple of days. They track this risk via the ultrasounds to check number of follies, and testing estrogen. Very high estrogen numbers are problematic, as are high numbers of follies. If you are at risk, your cycle could be cancelled, or they will go ahead with retrieval and fertilization, but freeze all embryos for transfer later. OHSS severity increases if a woman becomes pregnant from the same cycle.

Follicles have to be a certain size to contain likely mature eggs. Generally, in an IVF cycle, they look for 16mm to 20mm at trigger time. Follicles grow 1mm to 3mm per day, so based on that, having me on stims for two more nights makes sense.

My clinic aims for 8 to 12 eggs, of which about 70% will be mature enough to fertilize. Of those, about 70% will fertlize properly and become embryos. So, we're hoping for about five embryos when all is said and done.

Hope that helps!

[EmAnJ]

The clinic just called with my E2 numbers from this morning: up from 501 on Saturday to 3879 today (1057 in US terms)! This is a huge jump that I'm very, very pleased with!

[Girl From Mars]

Originally Posted by Sarabellum1976

Glad to hear you're feeling good, EmAnJ.

Since this IS an "Ask the" thread, maybe you could fight some ignorance and explain a little bit about linings and follicles.

Is it simply, "the more the better"?

In really simple terms, the better the better. As in, having lots of sub-par eggs is not as ideal as a few really good quality ones, particularly in the first few cycles when they are still trying to work out how a woman will respond to treatment and implantation of an embie.

So they usually try to be conservative with stimulation (to avoid hyperstimulation, which in rare cases can cause hospitalisation or death), and also to ensure that a bracket of eggs are all within a couple of mm of each other. If you have one large follie as an outlier, this can sometimes trigger early, cancelling the cycle. Instead, they try to monitor the dosage to allow a cluster of follies to all develop at the same time, and try to grow these to a suitable ~20 mm size for trigger. They generally say the longer it takes to grow the eggs (i.e. longer cycle), the better the quality of eggs produced. Although there are obviously other factors too, including age, hormone levels, basic DNA, diet etc.

Which brings me to a heads up for EmAnJ - as you get closer to the time, your formerly little ovaries are carrying 10+ follies each 2cm+ across, filled with fluid. They will begin to bounce around you in an uncomfortable way. Even something as simple as walking can become pretty uncomfy! I tended to keep exercise to low impact at that point, partially for comfort, and also to prevent the risk of ovarian torsion - where 'yow, I twisted my ovary" is not something you want to be saying.

[Girl From Mars]

Originally Posted by EmAnJ

My clinic aims for 8 to 12 eggs, of which about 70% will be mature enough to fertilize. Of those, about 70% will fertlize properly and become embryos. So, we're hoping for about five embryos when all is said and done.

I'll give you my stats as well, which I hope can show there is hope even if you don't get textbook results like that (it's not uncommon for follies to be empty):

Cycle 1 at 33 - 10 follies/4 eggs/4 fertilised/1 blast - 1 marvelously happy 2 year old.
Cycle 2 at 35 - 19 follicles/10 eggs/3 fertilised/1 day 3 embryo - BFN
Cycle 3 at 35 - 10 follicles/6 eggs/4 fertilised/2 blastocysts/1 frostie and 1 gorgeous 6 week old bubba

[EmAnJ]

Thanks Girl From Mars! I see you had success the first go-round. I am hoping for the same!

Do you remember what your protocol was?

[Neeps]

To answer your question, I don't remember the HCG injection being any different from the other injections. I would just do it in a oner and get it over with.

As you know, the most important thing is timing - my first on had to be done at midnight, which necessitated an alarm to make sure we didn't fall asleep and miss the injection time!

To add to Girl from Mars stats, here are mine (although can't remember follicle count)

Cycle 1 (at 33): Antagonist: 7 eggs / 5 fertilised / 5 embryos of varing quality at day 3 / best two transferred (nothing good enough quality to freeze) - one cheeky almost-2 year old

Cycle 2 (at 35): Agonist: 7 eggs / 1 fertilised / 1 embryo of really qood quality transfered on day 2 - one wriggly 14 week fetus

As you see, it's almost impossible to predict how it's going to go, even by the time you get to transfer. It's very frustrating, but also should give you hope that even when things look dire, you can have success!

[Girl From Mars]

Originally Posted by EmAnJ

Thanks Girl From Mars! I see you had success the first go-round. I am hoping for the same!

Do you remember what your protocol was?

Cycle 1 was a long down-reg ICSI, taking almost 2 months - birth control pill + Synarel + 100IU Puregon + trigger

Cycle 2 and 3 were antagonist, which I much preferred - quicker, and no Synarel which was the only drug which seemed to affect me:

ICSI#2 - 300IU Puregon + 0.25mg Orgalutran (trigger)

ICSI#3 + HA - 350IU Puregon + 0.25mg Orgalutran (trigger) - this cycle we used a new technique called HA-ICSI (pdf), as our FS reckoned our low fert results from cycle 2 were due to low sperm quality (which is why we were doing the ICSI in the first place). Was only an extra $250 and I'm really glad we did it, as I think it gave us noticably better results.

[EmAnJ]

Wow, interesting, thanks ladies! We will try to fertilize naturally and only use rescue ICSI if needed. DH has always had great SA's, so the doc didn't recommend ICSI out of the gate.

I am getting a cold, which sucks a lot, but I don't think it'll affect anything one way or another. Just sucks that I can't take anything for it.

[Finally]

And one more time, how times change! You women are so much better educated about the whole process than I was 17 years ago. You posts are greek to me. I do, however, wish you the best of luck.

[EmAnJ]

Originally Posted by Finally

And one more time, how times change! You women are so much better educated about the whole process than I was 17 years ago. You posts are greek to me. I do, however, wish you the best of luck.

I think we're similar in that we all want information. It gives us some semblance of 'control', I guess. I find that I look forward to my injects every night, simply because I'm doing something and have a bit of control over the whole thing. And I bet that 17 years ago you probably didn't even have access to this type of information!

Thanks again!

[EmAnJ]

Did the trigger shot last night, but I spilled some! It was mixed for me on Thursday by the nurse and I had to withdraw in to two syringes from the vial. For some stupid reason, I pulled the syringe out when I still has it upside down.

I ended up with just over 1mL in one shot and about 7.5mL in the other (supposed to have 1mL in each). I called the clinic this morning to let them know but they haven't called back yet. I honestly don't think it's a huge deal because I know some people trigger the same amount, or even less (only 1 mL), so I'm not super concerned. Hubby freaked out a bit though!

ER is tomorrow morning at 10 am. They gave me some Valium for a good sleep tonight as I'm sure I'll be stressing! Wish us luck!

[Eliahna]

Sending you all the luck I can muster!

[Girl From Mars]

Originally Posted by EmAnJ

Did the trigger shot last night, but I spilled some! It was mixed for me on Thursday by the nurse and I had to withdraw in to two syringes from the vial. For some stupid reason, I pulled the syringe out when I still has it upside down.

I ended up with just over 1mL in one shot and about 7.5mL in the other (supposed to have 1mL in each). I called the clinic this morning to let them know but they haven't called back yet. I honestly don't think it's a huge deal because I know some people trigger the same amount, or even less (only 1 mL), so I'm not super concerned. Hubby freaked out a bit though!

ER is tomorrow morning at 10 am. They gave me some Valium for a good sleep tonight as I'm sure I'll be stressing! Wish us luck!

Gah, totally what you didn't need. Fingers crossed it's all fine, and will be thinking of you tomorrow.

[EmAnJ]

Thanks! The clinic hasn't called back and they're nearly closed for the day, so I guess they aren't worried. Based on the research I've been obsessively googling today, a lot of doctors use 5,000 units and it works just as well. I think the 10,000 units is just my clinics standard procedure and most women are fine with less. I'm not too stressed.

[EmAnJ]

Turns out the spilled trigger shot wasn't a huge deal! We got 17 eggs this morning.

Now it's a waiting game. We'll hear from the embryologist tomorrow morning and he'll let us know how many fertilized.

The ER itself wasn't bad. The set up an IV and gave me a drug to relax me, and a drug for pain, but I was awake for it. I was able to watch him suck out the follicles on the ultrasound, and they also had a TV screen set up so I could see what the embryologist saw through his microscope. It was really neat to see all those little eggs!

I'm sore and crampy now, and pretty tired, but overall pretty decent...and very excited! We'll know Tuesday if it'll be a three day or five day transfer.

[Filbert]

Fingers, toes and teeth crossed for you!

[EmAnJ]

Hm, crossed teeth, eh? That must make it difficult to eat! Thanks!

[Drain Bead]

Seventeen? Wowzers!

[EmAnJ]

Wow again this morning! 14 of the 17 fertilized over night! That's crazy and way more then expected!

Now we wait until tomorrow morning to hear how they're dividing, if we need to do assisted hatching (they pierce the zone to allow the embryo to grow properly) and if we're doing a three day or five day transfer.

Fingers crossed they divide properly!

[Neeps]

Wow, those are impressive numbers! Keep us updated on the numbers. With any luck, you'll have a few good blasts to choose from, and some to freeze.

[Nawth Chucka]

Originally Posted by EmAnJ

Wow again this morning! 14 of the 17 fertilized over night! That's crazy and way more then expected!

Now we wait until tomorrow morning to hear how they're dividing, if we need to do assisted hatching (they pierce the zone to allow the embryo to grow properly) and if we're doing a three day or five day transfer.

Fingers crossed they divide properly!

Have you decided if you want to transfer more than one, since studies have shown transferring more doesn't increase conception rates, only the rates of twins or HOM?
Are they going to freeze the remaining embies? If so, how many embies does this clinic freeze per vial?

[Wednesday Evening]

Yay for 14 embies! That's neat that you were awake for it. When I did IVF they knocked everyone out. Hopefully they will divide quickly but my first kid started out as a day 3 4-cell embryo, so sometimes those slow-dividing ones can go the distance!

[Sarabellum1976]

Yay! This is awesome, amazing news, EmAnJ! Cool to think that one of these little specks of embryos is your future baby, in teeny-tiny format!

All the cute little baby toes and fingers, his or her future personality, the whole nine yards, all rolled up into one little microscopic dot.

[EmAnJ]

Thanks everyone! I called my husband to let him know he was a father to 14, and he got a bit quiet, haha!

Originally Posted by Nawth Chucka

Have you decided if you want to transfer more than one, since studies have shown transferring more doesn't increase conception rates, only the rates of twins or HOM?
Are they going to freeze the remaining embies? If so, how many embies does this clinic freeze per vial?

If we do a three day transfer, we will transfer two embryos. If we do a five day, we'll transfer one blast. We wanted to do two blasts on day five, if possible, but the clinic won't allow. They try to avoid multiples, even if we're ok with it.

We will freeze the rest. I am not sure how many embies they freeze per vial, I actually don't know much about the freezing process. Do you have any insight?

[Nawth Chucka]

Originally Posted by EmAnJ

Thanks everyone! I called my husband to let him know he was a father to 14, and he got a bit quiet, haha!



If we do a three day transfer, we will transfer two embryos. If we do a five day, we'll transfer one blast. We wanted to do two blasts on day five, if possible, but the clinic won't allow. They try to avoid multiples, even if we're ok with it.

We will freeze the rest. I am not sure how many embies they freeze per vial, I actually don't know much about the freezing process. Do you have any insight?

It all depends on the clinic; refrozen embies don't fare as well, as you might imagine. They're less likely to survive a second thaw. So most clinics want to make full use of thawed embies; well, if you have 3-4 embies per vial and all of them survive the thaw the question becomes a ticklish one. Transfer all? Or refreeze for another cycle and almost certainly waste them?

But if you wind up w/ more frozen embryos than you know you'll ever use, what do you do w/ those, donate to another couple or to science? Or, as some women have done, go through a cycle w/ no intervention aside from transfer and let nature decide?

For those playing along at home thinking these are only ethical and medical questions, keep in mind every step can be an costly one; maybe not so pricy in Canada but here in the States this is a very expensive process.

[EmAnJ]

Originally Posted by Nawth Chucka

It all depends on the clinic; refrozen embies don't fare as well, as you might imagine. They're less likely to survive a second thaw. So most clinics want to make full use of thawed embies; well, if you have 3-4 embies per vial and all of them survive the thaw the question becomes a ticklish one. Transfer all? Or refreeze for another cycle and almost certainly waste them?

But if you wind up w/ more frozen embryos than you know you'll ever use, what do you do w/ those, donate to another couple or to science? Or, as some women have done, go through a cycle w/ no intervention aside from transfer and let nature decide?

For those playing along at home thinking these are only ethical and medical questions, keep in mind every step can be an costly one; maybe not so pricy in Canada but here in the States this is a very expensive process.

Thanks, good points. I'll talk to the embryologist about how they freeze tomorrow.

Should we have left over embryos when we're done, we have already decided to anonymously donate them to another infertile couple. This had to be decided before we started this all, and we both had to sign the consent.

[lorene]

Wow, this is all super exciting! You know I'm rooting for you, EmAnJ!

[Nawth Chucka]

Originally Posted by EmAnJ

Thanks, good points. I'll talk to the embryologist about how they freeze tomorrow.

Should we have left over embryos when we're done, we have already decided to anonymously donate them to another infertile couple. This had to be decided before we started this all, and we both had to sign the consent.

Oh my, it seems premature to ask people who don't already have their family to make a decision one way or the other about leftover embies. There's so much flux and things can change in a day!
When you say, 'when we're done', what does that mean specifically? After this cycle or after all desired cycles?
I belong to a surrogacy board where there was this discussion about how many get frozen per vial/straw, how quickly more can be thawed if some don't survive, etc. Feel free to peruse and search, you can even search 10 seconds apart if you like - what luxury, eh?

[EmAnJ]

Thanks! I'll take a look when I'm not on my iPhone!

What I mean when I say 'when we're done' is when we feel our family is complete. We'd like two children, so if we have any leftovers to donate at that time, we will. I think part of the reason they get us to sign it now is if one or both of use die shortly after this cycle and they're left with all these embryos. Legally, it's hard for them to do anything without prior consent.

[Girl From Mars]

Originally Posted by EmAnJ

Thanks! I'll take a look when I'm not on my iPhone!

What I mean when I say 'when we're done' is when we feel our family is complete. We'd like two children, so if we have any leftovers to donate at that time, we will. I think part of the reason they get us to sign it now is if one or both of use die shortly after this cycle and they're left with all these embryos. Legally, it's hard for them to do anything without prior consent.

Firstly, fantastic results, really hope you have a grade A blast to transfer in a few days!

I don't know about you, but was kind of good to have to make the decisions up front about what we would do with the embies if we split, or if something happened to one of us. Forced some deep conversations about how we felt about things.

We also think we're done at 2 - but we have one bubsicle, and at this point will be donating it to science (to be honest, too weird to think about one of our kids' siblings walking around with other parents, but we want to contribute to the process somehow). But a small portion of me thinks perhaps we should do as Nawth Chucka mentioned and just put it back with no other intervention. Giving ourselves a year to decide. (So many decisions with IVF! Hard to believe this is so simple for most people).

[ENugent]

Wow, I'm jealous! We had five out of six fertilize, and ended up transferring two on day 3 and freezing one - the others didn't make it to blastocyst stage. But the important thing was that one of the two we transferred turned into my wonderful son.

I hope you'll have a great transfer and a great pregnancy. Good luck!

[PandaBear77]

First off, great thread

Secondly, ((bigsquishypandahugs)) Good luck!!!! *stickystickysticky*

Originally Posted by EmAnJ

Should we have left over embryos when we're done, we have already decided to anonymously donate them to another infertile couple. This had to be decided before we started this all, and we both had to sign the consent.

Which leads me to a question ...

Ok so ... like ... say you do have leftover embryos and you donate them anonymously. How anonymous are we talking? Will you be told if the other couple conceives and gives birth or would you just know that the other couple gave it a shot?

If they do have a baby, will the child be able to contact you when he or she is an adult? If you and Mr. E. were ok with that, is it even an option to make yourselves available to be found when the time comes?

Do you have any say as to what couple receives the embryos or do you basically just sign something and the clinic does the rest?

[Cinnamon Imp]

Originally Posted by EmAnJ

Thanks everyone! I called my husband to let him know he was a father to 14, and he got a bit quiet, haha!

Congrats! I'm trying to avoid Octomom jokes here

(actually, I don't even know what the word for that would be - quindecamom?)

[Sarabellum1976]

I wonder why the clinic won't "allow" you to transfer 2 blasts on day 5?

Is it possible that they just (for liability issues) "prefer" that you don't and make it sound like a hard-and-fast rule? Maybe you could be a little more insistent about it and wind up getting your way?

I'm not saying that their reasons for avoiding multiples aren't valid - obviously, twins, and to a greater extent, HOM, can be a very bad and risky idea for certain patients. But fertility treatments are expensive and it seems like the final decision should rest with the patient. Doesn't it?

Well, I suppose there've got to be SOME limits, or else you're going to get mentally ill Octomoms demanding 12 transferred at once, but two seems like a reasonable informed risk that should be allowed most of the time.

Of course, the couple that's seeking fertility treatments and is rewarded with twins is unlikely to be a repeat customer, and that's probably bad for business, but I could just be overly cynical here.

[Nawth Chucka]

Originally Posted by Sarabellum1976

I wonder why the clinic won't "allow" you to transfer 2 blasts on day 5?

Is it possible that they just (for liability issues) "prefer" that you don't and make it sound like a hard-and-fast rule? Maybe you could be a little more insistent about it and wind up getting your way?

I'm not saying that their reasons for avoiding multiples aren't valid - obviously, twins, and to a greater extent, HOM, can be a very bad and risky idea for certain patients. But fertility treatments are expensive and it seems like the final decision should rest with the patient. Doesn't it?

Well, I suppose there've got to be SOME limits, or else you're going to get mentally ill Octomoms demanding 12 transferred at once, but two seems like a reasonable informed risk that should be allowed most of the time.

Of course, the couple that's seeking fertility treatments and is rewarded with twins is unlikely to be a repeat customer, and that's probably bad for business, but I could just be overly cynical here.

The OP's in Cnada so they won't pay what we in the States would for IVF; still, twins and HOM have a higher risk of health difficulties in utero and after so only the truly naive would hope for more than a singleton pg when it could be easily avoided. Sick children w/ the potential for a lifetime of painful difficulties are not a reward. Transferring more than 1 only increases your chance of multiples, it doesn't increase the chance of conception.
I'm online friends w/ a woman whose surrogate carried quads resulting from 2 frozen embies that each split. Three of the 4 are severely autistic and will require special schooling their entire lives; one will almost certainly never be able to live alone.

[EmAnJ]

Just a quick update - I'll be back later to answer questions.

So, we only have 2 - 4 decent quality embryos this morning. The rest have begun to fragment and are very poor quality. We are doing a three day transfer tomorrow afternoon with the best two. We may transfer three if that's all that's left.

We're going to let the rest keep going to see if we get any to day five that resolve the fragmentation issue, but we likely won't have any to freeze.

I'm pretty gutted right now after such good news yesterday.

[lorene]

I am so sorry. We still have hope, though, correct?

[Girl From Mars]

Originally Posted by EmAnJ

Just a quick update - I'll be back later to answer questions.

So, we only have 2 - 4 decent quality embryos this morning. The rest have begun to fragment and are very poor quality. We are doing a three day transfer tomorrow afternoon with the best two. We may transfer three if that's all that's left.

We're going to let the rest keep going to see if we get any to day five that resolve the fragmentation issue, but we likely won't have any to freeze.

I'm pretty gutted right now after such good news yesterday.

Remember, you only need one! Very much still in with a chance so keep a positive outlook.