Tuesday, May 29, 2007

Two (or more) part two

Thank you all for the great comments on my last post!

Karen... In retrospect, you're right, of course. I was so convinced that NOTHING was going to work that multiples wasn't a reality when I decided to transfer 4. Actually, when I had the 'better' embryos, I didn't get pregnant at all... (I guess this is in line with what Mel wrote today). I've been following your story and all your thoughts about reduction. I know I would have made the same choice you did.

Sarah... My last IVF was the only one in which the doctors even asked how many embryos I wanted to transfer. I was willing to go for 3. My (now ex)-husband said 2 and that's what we did. I think that some clinics are still pushing their agendas of higher pregnancy per cycle rates and are therefore anxious to give you the best shot at pregnancy, even if it includes the risk of multiples - so, although the doctors may KNOW best, they may not always do it. It's exactly like Thalia put it - "change the way clinic stats are measured and rewarded. Currently it's not in their best interest to allow SETs (single embryo transfers) as that potential first failed cycle would be a negative mark against them" (BTW, the cycle mentioned above led to an unsuccessful single embryo pregnancy)

Kirby... I know just where you're coming from. My feeling is that there are cases where hoping for twins makes sense - it depends on your chances to succeed with IVF (there must be some parameters that give an indication, especially in cases of known fertility issues), your age, how many children you'd like to have and of course how many IVF cycles you'll be able to go through (emotionally / financially / physically). With the success rates being the same overall, as Thalia said, with the ETs being split between two cycles - it means that women/couples who feel they have more time can allow themselves to reduce the risk of multiples without reducing the chance of pregnancy per retrieval.

Bea... I am truly praying for you to have a healthy singleton pregnancy :-)

Thalia... I love your comments and I totally agree with you.

Lastly, congratulations to Mia whose daughter Ava Marie has finally come home from the hospital!


Sarah said...

i think things are changing in this department based on the new CDC recommendations. i noticed a definite difference in the recommendations of my clinic for my IVF cycle this winter (only one if at all possible) compared to what they were suggesting back in 2005 (2-3 if possible). of course all clinics and docs are different.

Ms. Perky said...

Rachel, I can totally understand decisions to transfer multiple embryos under some circumstances (particularly a decade ago). For me, had I done IVF, I would never have transferred more than 2 embryos (and even 2 would have been pushing it for me) because I was TERRIFIED of multiples, particularly high order multiples (and look what I got!!).

With regards to reduction... we didn't have a real clear-cut decision because of the medical issues that I've got, but we made the right decision for us. For someone else, it may not have been the right decision. I knew that I wasn't willing to make my decision based on anything other than the halacha and the medical considerations. I was not willing to allow emotional or financial factors to be considered, but for others, those factors are too overwhelming to ignore. I think having halacha to guide us probably helped because it forced us to focus our thoughts on the whole issue. Halachically, we were supported in the option to reduce, but I didn't feel like the medical evidence was quite compelling enough with triplets. If I'd had quadruplets, it might have been a whole different story!