With our IVF cycle in September, which I wrote about here, I produced 33 eggs, 14 of which fertilized to become “perfect quality” blastocysts, a.k.a. day-5 embryos (see a glossary of these terms for easy reference). Think about that: I produced 33 follicles in a single month, when a woman normally produces ONE. "Yikes" comes to mind. So does “ouch.”
Let’s be clear about something: I have absolutely no desire to become the next Octomom or Kate Plus Eight—there’s a lot I would do for cash (ahem, like oversharing my fertility struggles in a blog), but producing multiples is not one of them.
If this were 3-4 years ago, I would’ve (naively) said, Let’s have twins! In fact, I’ll admit it now: I did say that once. But being a mom now, I know better. A lot better. That’s been a big fear of mine throughout all of this. Could we handle twins, on top of already having a toddler? Could we handle twins period? (Can we handle a toddler!!?) There’s a lot to consider when deciding how many embryos to implant. But if twins happened naturally, I’d consider it a blessing of course.
If I were five years younger, a lot less tired, less informed, less naïve, less old, less ignorant about the costs, maybe twins wouldn’t scare me so much. Two of my best friends in the world are identical twins (conceived naturally). The cutest identical twins you’ve ever seen, in fact—there should be a reality show about their cuteness. I love twins! I just don’t know if I could handle being a mother to twins right now.
One of the most important things I’ve learned since becoming a mom is knowing what I can—and can’t—handle. Parenthood pushes your boundaries, in the best ways possible, and I’ve handled a lot of things I never thought I could, but I’m still not sure about having multiples, which is something you have to consider if you’re going through IVF. The incidence of multiples is higher than if you weren’t going through fertility treatments, which is why any good fertility clinic does everything they can to control it. They don’t want you to have multiples—they want you to have one healthy baby. (I learned that when I jokingly told my doctor to make sure he implanted the "girl embryos." It was a joke!) Anyone going into this with the hopes of having multiples needs to be better informed about the possible risks and complications involved (both for mom and baby), and needs to go to a better fertility specialist.
That said, it’s a risk you’re kind of signing up for—especially if you’re going through IVF and you have more than one embryo to implant. We had to sign consent forms that specifically laid out what we were agreeing to, with all the possible scenarios. After our first transfer was canceled and it was time to schedule our second one, with frozen embryos this time, we had to not only re-sign consent forms, but also really consider how many embryos we were going to transfer. I was tempted to do two, but my doctor's advice is what ultimately changed our minds. He said with my age (37), my number of good-quality embryos (14), having no anatomical or explainable fertility problems, a thick uterine lining, good ovarian reserve, etc., there was no reason why we shouldn't expect to get pregnant with a singleton embryo. All signs pointed to us conceiving through this frozen transfer. And he also said it's what he would've advised his own daughter to do in my position. That pretty much sealed the deal.
We are very lucky that we had 14 embryos to choose from—my hope is that I have enough that I will never have to go through another egg retrieval again, which is the hardest part of the IVF process (at least it was for me). We thought long and hard about whether to transfer one or two embryos, taking into consideration what my doctor mentioned, including costs of treatments and childcare, as well as our lifestyle—let's be honest here, if we have twins that changes things for us. Not that we live an extravagant life now, but we'd need to change our lifestyle pretty drastically, including moving to the 'burbs (much more economical than city-living with a gaggle of kids). I am so not ready for that right now, especially because I don't know if I'll be going back to work full-time, which would likely mean I'd be working in the city (the commute between the suburbs and city is ba-roo-tal and not something I'd be comfortable doing while leaving little babies at home). These are all big things to consider... So with our reproductive endocrinologist’s advice, we decided to implant one embryo at this point and time. With so many good-quality frozen embryos left, this seemed like the right choice for us.
How many embryos did you, or would you implant? If you’ve chosen two or three (or more), what helped you make that decision? In some European countries it’s actually illegal for a clinic to implant more than one embryo in a woman's uterus, but in America it's common to implant two or three. There's been a lot of research and literature in the last couple of years (since the Octomom controversy) on the case for implanting one embryo versus two, and also some literature that still argues for the benefits of IVF twins. What side are you on?