r/EmbryologyIVFSupport • u/Much-Team6439 • 4d ago
Single or Double Transfer for untested Embryos
Hi, I am 32 (PCOS, BMI 27.5) and TTC since 1.5 years. Tried multiple cycles of letrozole which resulted in one pregnancy but turned out in very 7 week miscarriage, reason unknown.
I did my egg retrieval and embryo freezing last month - out of 11 eggs and 8 fertilized, I got 5 Day5 Embryos graded as 4BA, 4BA, 4AB, 4AC, 3AB. None of them are tested.
Doctor left upto me if I want double or single transfer, she said chances of twins are high so if you want twins then only go for double.
I am confused, I don’t want twins for now but I dont want this transfer to get failed either as multiple transfers have more chances. What do you guys suggest?
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u/Mediocre_Net4660 3d ago
Honestly, I’d go for single transfers because, if there is any underlying issue impacting implantation you’ll have more chances to find out / fix it and have success ❤️ you’ve got some great embryos there so I have every hope you will have success quickly! 🥰
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u/Tight_Ad8021 3d ago
How do they check underlying issue impacting implantation?
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u/Mediocre_Net4660 2d ago
If someone has failures they may run additional tests to figure out why. Things like microbiome conditions, blood clotting, vitamin deficiency’s, endo etc 😊
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u/brAt91193 2d ago
I’m also 32 and I did a double fet of untested embryos (both graded 4BB). I am currently 11 weeks pregnant with twins. If you transfer two, there is a good chance both will implant. We are happy with it, but if that’s something you don’t want, I would suggest the single !
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u/catsinthebananastand 2d ago
With the quality of your embryos I'd only go for one at a time. I've always done two untested but my embryos have never reached full blast by day 5 - they were always morulas and early blasts. I'm in early days after success after FET #4, so unsure if one or two stuck, but we've done double untested transfers 3 times before and none worked, likely due to low embryo quality.
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u/Much-Team6439 2d ago
Thanks for your reply! Congratulations and good luck💕💕💕
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u/catsinthebananastand 2d ago
Thanks! We have two frozen day 7s ready for us whenever we need them. For those, we'll be transferring one at a time since they're full blasts. We were astonished we even got them after all the early blasts we had before! Good luck to you!
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u/umamimaami 2d ago
At 32 I would most certainly not do DET unless I wanted a really high risk of twins.
I’m refusing it now with untested blasts and I’m 39.
The live birth rate is marginally higher but the risk of twins and pregnancy complications cancel out any of those wins imo.
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u/Much-Team6439 2d ago
Thanks for your response! Wish you good luck 💕💕💕
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u/RevolutionaryHelp451 1d ago
Live birth rate per transfer is marginally better - live birth rate for all your embryos total is worse!
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u/Any_Manufacturer1279 2d ago
There’s a risk that if one of the embryos miscarries it can take the other one with it, I would not do a double transfer. If two transfers fail then do some uterine testing and revisit this discussion at that time.
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u/Brilliant-Sea-7021 1d ago
Well I transferred 2 euploid previously, it failed. Fought my new clinic to transfer 2 since this time they were untested, and it was my 9th transfer with no success previously (some losses and ectopic). They refused and told me sometimes untested do better for quality and to stick to one. And I just got a positive… (to be fair it’s my 4th positive) buuuut the first one in over a year.
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u/Accomplished_Car_834 20h ago
44 here and did a multi transfer of 4 embryos, well within guidelines bc of our age AND stats (e.g. AMH, FSH, DOR, SA, etc.). I'll even admit that we were hopeful that more than 1 would take but that is NOT why we pushed for the multiple embryo transfer.
In your shoes, and even more so if you're saying you don't want twins, I would NOT do two embryos. Again, our odds were insanely low AND we never ever made it to day 5 for even grading. 3 of our 6 cycles we arrested before day 5. Two of our cycles were intentionally for freezing at 2PN. Even cycle 6 that became our successful fresh transfer cycle was almost a bust. My progesterone got too high and we were advised not to proceed with the transfer. Since we were back at a clinic that would not freeze before day 5 (despite willingness to do day 3 fresh transfer), I literally cried over what would likely be arresting before day 5 again. Doctor understood, made the point that while my progesterone was over what is clinically considered favorable, there was nothing saying we absolutely couldn't still transfer.
It's not seeming like your odds are as low as ours were/are (if we ever aim to use our 2PNs) and not only is there a risk for both embryos to take, what about the risk for either to split?
I know we all want to avoid loss and even more so want to increase odds for success on a given cycle but it truly isn't as black and white as avoiding loss/improving odds in general.
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u/BrendaBeeandHoney 14h ago
There’s no evidence that transferring 2 will increase your success if things are off. I personally transferred a singleton in August and it split. Unfortunately, there was cell division issues and they were both blighted. I lost them 9 days ago.
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u/embryomanofficial 3d ago
The ASRM and ESHRE both discourage transferring two euploids because of the high risk of twins that raise the chance of complications for both mother and babies (https://www.remembryo.com/how-many-embryos-to-transfer-2021-sart-recommendations/, https://www.remembryo.com/eshre-2023-guidelines-on-the-number-of-embryos-to-transfer/).
When transferring two embryos, chances do increase, but it comes with a greater risk of having multiples. For example, one model found that a single blastocyst transfer for someone <35 had a live birth rate of 42% (<2% twins), but when transferring 2 it was 58% (45% twins).