Friday, April 13, 2012

Random IVF questions for my bloggie buddies

Since I have never made it to transfer before, you'll have to excuse all these really practical, boring, detail oriented posts I've had going on the last few days. This one is no exception! :)

Could IVF veterans answer these for me please?

1. When we do the PIO shots (KG is a pro - these haven't been bad for me), I get a little bit of oil that leaks out...are we doing something wrong?
2. Do I really need to drink 32 ounces of water for transfer? Would 20 do? I'm afraid I'll burst before the procedure!
3. How many of you transferred 1 embryo? The doctor is emphatic that if we have any to freeze, we should only transfer 1. This makes sense to me because I am not prepared for twins at all and multiples carry a higher risk of preterm labor. But, as many of you know, it is a difficult choice.
As of today, 15 of our embies are 6-8 cell, and "perfect" according to my doctor. This is exceptionally great news.

So, why am I still so scared something bad will happen?


  1. 1. Sometimes we had leaking of the shot too. I noticed it more after ET. Not sure what to do about that.
    2. You do not need to drink that much water. I had a small glass of juice before we left because juice usually makes me have to go, and then I had one 12 oz bottle of water on the drive there. Thank goodness because we have a 1 hours drive and they were 30 mins behind and I thought I was going BURST.
    3. We transferred 1

  2. Yay that you have 15 good-looking embryos!! Keep us posted!

    To answer your questions:

    1. You're doing nothing wrong. Sometimes that just happens. Have a tissue ready to mop it up.

    2. No. Try 12 ounces. They'll make you drink more if you aren't full enough. Promise.

    3. We transferred one once, during our second IVF. It didn't work. After that we were very aggressive. And now are finally pregnant with one. But I think we are outliers. Does your clinic use vitrification to freeze? That would personally make me more comfortable transferring one. Twins are more risky than 1, no question, even though most people still have a good outcome.


  3. We started our PIO injections the day after the retrieval. A little bit of oil loss should be fine and for us was normal. We only did one embryo both times because it was all we had.

    Good Luck!

  4. 1. Probably fine. I start rubbing as soon as the needle is out, so I wouldn't notice if there was any leakage.

    2. I needed to. They should have a pretty good idea as to how full your bladder needs to be based on your mock transfer. My cervix bends 90 degrees, so I need a very full bladder to straighten things out as much as possible.

    3. We transferred one with our fresh cycle. We had 6 blasts, so I knew we would have plenty to freeze. I did not want to risk multiples. We've done 2 with each of our frozen cycles. If we did another fresh, I'd be very tempted to do just one again.

  5. 1. He can try injecting a bit slower, if anything (If you are thin this might happen no matter what though!)

    2. NOPE, this is a per clinic thing. First two clinics required it, last clinic did not and didn’t even use ultrasound to do transfer!

    3. 1st transfer: FOUR Day 3 embies= BFN
    2nd transfer: THREE day 3 embies= Chemical
    3rd transfer ONE day 6 blast= Chemical
    4th transfer TWO day 5 blasts= BFP ONE baby!
    We transferred a 5AA & 4AA embryo top grade is 6AA. We too had some to freeze (5 frozen) and my RE tried to talk us in to doing a SET we were having none of that.. I will never transfer less than 2 from now on.. I would have done 3 if I thought he would let us, but we just wanted the best chance for us. FYI, you shouldn’t need assisted hatching since they’re blast. Day 3 embies tend to have a thicker shell, but blasts are close to if not already hatching. I found this info out from the embryologist just before transfer even though I paid for assisted hatching (they refunded me!) so ask them if your embies are already hatching or about to be! At the end of the day all you can do is make the best decision for you guys! Best of luck!

  6. Sure I'll answer these!
    1. It's normal for a drop to come out after taking the needle out, but maybe have him count to 5 before pulling the needle out to give some of the oil left in the needle time to exit. It happens to us sometimes too.
    2. I drank too much the last time and had to pee for a few seconds to relieve the pressure before the transfer. Drink 20 and then more if they tell you to just beforehand.
    3. I will be transferring one. If you have ones to freeze, this would be my suggestion. I have lots of personal feelings about multiple embie transfers, but since this will be your first time, one should be a good place to start. If it doesn't take, you can try two next time.

    Good luck! I'll be there with you!

  7. 1. Same as ADSchill. Plus, stop squeezing the bootay before you pull the needle out.
    2. 20 oz would be fine for me (and has been each time), but I guess it depends on your bladdar. My clinic says "two glasses w/in an hour". It's so they can see through your belly into the ute, since they use an external u/s for the transfer.
    3. We've only transferred two, but only had one blast on our first transfer day 5, so we did that and the next furthest along. Didn't know for sure if the rest of the 15-ish that were still dividing would continue since they all slowed down. Bastards. If we had more than one blast, we would have transferred just one.

    Ultimately, we decided we were willing to handle two babies, and were willing to take on the risk of a twin pregnancy. My RE asked us this: The day before your beta, what would you be more fearful of: Being pregnant (and parenting) with twins? Or that a BFN after transferring just one?

    I've heard mixed stories about whether transferring more than one on day 5 raises pregnancy rates significantly, so I think it's all about what you're comfortable with. Good luck!

  8. 1. I've only used Crinone, sorry!
    2. I would guess not, but it depends on your bladder. I had a retroverted uterus, so in the end they weren't pressing on my bladder at all during transfer - they were pushing from above at a really weird angle. I'd go in at about 80% full and sip water as you wait for the actual transfer to begin.
    3. We transferred one for a variety of reasons, which I wrote about at the time. For us, it came down to the economics of having twins, both for us and the medical system overall. Because we had 3 more cycles covered by insurance, we were able to be much more confident in a conservative transfer and a later FET. Since we ended up with a high-risk pregnancy even with a singleton, I do think we made the right decision for us, but you may feel differently - and that's okay! You and you alone know what feels right for your own family planning.

  9. 1. No big deal, I always had this, I tried to just wait longer before pulling out the needle.
    2. I am quite small, my acupuncturist told me to drink 3/4 of a 500 ml bottle of water one hour prior to transfer. It was perfect.
    3. I was DEAD set on transferring one the first cycle, then when they thawed and one declined in quality I caved and transferred two. After failing I always transferred two (which resulted in complete heartbreak for us this round). But one cycle they convinced me to do three when we were using our last crappy embryos. I have never been so terrified in my life. I was a total wreck immediately after the transfer until beta day (chemical). I would never do that again. After our first failure I decided that I could better handle a twin pregnancy than another failure.
    Good luck, I think one will be just great. Having had failures and success now I truly think either it works or it doesn't and it's all or nothing.

  10. Ps - I found out later (and took it hard) that only about 30/40% make it to freeze. First time 9/22 fertilized made it, but this time 10/17.

  11. 1) I haven't done PIO shots, but I think you're okay.
    2) It all depends. I undershot water for the first transfer and ended up having to wait for everything because I needed more. Not fun. Hence I drank a ton before the second one and was done right away. Do what feels best, but bring a water bottle.
    3) We pushed for two because of the data that showed higher success rates. That said, everyone I know in real life who is pregnant following IVF or FET transferred one.

    Yay for 15 embies!!!

  12. I can only answer #3. I'm planning on transferring 2 if we have them. We are going as aggressive as possible because of DH's age. And I would definitely rather nave twins than a BFN and I'm we're planning to stop after 1 child so that affects our decision too.

    Good luck!!

  13. Not answering any questions, just telling you how great you area and how proud of you I am! Love you.

  14. 1. My husband said we had small leaks on occasion as well. (he probably didn't tell me at the time because he thought I would freak out!). We always warmed up the injection sight, and the oil so it would flow well, injected slowly, and counted to 5 before withdrawing the needle.

    2. The didn't dictate how much water I should drink, they just said have a full bladder. I always peed right when I got to the hospital (an hour before transfer) and then drank a regular sized bottle of water during the hour while waiting, and it was always fine.

    3. As far as how many to transfer, you have to do what makes you most comfortable. We always transferred 3, but I was 36 and our fertilization rate wasn't that great until the third go, but by then, they factor in that it's the third time, which makes them want to transfer more anyway. We would have been ok with twins in a lot of way, but I am actually mostly relieved it's just one. It does make me wonder about ttc #2 though, I'll only be older, they'll want to transfer more, and I really don't want three kids! Ah, but we'll cross that bridge when we get to it, right? It sounds for you like everything is going great right now. I'd guess you'll have at least a few to freeze, and there does seem to have been a boom in twins these days.

    I'm so excited for you!

  15. I don't think you need to drink as much, just have a full bladder and you'll be fine. We have done transfer twice, both times two embryos were put back. First failed and the second we got pregnant with a singelton (that we unfortunately lost later on). If you are not comfortable with the thought of twins then go with one. You have a lot of embabies growing! Best of luck tomorrow.

  16. I can't help at all. But I CAN send you good thoughts for your transfer! I really, really, really hope that all goes well.

  17. 1. Some oil is gonna ooze out. No biggie. You're putting in 1cc of the stuff. Enough progesterone is getting into your system.

    2. I don't know ounce-wise what you need to drink, but your bladder needs to be full in order for them to use the ultrasound to guide the catheter to transfer the blastie. My clinic was running late and warned me that if my bladder wasn't full enough, I'd go to the back of the line. If your bladder is too full, they will let you pee some of it out.

    3. I am old and did 3DT, so they put back two. If you have enough to freeze, given your age and the fact that you'll have blasties, I'd put back one, especially if you are not prepared for the possibility of twins. I mean, if they tell you tomorrow that the blasties are excellent quality, put back one. That's what I would do in your shoes.

  18. Because everything about this journey is scary and rarely goes perfectly! But you've gotten great news and I'm so excited for you! I haven't done IVF or any injectables so I can't help, but I'm crossing my fingers for you!! :-)


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