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My clinic had guidelines that were adhered to pretty strictly. For my first LO, I was under 35, with no previous IVF failures, diagnosed PCOS as the cause of IF and had a number of highly graded embryos to work with. For all of those reasons, they would only transfer one. For my frozen cycle with this LO, I was 35, but because of my previous successful cycle and number of frozen embryos, I was still firmly in the single embryo transfer camp.

With my first fresh Ivf they transferred two bc it was a day 3 transfer and I got pregnant with 1 embryo that cycle. With my first FET they only transferred 1 bc I had a successful Ivf and it did not work. For my second FET i transferred 2 and 1 took but it was a blighted ovum. For my third FET I was at a new clinic and they have a strict one embryo only policy. However, my embryos looked "average at best" so they let me transfer two. I am currently pregnant with a singleton from that transfer. All of that to say- I am a big fan of double embryo transfers because - for me- that is the only time even 1 seems to stick. However I am sure a lot has to do with the quality of your embryos.

@agold: haha but clearly not that strict since they broke it for me do you know the quality of the embryos you have? Honestly I think most studies show there is no benefit to transferring two- you are just more likely to have twins. With that in mind, transferring 1 is probably what most clinics would recommend. I think my experience might be an outlier one.

@agold: such a tough decision. The doctors at my clinic are huge proponents of single embryo transfer when possible - my doctor used to tell me that transferring 2 doesn't increase your odds of getting pregnant, it only increases your odds of having twins. I'm a little surprised your doctor wants to transfer more embryos than during your fresh cycle - I was pretty sure that recent research indicates that frozen cycles actually have a higher success rate than fresh cycles - so much so that many doctors are moving toward frozen cycle transfers only. I have zero medical background though, so take that with a grain of salt...I'm only repeating what I remember about my conversation with my RE before my frozen cycle.

I would decide based on history, embryo quality and doctor recommendation. I also find it strange that your doc would recommend transferring three, especially since you don't have a bunch of transfer failures behind you. I agree with everyone else that transferring two doesn't really increase your odds of getting pregnant, only of getting twins. And from a financial perspective paying out of pocket, you'd get two chances doing them one at a time. That being said, I understand the emotional draw towards transferring two, even if the stats don't support it. I transferred one in my first IVF cycle and first FET (only had one frozen), but then upped it to two for subsequent cycles. However, I'm pregnant now from a single embryo transfer (but from a donor egg, so that's a big quality difference to my own 38-year old eggs.)

@agold: there's an HB member called Mrs Greengrass who has blogged about the complications from her double embryo transplant (I hope that's the correct terminology!), I believe her IVF cycle resulted in four babies and she talks about undergoing selective reduction. She writes over at Baby Making Merry Go Round.

I hope I'm not overstepping the mark by bringing up her experience or her blog and wish you luck with whatever you decide!

We transferred two on our first fresh IVF cycle and ended up with our son. Our clinic let us choose between 1 or 2 on the day of transfer after telling us the grade...I think we had 1 excellent and 3 average embryos. We had talked about it and decided we were ok with twins and thought we would always wonder what would have happened if we just transferred one and it was unsuccessful. I believe under 35 it's a max of two at our clinic and they strongly prefer you transfer only one. They were very realistic about the chance of multiples. If we were to do it again for a second child, we would likely only transfer one...I think we were pretty nonchalant about the realities of having twins and I think with an already increased chance of multiples with IVF, it's important to think through those realities if that should happen.

Here are the guidelines from the American Society of Reproductive Medicine by age (note these do not distinguish between fresh and frozen):

Under 35: 1 embryo for favorable prognosis/blastocyst transfer; 1 to 2 embryos for favorable prognosis/cleavage-stage transfer; 2 embryos for all others

35 to 37 years: 2 embryos for all patients (except 3 embryos for women with less favorable prognoses who receive cleavage-stage embryos)

38 to 40 years: 2 embryos for favorable prognosis/blastocyst transfer; 4 embryos for less favorable prognosis/cleavage-stage transfer, and 3 embryos for all others

41 to 42 years: 3 embryos for those receiving blastocysts and 5 embryos for those receiving cleavage-stage embryos

AFM: I had a single embryo for my fresh cycle ( age 34), 2 for FET #1 ( single age 34), 2 for FET #2 and #3 ( age 36 & 37 ), and 3 for FET #4 ( age 37). All embryos were blasts day 5 or 6. I'm pretty sure we will transfer 2 if we go through a fresh cycle again and have good embryos.

Tough decision, I know!

My DH and I based our decision on how many babies we would be comfortable with. My clinic transfers up to 3. We went with 2 because we would have been ok with twins.

After losing a twin in the first trimester I'm not sure I would transfer 2 again.

@agold: The RE VERY strongly recommended that we only transfer one as long as we had a blast on day 5. We were told that transferring 2 only increased our risk of multiples, not of it working. At the time of our fresh transfer I was 30 and our issues were MF and endo+DOR; also it was our first cycle.

For my SO and I personally we also discussed the fact that our life would need to change dramatically if we had multiples. The cost of living is very high and daycare for one infant is $1900++ :shocked:. It is such a personal decision but you have to trust your instincts.

ETA: We also did ICSI and assisted hatching which can increase the chances of embryos splitting. Stories like Mrs. GreenGrass' weighed on me as yet another reason to only transfer one

We transferred 2 very good quality 3 day ICSI embryos that resulted in our twins. Two was recommended (but in the end completely our choice) based on my history (unexplained, previous loss). We knew that twins was a high possibility and were completely at peace with it. If we were to do it all over again I would choose two all over again...that being said, like @twodoghouse: mentioned, multiples are very HARD! At least they are for us, they'll be two soon and they're nonstop. Also for me, the twin pregnancy was pretty difficult. It's a tough decision, I hope you're able to have peace with whatever route you take!

At my first clinic, they strongly recommended single embryo transfer because their own stats showed that it was statistically just as successful as transferring more than one (*again, at their clinic). We didn't get to do IVF there, but that idea stuck with me when we went to our second clinic after we moved, so I transferred just one. I also knew two sets of IVF twins who had lots of minor-to-moderate health problems. Of course I'm not a doctor and I have no idea whether their twinness had anything to do with it, but it scared me a little. I decided I'd rather it take longer and go through more cycles with one embryo at a time than possibly risk health issues for twins. This was for a fresh transfer.

Good luck to you! I hope you get some clarity and make a decision you feel good about!

according to the guidelines posted above, i'd be in the 2 embryo category, but my RE will only do a SET (hubby and I were discussing 1 vs 2, and it ended up not being an issue anyways). This is our first cycle and we're doing FET

Oh, I'll also add that I left my first clinic and went to one that had more success rates from people who failed to conceive at other local clinics. The IUIs done (#4-6) were unsucessful but my 1st IVF (FET) cycle worked for me.
I definitely agree that the number you ultimately choose to transfer is a personal decision. Lots of luck to you!

@GreenThumb:

I only had one good embryo (PGD testing) so that made it very easy.
But we had decided that if we had two we would have transferred both. We want(ed) two kids total and felt that if we could avoid the stress and expense of IVF by having two at once, we would do it.
Now I'm glad we only had one. The twin mommas out there are my rockstar heroes! I don't know how you do it But I would still MAYBE transfer two if the opportunity arose next time (if there is a next time, we might be one and done). This time the deciding factor would be that I don't think I want to be pregnant 3 times, for various reasons. So if we ended up with 2 embryos by some miracle, Id probably just transfer both. But that is a highly unlikely scenario.

@agold: what does your RE recommend?

@SweetiePie: I know, the reason I asked at our appointment last week is actually because I have a friend who recently had a failed cycle and her RE is recommending they screen the three frozen embryos that she has left. I was pretty surprised at my REs answer, too, based on what my friend is doing, but I guess every clinic has their own stance. I'm just hoping our fresh cycle is a .

Thank you ladies.

Just wanted to stop by and say what an interesting thread this is - even if it's 2.5 years old.

We are awaiting the results of PGS on our 9 frozen embryos. On our first round of IVF (age 38, single transfer, ) they recommended we transfer only one. We hadn't yet done PGS though, so they gave us a 30% chance of success, and fortunately we were in that minority. Since then, we conceived naturally (age 39) but underwent an emotionally painful TFMR for T21. This time, we'll do a FET with PGS tested embryos, and again they are recommending only a single transfer, but this time giving us a 70% chance of success, despite me now being 40. I imagine since the embryo will be tested, the chromosomal variables contributing commonly to loss are much less likely.

I had entertained the idea of transferring 2 on our initial fresh cycle 2 years ago but am so glad I didn't. I ended up getting sick with severe pre-E and HELLP, and delivered a premie at 32 weeks. We most certainly would have lost one or both if it had been a twin pregnancy - I'm sure of it.

Despite occasionally wanting to do impulsive things, I've learned to trust and listen to our RE. So far he's been right 100% of the time.