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overheard strange conversation at RE office today about multiples


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  #1  
November 19th, 2011, 12:02 PM
junglepeachpie's Avatar Super Mommy
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I was waiting for my ultrasound this morning when I overheard a doctor call a patient from the nurse's station. He was telling her that she responded very strongly to the medication and is ready to trigger but was concerned that there is a high risk of triplets, quads, or quints and that if that happened, they would strongly recommend electively removing all but two of the embryos from her uterus. His advice seemed to be that they should skip that cycle if she wasn't comfortable with that.

Has anyone heard of someone going through that? I didn't even know that a possibility. I've heard of people losing a multiple naturally but never voluntarily.

I was mildly concerned because it looks like I have SEVEN follicles developing this cycle. It's still early so maybe some of them won't mature, but I didn't know that was a position people could end up in.
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TTC #1 since September 2009. Stopped TTC in January 2012
IUI #1 April 2011 was a success, but lost baby at 9 weeks
IUIs #2-5 BFN
Decided not to do IVF and embrace a childfree life (at least for awhile)
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  #2  
November 19th, 2011, 12:13 PM
Mega Super Mommy
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I have heard of that before. I think they do it for the mother and babies health.
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  #3  
November 19th, 2011, 12:54 PM
KMH KMH is offline
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It is called selective reduction. From what I understand, they wait until 8-12 weeks and pick the healthiest two babies. There are risks, of course, and the procedure could cause the loss of all of the babies. On the other hand, attempting to carry more babies than your body can handle could result in the same thing. A lot of REs won't proceed if you have too many follies unless you agree to selectively reduce.

We skipped injectables w/IUI for this very reason...I didn't want to be put in a position where I had to make that type of decision.

Katherine, I hope just the very strongest few follies develop so you can get that BFP this cycle!
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  #4  
November 19th, 2011, 01:14 PM
*Melissa*'s Avatar Mega Super Mommy
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Honestly it makes my stomach turn to even think about that. Our RE knows that selective reduction will never be an option for us. When ivf wasn' t quite as effective/ bad equipment, they often wouldtransfer many many embryos in hopes of 1 or 2 making it, then if more did take, it was common to just plan for one... blech. I am happy for technology making it possible to minimize those chances now. If you have too many follies, you can either cancel, risk it, OR my doctor would perform a quick FOLLICLE reduction.
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  #5  
November 19th, 2011, 02:05 PM
junglepeachpie's Avatar Super Mommy
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For some reason I thought RE's just cancelled the cycle when there were too many follicles. I didn't know they would let you conditionally proceed. The woman sitting next to me at the office was also really shocked.

I'd be more comfortable with this if they would do it earlier in the pregnancy. Removing something with just a few cells doesn't seem all that different to me that leaving embryos in frozen storage indefinitely. But at 8-12 weeks... After my loss I don't know if I could do that.

Odds are that I'd never have to make this decision, but I'm glad to know it's a possibility so I can let the ideas bang around before being put on the spot. The woman on the phone call naturally said she'd have to call the doctor back and let him know what they were going to do.
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Katherine (31) and Hubby (33)
TTC #1 since September 2009. Stopped TTC in January 2012
IUI #1 April 2011 was a success, but lost baby at 9 weeks
IUIs #2-5 BFN
Decided not to do IVF and embrace a childfree life (at least for awhile)
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  #6  
November 19th, 2011, 11:45 PM
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Sometimes the RE will switch to a IVF because of this.. just depends

7 follies is a great sign!
What kind of injections are you using?

Menopur works best for me
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  #7  
November 20th, 2011, 06:35 AM
Sarah S.'s Avatar Veteran
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That's why I always get nervous when I hear RE's aiming for 6+ mature follicles. I could never do selective reduction but I'm a NICU nurse (neonatal intensive care unit) and I fully understand the complications of multiples! Not to mention I work in the nicu where the gosslin sextuplets (jon & kate plus 8) were born! Having one baby at a time is hard work can't imagine twins or more!
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  #8  
November 20th, 2011, 09:23 AM
junglepeachpie's Avatar Super Mommy
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I'm using Bravelle - the lowest dosage once per day. It seems to be working! It's the same drug my RE would want to use for IVF so this is sort of a trial run to see how my body responds to it before committing all that money. I go back tomorrow for another ultrasound so we'll see how things are progressing.

Sarah - that's crazy you worked in that nicu unit! I was thinking about that family yesterday and wondering if they had been pushed to selectively reduce and refused.
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Katherine (31) and Hubby (33)
TTC #1 since September 2009. Stopped TTC in January 2012
IUI #1 April 2011 was a success, but lost baby at 9 weeks
IUIs #2-5 BFN
Decided not to do IVF and embrace a childfree life (at least for awhile)
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  #9  
November 20th, 2011, 11:09 AM
*CAMM*'s Avatar Platinum Supermommy
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our RE would not continue with a cycle that had more than 4 mature follicles unless you knew that selective reduction would be on the table (if more than 3 implanted)
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  #10  
November 20th, 2011, 02:07 PM
Sarah S.'s Avatar Veteran
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I came to the unit about 6 months after they left. I believe it was highly recommended she reduce and she said no. My co-workers do not have many (if any) nice things to say about her
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  #11  
November 21st, 2011, 09:05 AM
♥Ashley♥'s Avatar Platinum Supermommy
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Quote:
Originally Posted by KMH View Post
It is called selective reduction. From what I understand, they wait until 8-12 weeks and pick the healthiest two babies. There are risks, of course, and the procedure could cause the loss of all of the babies. On the other hand, attempting to carry more babies than your body can handle could result in the same thing. A lot of REs won't proceed if you have too many follies unless you agree to selectively reduce.

We skipped injectables w/IUI for this very reason...I didn't want to be put in a position where I had to make that type of decision.

Katherine, I hope just the very strongest few follies develop so you can get that BFP this cycle!

It is very common (not actually the procedure itself, but the talk about it with the RE) in the infertilty world. I know a couple of women here on the boards that have had to go through with it. It is a scary/sad situation to be in im sure.
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Cycle #10-11 - Met with first RE, diagnosed with heterzygeous MTHFR mutation & slightly low SA on all counts. -BFN, Cycle #12 - First IUI+Trigger - BFN, Cycle #13 - BFN
Cycle #14-15 - Met with new RE, diagnosed with a blocked right tube that previous RE completely overlooked or didnt care to mention. Soy (120mg) - BFN
Cycle #16 - Clomid (100mg) - BFN, Cycle #17 - Clomid (100mg)+Trigger+IUI - BFN
Cycle #18 - Acupuncture+Clomid (100mg) - BFN
Cycle #19-27 - 2 Soy (160mg) cycles, the rest all natural also 30lbs lost!! - BFN's
Cycle #28 - New RE is GREAT! Put on bcp 7/6/11, Lap surgery 8/1/11- Tubal cyst (5cm) found and removed, Uterine Septum removed, and Stage II-III endo removed. Cycle #29 - All Natural - BFN, Cycle #30 - All Natural - BFN, Cycle#31 - All Natural - BFN, DONE TTC FOR NOW




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  #12  
November 21st, 2011, 04:21 PM
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I could never go through with that
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  #13  
November 22nd, 2011, 11:37 AM
kayakr's Avatar Persuaded by POAS’ers
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I don't think I could do it either and I know DH would be against it without question.
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Me (43) DH(33) 12 years together - ttc our first together-I have 14yr old DS
Cycles 1-6 = BFN
Cycle 7 SA results abnormal morphology 2%, 50 mg clomid = BFN
Cycle 8 sonogram normal 50 mg clomid + trigger = BFN
Cycle 9 SA results abnormal morphology and motility. Count 200 mill, 100mg clomid + trigger = BFN
Cycle 10 natural = BFN
Cycle 11 hsg tubes clear, natural + trigger+IUI = BFN
Cycle 12 repronex + trigger + 2 IUI = BFN
Cycle 13 natural ovaries to stimulated for more meds = BFN
Cycle 14-22 natural cycle with Acupuncture and planning ivf/icsi/DE = ALL BFN
Cycle 23 Clomid 50 mg & Progesterone = BFN
Cycle 24 Natural = BFN
Cycle 25 BCP, SA result 7% morphology = BFN
Cycle 26 BCP and Lupron preparing for IVF
Cycle 27 IVF Acupuncture, DE Retrieval April 7, Transfer April 12 =
7 eggs retrieved, 3 fertilized, 2 transferred - zero snow babies
BETA # 1 16DPO or 11dp5dt = 569
BETA # 2 19 DPO or 14dp5dt = 1078
BETA # 3 22DPO or 17dp5dt = 2414 TWINS!
BETA # 4 30DPO or 25dp5dt = 12,685 6weeks 3days 2 heartbeats! 114 & 116
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  #14  
November 22nd, 2011, 07:30 PM
Kobain's Mommy's Avatar Future A&M Aggies Mommy
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I couldn't do it but our RE said that he'd cancel any cycle over 6 follicles. With our track record of MC/twin loss the RE figures if all 6 fertilized that most likely only 2 would make it if that.
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  #15  
November 23rd, 2011, 04:37 AM
lunarmagic's Avatar Platinum Supermommy
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Yes, they gave me a similar warning with my first clomid cycle, I had 4 follicles and they wanted to make sure I knew the risks going forward. I really didn't want multiples. And honestly had I gotten triplets or more I would have reduced.... I'm not comfortable with the risks of a high-order-multiple pregnancy. It usually doesn't come to that (case in point, I didn't get pregnant at all that cycle or any on clomid). Cancelling is hard but often the right call.
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  #16  
November 26th, 2011, 09:11 AM
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That is crazy. Back in Jan 10, I did injectables / IUI. My RE told me the high risk of multiples and I was ok with that. I had 4 mature follies and he never once mentioned selective reduction. I could have ended up with quads, but after a miscarriage, 3 failed clomid cycles, and one failed clomid / IUI, I didn't think all four would make it and they didn't. I could never do selective reduction, thankfully I only had twins!
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  #17  
November 29th, 2011, 02:57 PM
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Before our RE would transfer 3 embryos for our IVF cycle we had to discuss selective reduction. Thank goodness we didn't have to make that decision!
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