After getting settled in our new home after moving, it was time to seek out a new fertility center. This will be the third fertility center (fourth facility) we’ve used since beginning this journey so we at least had an idea of what we were looking for.
After careful and thorough consideration, before going into this appointment we had basically decided that we would probably be pursuing IVF this time around. There are many reasons for this decision:
- We’d really like to have only one baby (not that twins aren’t great, we’d just like to have a singleton this time), and IVF would be the best way to virtually guarantee that if we choose to transfer only one embryo.
- We have only three more vials of Donor #2 (our current donor), and that would only leave us with one try (if they use two vials per cycle) or three tries (if they use one vial per cycle) using gonadotropins like we used before when we got pregnant with the twins. Considering it took us a total of seven tries before (though admittedly we got pregnant with the twins on the first try with gonadotropins, but we have already done one gonadotropins try so far that did not work), this feels like it is cutting it too close.
- We have also decided that we will not pursue using a different donor if we do not get pregnant with the vials that remain of our current donor. I actually struggled with this decision, because I want my kids to know and feel that it is not their genetics that make us family – so why would using a different donor matter? For me, it came down to the fact that we have a very special relationship with a donor sibling family, and our twin girls already feel that as well. I worry how my third child would potentially feel if we chose a new donor for our third child but then we were unable to connect with one of their donor sibling families.
- As I mentioned a little while ago, there still may be a mechanism to obtain more of this donor, but it wouldn’t necessarily be a simple “buy more” plan, and I’m just not convinced that the time is right for everyone to fairly and fully consider the details of what that would involve. This could change in the future, but for right now, I think we should continue under the assumption that we have only our three remaining vials.
So, because we were planning on going the IVF route, we set out to find a new fertility center with this in mind. Not really knowing much about the IVF process, we basically just looked online to see which ones were in our area and which ones took our insurance (not that insurance will pay for much of IVF, but one can hope). We also consulted the National Summary and Fertility Clinic Success Rates from the CDC. It’s important to point out that there are a lot of factors that need to be considered when interpreting these types of data (which I won’t go into, but you can read more about them here), and after reading through all of the material and considering our unique situation, we settled on one that had the highest implantation, pregnancy, and live birth rates of all of the assisted reproductive centers in our area that also took our insurance. Interestingly, they also have the highest singleton birth rate (possibly because they have the highest overall live birth rate) but also lower twins and triplets birth rates (despite having the highest overall live birth rate). This latter part was especially important to us, and while this is likely due to a number of factors (including the specific infertility issues of patients they accept), it hopefully also indicates that they will be understanding of our desire to minimize the chances of a multiple birth.
Due to the appointment date and time that fit my new work schedule the best, we had no choice but to bring the twins with us to the consultation appointment. Let’s just say that they weren’t exactly the most cooperative during the appointment – and the reproductive endocrinologist and resident we met with were probably wondering why in the world we wanted more kids – but everyone made it out alive.
As we suspected, the RE felt like a single-embryo IVF cycle was the best way to go for us, considering our limited number of sperm vials left and, most importantly, the desire to have a singleton. She said Molly’s chance of pregnancy using IVF should be about 60%, and using a single 5-day embryo (blastocyst) transfer, the chance of twins should be about 2-3%. Choosing to transfer a single 3-day embryo reduces the overall likelihood of pregnancy, and choosing to transfer two 3-day embryos increases the chances of twins. This is all opposed to using injectable gonadotropins and IUI again, where the chance of twins (or more) is about 30%.
IVF, here we come!