I can’t believe I’m saying this: should I do another egg retrieval?

Question

Hi ladies! 
So I woke up this morning with kind of a nutty idea. 
We just had our first retrieval and had really good results, even though we lose an extra 50% of embryos because my husband has an autosomal dominant mutation that we want to screen out. Ultimately we got 4 embryos!
We were planning to go straight to FET...but I just today thought: should we do another retrieval now?
I know that I actually want 3 kids, and would LOVE to have a girl. I’m 34 now, and the likelihood that we could get 3 live births out of 4 embryos is kind of low, and by the time we would be trying for a third, id be like 37 or 38 at least. Plus for me, we’ve had trouble staying pregnant(multiple losses), so I feel like we kind of need some extra chances to get there. 
I feel like it’s sort of selfish to be thinking about 3 kids now when really we would do anything for 1 in this moment. But at the same time, if my eggs are pretty good right now, maybe we should just bite the bullet both for my peace of mind and to improve our chances? It would be a big additional financial expense...but I can imagine it would be so much harder to get good results a few years later. 
Thoughts? Anyone out there in a similar situation, trying for #1 but at an age that you’re already worrying about #2 or #3?

Answer

If I could do anything over again I would have retrieved as many eggs as possible in my early to mid 30s. So, I say do it now if you want multiple kids. I started late in life and didn't have my first until 40. It was super easy and got pregnant the first month after trying.  Now 2 years later we are struggling for baby #2, multiple miscarriages , abnormal embryos a
Starting my second ivf cycle @ 43. I know nothing is guaranteed but kicking myself for not freezing eggs in my 30s.

Answer

Thank you all for weighing it! Keep it coming!
I’m also reflecting that I think my perception of probability is super messed up - after all there’s only a 1% chance that a naturally conceived pregnancy is ectopic, and yet we were that 1%! So I just feel like anything closer to certainty feels good. And it’s also made me feel like we just have bad luck, so even high probabilities (eg 60%+ chance of a tested FET working) make me skeptical 
For us I think it would be about $15k, half of which we have in an HSA (the prior retrieval and any FETs are covered which we are SO LUCKY about). Plus I have tons of meds left over from the prior retrieval, so that could help a bit. 
I kind of like the try one transfer then see if it works and decide idea...but then again, there is something unbelievably attractive to me about doing another one now and getting it OVER with, and then just feeling really confident that we could be really likely to at least get 2 babies, maybe 3.
The 35 year cliff looms large in my mind (my birthday’s at the end of January). I think if I were just a bit younger I’d feel better about it!  
Hubby would rather just take our chances, and he worries about me having to go through all the tough stuff of another retrieval. But he’s also ready to be supportive and feels that it’s my decision since I’d be the one going through the retrieval. 
Oh! Another thing: covid has actually made my life a LOT easier to do a retrieval, since I used to travel all the time for work and now I’m working from home (plus there’s no traffic to get to the clinic in the morning, and I can take the car since my husband is wfh for now too). If we wait a few years, and do end up needing to do another retrieval, my age would be stacked against me AND (hopefully) the world would be back to normal, and presumably we’d have a toddler to find care for while I’d be doing this. 
Aghghgh there’s no right answer! I wish I had a crystal ball!!

Answer

I'd talk to your doctor first BUT if it were me, I'd do the retreival now then transfer. I'm 28 and also struggle with this. Our last retreival yielded 4 blasts (untested). I know I atleast want 2 (though at this point 1 feels good too lol). It would have been a long shot to get 2 out of the 4 but I also knew that as long as I stayed diligent, I had time on my hands. Yet here we are starting retreival cycle #2 lol. 
You know what you want. You had a pretty good outcome given your circumstances so it wouldn't be such a bad idea to preserve your fertility now instead of 2-3 years from now. I know they make you wait awhile after birth to consider another transfer or retreival and that gets extended even longer if you choose to breast feed. What are hubby's thoughts?

Answer

I’ll share my experience and let you draw your own conclusions.  Sorry for any typos my daughter is napping on my arm.  We have pcos and mfi, always thought we’d get lots of embryos.  I was 29 at time of retrieval.  We ended up with 3 untested frozen.  I was devastated.  We talked to my re about another retrieval before transfer.  She told us we had 70% chance of one baby, 60% of two and 50% of three.  She also said we had time since we weren’t even 30 to try our three then do another retrieval.  She also pointed out that the number of kids we want may change after we have them.  We transferred and now she’s 17 months.  I’m now 31 and 7w1d with our second transfer.  We still have one on ice.  I would ask for % likelihood of success.  I think it’s tougher since that 35 age line is a bit closer for you than it was for me.  What about trying a transfer and then if it doesn’t work another retrieval? Sort of splitting the difference?  I can say I always wanted 2-4 kids.  I think eventually we will transfer our 3rd embryo, but if it doesn’t take we would consider our family complete with 2.  4 tested embryos gives you a great chance at multiple kids in my non-expert opinion.  Best of luck!

Answer

I wish someone had told me to do another retrieval after my first one four years ago. I only had one embryo, and we ended up transferring. He is now my amazing 3 year old (and I wouldn’t change him for the world), but three retrievals later, and it’s looking like he’ll be our one and only. We were strictly MFI, but my AMH dropped a lot in the 3+ years between retrievals (I was 29 during the first one and 32 during the next three), and now I’m borderline DOR. Another thing you’d want to consider is how long (if at all) you plan to breastfeed for. My clinic wanted my son to be weaned for three months before I could start stims again.  I loved nursing and neither of us were ready to be done until right around his 2nd birthday, so that pushed our timeline back a bit as well. Good luck to you - it’s a tough choice!

Answer

This is tough! I was 36 at my retrieval and I also had 4 tested frozen embryos. I told my RE I wanted 2 more kids and she said she was confident I could get 2 kids out of 4 embryos so we decided not to do another retrieval. However, I think if I wanted 3 kids she probably would have recommended another retrieval. We also knew we wanted a girl this time so my dr suggested that we try transferring our two girl embryos (2 separate transfers), and if both of those transfers failed then we could do another retrieval. Retrievals are so expensive so I would hate for you to spend extra money if it’s not necessary, so maybe you could try transferring 1 embryo and if that fails then go for another retrieval after that? My biggest hesitation is obviously the cost, plus I’m very attached to all of my frozen embabies and I might feel guilty if I don’t try to transfer every single one of them at some point. I can’t stand the thought of “throwing away” my babies, but my husband and I also have moral hesitation about donating our unused embryos. On the other hand it’s always nice to have as many embryos in the bank as possible in case some of them don’t work out because you’ll never get your youth back and you might regret it later if you don’t do another retrieval. Anyway, I still think if I were in your shoes I’d probably transfer 1 and see what happens, then do another retrieval if it doesn’t work. Good luck!

Answer

I want 2 kids and have 3 embryos.  If fet doesn’t work, I’ll be in the same situation.  I don’t have the extra 30k, but also don’t know what my eggs will be like at 39/40.  
If I were you, I’d wait till one transfer attempt, but I’m not you, and if you’re prepared for it, why not?

Answer

I'd do a retrieval! I had my first retrieval at 35 and only got 2 good embryos (untested). I got pregnant with my son with our fresh transfer, which was incredible, but that pretty much cancelled any discussions we might have had about having more embryos for the future. 
Fast-forward 3 years and we decided to try for a second. Our results for the next 3 retrievals were even worse, so I really wish we'd started earlier and done multiple retrievals with my 35yo eggs!

I can’t believe I’m saying this: should I do another egg retrieval?

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